ObjectiveTo systematically analyze the distribution of research evidence on diabetes in current clinical practice guidelines of Chinese medicine (CM). MethodsThe PubMed, EMbase, Cochrane Library, CBM, WanFang Data, CNKI, VIP databases and related guideline website were electronically searched to collect clinical practice guidelines for CM in diabetes published before December 2023. We systematically reviewed the distribution of evidence in these guidelines. ResultsThe content of 27 CM guidelines on diabetes mainly covered syndrome differentiation and treatment, specific disease-specific drugs, diet, external therapies, and traditional exercises. The included guidelines used three different levels of evidence grading, with most of the evidence falling into the low-to-moderate level (67.3%). However, guidelines on diabetes-related osteoporosis, diabetic cardiomyopathy, prediabetes, and diabetic peripheral neuropathy had a relatively low proportion of high-level evidence, accounting for only 7.2%, 7.6%, 13.2%, and 13.3% respectively. Only guidelines on diabetic nephropathy provided evidence on the toxicity of Chinese herbal medicine, while other guidelines did not cover this aspect. Acupuncture, Tai Chi, Baduanjin, and other characteristics therapies had varying levels of evidence for different types of complications. Low-level evidence mainly focused on syndrome differentiation and treatment, symptom-based treatment, sign-based treatment, indicator-based treatment, Chinese patent medicine, specific disease-specific formulas, etc., for diabetes and related complications. ConclusionCurrently, topics supported by low/no evidence, new themes, inconsistent content between guidelines, evidence sources for overlapping targets, classical formulas, toxicity of Chinese herbal medicine, and characteristic CM therapies can provide directions for future research on CM in diabetes. We advocate addressing important issues related to diabetes specifically, to improve research value, eliminate unnecessary duplication of studies and resource waste, and promote the healthy development of CM research in the field of diabetes.
ObjectivesTo systematically review the proportion of Tregs in peripheral blood of patients with ankylosing spondylitis (AS) and its relationship with Treg's diffrent phenotypes.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect case-control studies on peripheral Tregs of AS patients from inception to November 31st, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 61 case-control studies involving 2 466 AS patients and 1 879 controls were included. The results of meta-analysis showed that: the proportion of peripheral Tregs of patients with AS was significantly lower than that of the normal control (SMD=−0.905, 95%CI −1.294 to −0.517, P<0.000 1), and the proportion of Tregs in the disease-active group was significantly lower than that in disease-inactive group (SMD=−0.928, 95%CI −1.431 to −0.425, P<0.000 1). The proportion of CD4+CD25+FOXP3+Tregs and CD4+CD25+CD127low/−Tregs were lower in AS patients than that in control subjects (SMD=−2.547, 95%CI −3.521 to −1.573, P<0.000 1; SMD=−0.709, 95% CI −1.056 to −0.362, P<0.000 1). The proportion of Tregs defined by CD4+CD25low/−FOXP3+ was higher in AS patients (SMD=0.683, 95%CI 0.161 to 1.206, P=0.01). There was no significant difference betweew other phenotypes of Tregs groups.roups.ConclusionsThe reduction of Tregs may be one of the important reasons for the occurrence and development of AS, which may provide a new approach for the diagnosis and treatment of AS.
To systematically and retrospectively analyze Chinese exploration of novel coronavirus pneumonia, including emergency command, medical treatment, health and disease prevention, resource scheduling and other aspects, in order to provide references for the prevention and treatment of global infectious diseases.
目的 调查极重灾区某中学学生的创伤后应激障碍（PTSD）症状检出率及影响因素，为进一步开展灾后心理卫生服务提供依据。 方法 2008年9月下旬，对汶川地震的极重灾区都江堰某镇中学1 500名同学进行调查，获有效问卷1 498份。采用一般情况调查问卷、儿童事件影响量表（CRIES-13）中文版进行集体施测。 结果 某镇中学学生灾后4个月PTSD症状检出率29.71%（445/1 498）。经非条件逐步logistic回归筛选PTSD症状的影响因素有：地震时是否受伤（OR=1.995，P=0.000）、性别（OR=1.785，P=0.000）、绝望感（OR=1.597，P=0.000）、是否目睹死亡（OR=1.344，P=0.000）、年龄（OR=1.308，P=0.000）、是否目睹受伤（OR=1.262，P=0.000）、地震时是否被困（OR=1.209，P=0.011）、震后居住地点（OR=1.182，P=0.000）、是否目睹垮塌（OR=1.176，P=0.000）、家人情况（OR=1.104，P=0.000）、地震后是否住院（OR=0.828，P=0.041）12个因素。 结论 在灾后重建过程中，该中学的学生PTSD症状检出率较高，其与地震时是否受伤、性别、绝望感、是否目睹死亡、年龄、是否目睹受伤、地震时是否被困、震后居住地点、是否目睹垮塌、家人情况、地震后是否住院呈显著相关。