To identify the best evidence in the management of indicator, short and long term of prophylactic platelet transfusion in patient with myelodysplastic syndrome (MDS). We searched the latest evidence-based guidelines in PubMed,reviewed and appraised these guidelines. Clinical decision was made based on the guidelines and the actual patient with MDS. Perfect treatment effect was obtained through evidence-based clinical decision.
Objective To summarize results of the correlation of tumor necrosis factor-α (TNF-α) promoter –308A/G polymorphism with systemic lupus erythematosus (SLE) susceptibility in Chinese populations. Methods We collected all the publications about the correlation between TNF-α promoter –308A/G polymorphism and SLE in Chinese populations by searching PubMed, EBSCO, CBM, CNKI and Wanfang Data before the date of March 20, 2010. Meta-analysis was performed for checking the difference between two groups about genotypes such as AA versus GG, GA versus GG, AA versus GG+GA, GA+AA versus GG, and A allele versus G allele. Results A total of 8 studies involving 731 SLE patients and 901 healthy people were included. The meta-analysis of total populations showed that, there was no significant correlation between A allele and increased SLE risk (OR=1.42, 95%CI 0.97 to 2.09, P=0.07); the meta-analyses of populations in different regions showed there was no significant correlation of A allele and increased SLE risk in Chinese Taiwan populations (OR=1.04, 95%CI 0.77 to 1.40, P=0.82). Moreover, there was no significant difference between SLE group and control group in the genotypes of AA versus GG, GA versus GG, AA versus GG+GA, and GA+AA versus GG.Conclusion This meta-analysis dosen’t demonstrate the correlation between TNF-α promoter–308A/G polymorphism and SLE in Chinese populations.
During the medical rescue after the earthquake, the Security Department of West China Hospital understood those factors affecting the hospital safety in the earthquake disaster, established emergent communication platform and information release channel, and opened up special areas and passages for the wounded, so as to ensure smooth passages for the rescue work, security of disaster-relief materials as well as an orderly, safe and stable medical environment.
Objective To evaluate the expression of cyclin E and p27kip1 protein and their significance in gallbladder carcinoma. Methods SP immunohistochemistry was used to detect the expression of cyclin E and p27kip1 protein in 41 cases gallbladder carcinomas,15 cases chronic cholecystitis tissues. Results The positive rate of cyclin E in gallbladder carcinoma was 61.0%（25/41）,which was significantly higher than that in chronic cholecystitis (20.0%，3/15)，P＜0.05; The expression of cyclin E positively correlated with tumor TNM staging (r=0.314,P＜0.05). The positive rate of p27kip1 in gallbladder carcinoma was 53.7%(22/41),which was lower than that in chronic cholecystitis (100%). The positive rate of p27kip1 was decreased with the poor differentiation and progression of TNM staging. There was negative correlation between cyclin E and p27kip1 expression (r=-0.342,P＜0.05). Conclusion The high expression of cyclin E and the decreased expression of p27kip1 result in abnomal regulation of cell cycle,which may be associated with gallbladder carcinogenesis and progression.
The financial conflict of interests is drawing a wide attention, while several problems such as the unclarity of definition and blurred boundary of classification exist when it comes to the nonfinancial conflict of interests. Taking clinical practice guidelines as the example, this study introduce how nonfinancial conflict of interests happen, their classifications and impact based on present situation of relevant studies.
Surgical management of osteoarthritis of the knee: evidence based guideline contains 38 recommendations pertaining to the preoperative, perioperative, and postoperative care of patients with knee osteoarthritis (KOA) who are considering surgical treatment. Compared with the domestic consensus on diagnosis and treatment for KOA, this clinical practice guideline (CPG) prepared by the American Academy of Orthopedic Surgeons (AAOS) has some advantages in terms of methodology selection and recommendation. Therefore, it is necessary for us to interpret this CPG to speed up the understanding and dissemination of the CPG. The ultimate aims are to: ① strengthen the standardization and understanding of surgical treatment of KOA; ② enhance the understanding of clinicians for this CPG in treating KOA; ③ speed up the development of guideline development methodologies in China; ④ provide methodological guidance for the development of CPG based on the current situation in China.
The focus of health equity is to enable the public to have fair access to health services and achieve satisfactory health outcomes. With research developments, guideline developers increasingly pay more attention to the fairness in the practice guidelines and have carried out exploration and practice in the relevant guidelines. The GRADE working group has begun to investigate how to use GRADE to assess health equity in practice guidelines since 2014. In 2017, the series of methodological guidelines of health equity in guideline development was officially published. It proposed 5 approaches to evaluate health equity and pointed out current methodological challenges of applying GRADE to assess health equity. This paper aims to introduce the GRADE equity guidelines, so as to provide a reference for Chinese researchers in their practice.
Adapting the existing guidelines in the context of specific regions can improve the efficiency of guidelines development, and reduce cost and time for developing guidelines. ADOLOPMENT is a methodological tool for guidelines adaptation, which was developed by the GRADE Working Group based on the standardized international guidelines making process. With ADOLOPMENT, developers can effectively use existing guidelines and evidence, avoid duplication of the evidence evaluation, and record the process from evidence to recommendations, which will ensure the transparency of adaptation, help users to understand the process, and improve the acceptability and credibility of guideline adaptation. This paper aims to introduce the ADOLOPMENT and its application.
ObjectivesTo investigate Chinese health practitioners’ usage and demand for clinical practice guidelines in general so as to improve the development and implementation of guidelines.MethodsWe conducted a cross-sectional questionnaire survey that covered health practitioners from different levels of medical institutions in 17 provinces in China. Attitudes, adherence, usage barriers and demands for clinical practice guidelines were investigated.ResultsA total of 953 health practitioners were involved in the survey in which 931 completed the questionnaires. Respondents generally held positive attitudes toward guidelines and agreed that they improved quality of care and standardized diagnosis and treatment. More than 80% of the respondents reported a fine adherence to guidelines. The most reported barriers to follow the guidelines were " several guidelines are competing” and " lack of facilities and medical resources”. Most respondents agreed that it was necessary to establish a national guideline database, appraise implementation effect of guidelines, develop evaluation tools for guidelines that are applicable for Chinese clinical practice, and provide guidelines training.ConclusionsThis study finds favorable attitudes and fine adherence towards clinical guidelines in general in China. However, internal barriers, such as authority of guidelines, and external barriers, such as supplying system and patients’ preference, can affect guideline dissemination and implementation. It is suggested that establishing a national guidelines database, developing evaluation tools for guidelines that fit for Chinese clinical practice, and provision of guideline training, would facilitate the use of guidelines.
ObjectivesTo evaluate the reporting quality of clinical practice guidelines published in Chinese journals in 2015.MethodsCBM, CNKI, VIP and WanFang Data databases were searched to collect clinical practice guidelines published in Chinese journals from January, 2015 to December, 2015. Two reviewers independently screened literature, extracted data, and the reporting quality of clinical practice guidelines were evaluated by the Reporting Items for Practice Guidelines in Healthcare (RIGHT). Excel software was used for data analysis.ResultsA total of 74 clinical practice guidelines were included. It was found that among the seven domains of RIGHT, the reporting quality of basic information and background domains were acceptable. There were fewer problems in the domain of evidence and recommendation. There were many deficiencies in three domains, such as review and quality assurance, funding and the declaration/management of interests and other information.ConclusionsThe reporting quality of clinical practice guidelines published in Chinese journals in 2015 is low, and the full reporting rate of clinical practice guidelines need to be improved. It is suggested that guideline developers construct strict guidelines for the development and report the guidelines with international standard, thus improving the quality of the clinical practice guidelines.