Objective:Based on the six-step curriculum development process proposed by Professor Schneiderhan et al.,the course needs,the cognition,and course summative assessment results,combined with the career preferences and ...Objective:Based on the six-step curriculum development process proposed by Professor Schneiderhan et al.,the course needs,the cognition,and course summative assessment results,combined with the career preferences and work value orientation of clinical medical students undertaking the course“Introduction to General Medicine”were surveyed.Methods:A self-designed questionnaire was used to collect information on the course cognition,course summative evaluation,and professional inclination of 233 junior medical students majoring in clinical medicine undertaking the course“Introduction to General Practice.”An analysis was conducted to provide a basis for curriculum revision in accordance with the structured composition of the curriculum development process.Results:(i)In terms of course cognition,before the course,67.0%of students were unaware of general medicine and general practitioners,73.0%of students had never participated in practical activities(including volunteer work),and 53.6%of students expressed interest in the course;there were significant differences in the growth environment,the frequency of participation in club activities,the cognition of general medicine/general practitioners before the course,participation in practical activities(including volunteer work),attentiveness to the current situation of medical treatment,and the interest toward the course(P<0.05);multi-factor logistics analysis showed that the factors influencing the interest toward the course include growth environment,frequency of participation in club activities,course cognition,participation in practical activities,and attentiveness to the current status of development of medical treatment.(ii)The course summative assessment results showed that 91.8%of students felt that it is necessary to learn this course,33.9%of students felt that the most important thing in the course is to learn the theoretical knowledge of general medicine and related diagnosis and treatment skills,53.2%of students felt that the most unfavorable factor affecting the learning of this course is the lack of interest in general medicine,and 64.4%of students hoped for more clinical practice to understand and participate in the work of general practitioners;paired t-test revealed differences in career preferences before and after the course(P<0.05);after the course,more students thought that general practitioner is an ideal career option.(iii)The results showed that 58.8%of students had considered their future specialty but did not have specific goals or plans,while 21.9%had considered their future specialty and had clear goals;there was a significant difference in professional inclination between genders as well as those who were attentive to the current state and development of medical treatment in our country and those who were not(P<0.05);with regard to the scores of importance in terms of the influencing factors of professional inclination,interest and possibility of professional development scored 3.92,ranking first,followed by income,which scored 3.91,and career prestige,which scored the lowest(3.62).Conclusion:Based on the needs assessment of clinical medical students,it is important to focus on improving students’interest in general medicine,especially their cognition and professional understanding of the course before the course itself,in addition to the development of relevant practical activities,and their attentiveness to the current state and development of medical treatment.The summative assessment results suggest that the implementation of this course has a positive influence on the career preferences of clinical medical students to a certain extent.Therefore,it is necessary to combine the course content with the development of general medicine,so as to stimulate students’interest in self-driven learning and in general medicine.This will attract more students whose work value orientation is influenced by interest and possibility of professional development to choose general practitioner as their future professional inclination.展开更多
Introduction: Haemolytic anaemia (HA) is defined as a decrease in haemoglobin (Hb) levels below baseline due to excessive and premature destruction of red blood cells (RBCs) in the periphery resulting in a shortened l...Introduction: Haemolytic anaemia (HA) is defined as a decrease in haemoglobin (Hb) levels below baseline due to excessive and premature destruction of red blood cells (RBCs) in the periphery resulting in a shortened life span of less than 120 days. Haemolysis can be corpuscular or extra-corpuscular. The aim of our study was to investigate the factors associated with it for optimal management of patients hospitalised in internal medicine at the Douala General Hospital (DGH). Methodology: We conducted an analytical cross-sectional study, including all patients admitted to the internal medicine department of the DGH from 11 February to 20 May 2022, and excluding patients with non-compliant samples. The search for haemolytic anaemia was carried out by means of blood count, reticulocyte count, blood smear, unconjugated bilirubin, lactate dehydrogenase and direct Coombs test. Sociodemographic, clinical and biological parameters were collected and analysed. Correlation was defined for a p value 0.05. Results: This study included 147 patients, 50.34% of whom were men, for a sex ratio of 1.01. The mean age was 52 ± 17.9 years. The most represented age group was 56 - 70 years (n = 49;33%) with extremes from 15 to 90 years. We counted 29.3% cases of haemolytic anaemia (HA) and 13.9% cases of autoimmune haemolytic anaemia (AIHA). Haemolytic anaemia (HA) was present in 54.14% of men for a sex ratio of 1.38;the most represented age group was 40 - 55 years, 37.2%. HA was associated with jaundice (OR: 3.74, CI: [1.70 - 8.22], p = 0.001), HIV - AIDS (OR: 2.72, CI: [0.98 - 7.53], p = 0.05), thrombocytopaenia (OR: 3.53, CI: [1.58 - 7.89], p = 0.02). LDH was elevated (OR: 2.86, CI: [1.30 - 6.26], p = 0.00) as well as elevated reticulocyte count (OR: 3.84, CI: [1.75 - 8.44], p = 0.01). Unconjugated bilirubin was elevated in all these patients. In multivariate analysis, factors associated with HA were a history of HIV/AIDS, jaundice, thrombocytopaenia and elevated reticulocyte count. Conclusion: Hemolytic anaemia is common in internal medicine and is significantly associated with thrombocytopenia, HIV/AIDS infection and jaundice.展开更多
Ever since the introduction of Western biomedicine into China, there has been friction between proponents of this new approach, and proponents of the traditional medical practices that had evolved over thousands of ye...Ever since the introduction of Western biomedicine into China, there has been friction between proponents of this new approach, and proponents of the traditional medical practices that had evolved over thousands of years in China. For the most part, this friction has been couched in the unexamined assumption that Western medicine is based on science, while Chinese medicine is not. This article will examine that assumption, which in this author’s opinion is unjustified and incorrect. Having practiced acupuncture for the past 50 years, after receiving my doctoral degrees in medicine and physiology, my thinking on this topic has also evolved over time. I will begin this article with some historical information that bears on the topic under discussion, followed by my personal ideas about how to resolve the confiicts that have arisen.展开更多
Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disp...Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disposed of. In Burkina Faso, there are as yet no guidelines for the disposal of unused medicines in households. The aim of this study was to estimate the extent of household possession of unused or expired medicines, and to describe attitudes and disposal practices. Methods: This was a descriptive cross-sectional study covering households in the Ouagadougou commune conducted from June to August 2021. Two-stage stratified sampling was used: selection of Enumeration Zones (EZs) and selection of households, with each EZ comprising several households. Data collection was based on direct interviews using a structured questionnaire. Data were processed using Epi Info software version 7.2.4.0. Results: In total, 417 household residents were surveyed out of the planned 423 households, corresponding to a completion rate of 98.58% compared with the initial sample. Among the respondents, 79.62% had unused and/or expired medicines in their household. A total of 2562 drug packaging units were counted, for a total weight of 121.90 kg. Nearly 75% were aware that improper disposal was a danger to the environment. Some respondents kept their unused medicines at home until they expired (43.41%), and disposed of them mainly by throwing them in the household garbage (75.58%). The majority (79%) were in favor of the government setting up a take-back program for these medicines. Conclusion: The introduction of a take-back program for unused or out-of-date medicines will ensure safer disposal of medicines, and better protection for households and the environment.展开更多
In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of nor...In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of normalizing constants.It is shown that M_(n)^(p),when v=1,converges to the Frechet extreme value distribution at the rate of 1/n,and if v>1 then M_(n)^(p)converges to the Gumbel extreme value distribution at the rate of(loglogn)^(2)=(log n)^(1-1/v).展开更多
This interview was conducted on August 21st, 2022 by Charles Buck and Ioannis Solos. Peter Deadman has worked in the field of health promotion for 50 years. He co-founded Infinity Foods(an organic and natural foods wo...This interview was conducted on August 21st, 2022 by Charles Buck and Ioannis Solos. Peter Deadman has worked in the field of health promotion for 50 years. He co-founded Infinity Foods(an organic and natural foods workers co-op) in 1971, followed by the Brighton Natural Health Centre-a charity dedicated to teaching ways to improve personal, community and planetary health and wellbeing. He qualified as an acupuncturist in 1978 and in Chinese herbal medicine in 1990. He founded The Journal of Chinese Medicine(UK) in 1979(Fig. 1), and co-authored A Manual of Acupuncture(published in 1998). He is the author of Live Well Live Long: Teachings from the Chinese Nourishment of Life Tradition. He has taught Chinese medicine and health promotion internationally for decades and is a dedicated practitioner and teacher of Qi Gong(气功).展开更多
Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has ear...Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has earned his Master of Medicine in Traditional Diagnosis at the Beijing University of Chinese Medicine,and his Medical Ph.D.in Chinese and Western Integrative Medicine at the Jinan University in Guangzhou.He practices and teaches integrative clinical medicine,Jing Fang(经方TCM formulas),martial lineage acupuncture,and his personalized style of“tendon and fascia reconditioning manipulations for bone and joint disease”.展开更多
In this editorial we comment on the article“Potential and limitations of ChatGPT and generative artificial intelligence in medial safety education”published in the recent issue of the World Journal of Clinical Cases...In this editorial we comment on the article“Potential and limitations of ChatGPT and generative artificial intelligence in medial safety education”published in the recent issue of the World Journal of Clinical Cases.This article described the usefulness of artificial intelligence(AI)in medial safety education.Herein,we focus specifically on the use of AI in the field of pain medicine.AI technology has emerged as a powerful tool,and is expected to play an important role in the healthcare sector and significantly contribute to pain medicine as further developments are made.AI may have several applications in pain medicine.First,AI can assist in selecting testing methods to identify causes of pain and improve diagnostic accuracy.Entry of a patient’s symptoms into the algorithm can prompt it to suggest necessary tests and possible diagnoses.Based on the latest medical information and recent research results,AI can support doctors in making accurate diagnoses and setting up an effective treatment plan.Second,AI assists in interpreting medical images.For neural and musculoskeletal disorders,imaging tests are of vital importance.AI can analyze a variety of imaging data,including that from radiography,computed tomography,and magnetic resonance imaging,to identify specific patterns,allowing quick and accurate image interpretation.Third,AI can predict the outcomes of pain treatments,contributing to setting up the optimal treatment plan.By predicting individual patient responses to treatment,AI algorithms can assist doctors in establishing a treatment plan tailored to each patient,further enhancing treatment effectiveness.For efficient utilization of AI in the pain medicine field,it is crucial to enhance the accuracy of AI decision-making by using more medical data,while issues related to the protection of patient personal information and responsibility for AI decisions will have to be addressed.In the future,AI technology is expected to be innovatively applied in the field of pain medicine.The advancement of AI is anticipated to have a positive impact on the entire medical field by providing patients with accurate and effective medical services.展开更多
In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs t...In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs targeting the receptors,and species variability.Some scientists have focused on natural medicines,especially herbal medicines in traditional Chinese medicine.New drugs with excellent anxiolytic activity are hoped to be found in herbal medicines with anxiolytic effects.This mini-review summarised three Chinese herbal medicines with anxiolytic effects and anxiolytic herbal formulas used in the traditional Chinese medicine clinic.Several key issues that block the development of new anxiolytic drugs are also discussed.We hope to provide some ideas for researching and developing new anxiolytic drugs and studying anxiolytic components in traditional Chinese medicine.展开更多
Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previou...Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previously untreatable,most research in this field has focused on the early phase of incomplete injury.However,the majority of patients have chronic severe injuries;therefore,treatments for these situations are of fundamental importance.The reason why the treatment of complete spinal cord injury has not been studied is that,unlike in the early stage of incomplete spinal cord injury,there are various inhibitors of neural regeneration.Thus,we assumed that it is difficult to address all conditions with a single treatment in chronic complete spinal cord injury and that a combination of several treatments is essential to target severe pathologies.First,we established a combination therapy of cell transplantation and drug-releasing scaffolds,which contributes to functional recovery after chronic complete transection spinal cord injury,but we found that functional recovery was limited and still needs further investigation.Here,for the further development of the treatment of chronic complete spinal cord injury,we review the necessary approaches to the different pathologies based on our findings and the many studies that have been accumulated to date and discuss,with reference to the literature,which combination of treatments is most effective in achieving functional recovery.展开更多
Lung cancer is the most common and fatal malignant disease worldwide and has the highest mortality rate among tumor-related causes of death.Early diagnosis and precision medicine can significantly improve the survival...Lung cancer is the most common and fatal malignant disease worldwide and has the highest mortality rate among tumor-related causes of death.Early diagnosis and precision medicine can significantly improve the survival rate and prognosis of lung cancer patients.At present,the clinical diagnosis of lung cancer is challenging due to a lack of effective non-invasive detection methods and biomarkers,and treatment is primarily hindered by drug resistance and high tumor heterogeneity.Liquid biopsy is a method for detecting circulating biomarkers in the blood and other body fluids containing genetic information from primary tumor tissues.Bronchoalveolar lavage fluid(BALF)is a potential liquid biopsy medium that is rich in a variety of bioactive substances and cell components.BALF contains information on the key characteristics of tumors,including the tumor subtype,gene mutation type,and tumor environment,thus BALF may be used as a diagnostic supplement to lung biopsy.In this review,the current research on BALF in the diagnosis,treatment,and prognosis of lung cancer is summarized.The advantages and disadvantages of different components of BALF,including cells,cell-free DNA,extracellular vesicles,and micro RNA are introduced.In particular,the great potential of extracellular vesicles in precision diagnosis and detection of drug-resistant for lung cancer is highlighted.In addition,the performance of liquid biopsies with different body fluid sources in lung cancer detection are compared to facilitate more selective studies involving BALF,thereby promoting the application of BALF for precision medicine in lung cancer patients in the future.展开更多
目的研究Aerospace Medicine and Human Performance更名前后的主要报道方向、国别、发文机构的变化情况等,以期为国内同行提供参考。方法主要利用CiteSpace的共词网络功能来对期刊报道方向、发刊国别、发文机构等变化进行分析。数据来...目的研究Aerospace Medicine and Human Performance更名前后的主要报道方向、国别、发文机构的变化情况等,以期为国内同行提供参考。方法主要利用CiteSpace的共词网络功能来对期刊报道方向、发刊国别、发文机构等变化进行分析。数据来自Web of Science核心合集的SCI拓展版,以期刊名“Aviation Space and Environmental Medicine”检索,时间跨度为1991年1月1日至2014年12月31日,剔除征稿启事、会议通知等非学术文献。导入NoteExpress软件进行去重,共有4830篇文章。该刊于2015年更名为“Aerospace Medicine and Human Performance”,检索策略为:时间跨度为2015年1月1日至2023年6月13日,数据清洗方法同上,共检索到1076篇文章。结果(1)主要发文机构:更名前主要供稿机构为美国空军(160篇)、美国国防部(93篇)和美国宇航局(NASA,77篇);更名后主要供稿机构未发生变化,但发文数量均较更名前减少,美国空军47篇,美国国防部24篇,NASA 24篇。(2)主要关键词对比:更名后主要关键词与飞行、航天相关的连接强度显著增加,而对一般健康问题的关注相对减少,出现了spaceflight、air travel等直接与飞行行为相关的内容。(3)主要国别:更名前美国发文2411篇(49.91%)、加拿大发文314篇(6.50%)、英国发文279篇(5.77%)、法国发文167篇(3.45%)、德国发文160篇(3.31%);更名后美国发文501篇(46.56%)、英国发文98篇(9.10%)、中国发文54篇(5.01%)、加拿大发文53篇(4.92%)、法国发文42篇(3.90%)。(4)年均发文量:根据检索结果,更名前共24年,年均发文201篇;更名后从2015年至本文检索截止时间共8.5年,年均发文127篇,年均报道量下降较多。(5)影响因子:截止2014年更名前共发文164篇,影响因子1.0051(含自引);2016年是该刊更名有影响因子等统计数据的第一年,共发文132篇,影响因子0.8250;2022年发文109篇,影响因子1.0001(含自引)。综合考量发文量和影响因子,该刊的综合影响力更名后并无显著提升。结论该刊在更名后,对于飞行环境的影响报道有所减少,主要讨论范围从之前的所有飞行类型聚焦为以太空飞行为主,关于飞行行为对人体健康的影响和绩效表现的报道大幅增长,同时也增加了关于飞行装备对飞行安全影响的讨论。随着航空航天技术的进步和航空装备的发展,更深入地探讨航空活动中环境因素对人体长时间复合作用的影响是必然。在该刊更名后,我国的发文数量排名第三,也在一定程度上说明存在高质量原创性成果外流的情况。我国期刊在坚持刊物原有特色的前提下,根据领域研究的发展,与时俱进,探索可持续发展的办刊模式;要进一步明确期刊定位与服务对象,以国家重大需求为导向,聚焦航空航天领域前沿、热点,适时调整栏目设置,提升期刊的学术质量和学科影响力,打造高质量的学术交流平台。展开更多
The traditional standard wet sieving method uses steel sieves with aperture?0.063 mm and can only determine the particle size distribution(PSD)of gravel and sand in general soil.This paper extends the traditional meth...The traditional standard wet sieving method uses steel sieves with aperture?0.063 mm and can only determine the particle size distribution(PSD)of gravel and sand in general soil.This paper extends the traditional method and presents an extended wet sieving method.The extended method uses both the steel sieves and the nylon filter cloth sieves.The apertures of the cloth sieves are smaller than 0.063 mm and equal 0.048 mm,0.038 mm,0.014 mm,0.012 mm,0.0063 mm,0.004 mm,0.003 mm,0.002 mm,and 0.001 mm,respectively.The extended method uses five steps to separate the general soil into many material sub-groups of gravel,sand,silt and clay with known particle size ranges.The complete PSD of the general soil is then calculated from the dry masses of the individual material sub-groups.The extended method is demonstrated with a general soil of completely decomposed granite(CDG)in Hong Kong,China.The silt and clay materials with different particle size ranges are further examined,checked and verified using stereomicroscopic observation,physical and chemical property tests.The results further confirm the correctness of the extended wet sieving method.展开更多
In 2012, traditional Chinese medicine(TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herb...In 2012, traditional Chinese medicine(TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold Rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd.(AACMA), also developed a framework of professional selfregulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans Affairs.展开更多
Vitiligo has a significant impact on a substantial number of individuals worldwide.Traditional Chinese medicine has a long history of serving as a therapeutic treatment for vitiligo.Nevertheless,given the increasing v...Vitiligo has a significant impact on a substantial number of individuals worldwide.Traditional Chinese medicine has a long history of serving as a therapeutic treatment for vitiligo.Nevertheless,given the increasing volume of research on the utilization of traditional Chinese medicine for vitiligo treatment,it is imperative to conduct a comprehensive review that elucidates the efficacy of Chinese traditional medicine and other active ingredients in the treatment of vitiligo.This paper presents a comprehensive overview of the clinical preparations used to treat vitiligo,while also highlighting the potential monomers and extracts derived from traditional Chinese medicine for vitiligo treatment.A thorough analysis of the pharmacological effects of traditional Chinese medicine on vitiligo treatment will provide valuable insights and reliable information for the development of new treatment strategies.展开更多
Hepatitis B virus(HBV)infection is a major player in chronic hepatitis B that may lead to the development of hepatocellular carcinoma(HCC).HBV genetics are diverse where it is classified into at least 9 genotypes(A to...Hepatitis B virus(HBV)infection is a major player in chronic hepatitis B that may lead to the development of hepatocellular carcinoma(HCC).HBV genetics are diverse where it is classified into at least 9 genotypes(A to I)and 1 putative genotype(J),each with specific geographical distribution and possible different clinical outcomes in the patient.This diversity may be associated with the precision medicine for HBV-related HCC and the success of therapeutical approaches against HCC,related to different pathogenicity of the virus and host response.This Editorial discusses recent updates on whether the classification of HBV genetic diversity is still valid in terms of viral oncogenicity to the HCC and its precision medicine,in addition to the recent advances in cellular and molecular biology technologies.展开更多
In Chinese medicine, practitioners assess patients’ complaints, analyze their underlying problems, identify causes and come to a diagnosis, which then directs treatment. What is not obvious and not recorded in a cons...In Chinese medicine, practitioners assess patients’ complaints, analyze their underlying problems, identify causes and come to a diagnosis, which then directs treatment. What is not obvious and not recorded in a consultation is the clinical reasoning process that practitioners use. The research filmed three practitioners in the UK while they conducted a consultation and treatment on new patients. The practitioners and researchers viewed the films and used them as aide-memoirs while the reasoning process throughout was discussed. In order to determine the pattern, practitioners used the four examinations to gather information from the patient in an iterative process;their aesthetic reasoning was highly developed. Through triangulation they checked the information they received against a detailed understanding of the qi-dynamic. They used highly analytical strategies of forward(inductive) and backward(deductive) reasoning against the prototypes of the signs and symptoms that indicate a specific Zheng. This was achieved through an abductive process that linked description with explanation and causal factors with pathological mechanisms. The feedback loop with the patient continued through the consultation and into the treatment. A process of translation and interpretation was needed to turn the patient’s story into the practitioner’s story of qi-dynamics that then directed the treatment. Awareness of our clinical reasoning process will mitigate against biases, improve our diagnoses and treatment choices and support the training of students.展开更多
The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alteration...The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alterations and their functional significance were unveiled in cancer cells,which led to the development of molecular targeted therapies in the 2000s and beyond.Although CGM is still a relatively new discipline and it is difficult to predict to what extent CGM will benefit the diverse pool of cancer patients,the National Cancer Center(NCC)of Japan has already contributed considerably to CGM advancement for the conquest of cancer.Looking back at these past achievements of the NCC,we predict that the future of CGM will involve the following:1)A biobank of paired cancerous and non-cancerous tissues and cells from various cancer types and stages will be developed.The quantity and quality of these samples will be compatible with omics analyses.All biobank samples will be linked to longitudinal clinical information.2)New technologies,such as whole-genome sequencing and artificial intelligence,will be introduced and new bioresources for functional and pharmacologic analyses(e.g.,a patient-derived xenograft library)will be systematically deployed.3)Fast and bidirectional translational research(bench-to-bedside and bedside-to-bench)performed by basic researchers and clinical investigators,preferably working alongside each other at the same institution,will be implemented;4)Close collaborations between academia,industry,regulatory bodies,and funding agencies will be established.5)There will be an investment in the other branch of CGM,personalized preventive medicine,based on the individual's genetic predisposition to cancer.展开更多
In this editorial,we comment on the hard and soft tissue applications of different ceramic-based scaffolds prepared by different mechanisms such as 3D printing,sol-gel,and electrospinning.The new concept of regenerati...In this editorial,we comment on the hard and soft tissue applications of different ceramic-based scaffolds prepared by different mechanisms such as 3D printing,sol-gel,and electrospinning.The new concept of regenerative medicine relies on biomaterials that can trigger in situ tissue regeneration and stem cell recruitment at the defect site.A large percentage of these biomaterials is ceramic-based as they provide the essential requirements of biomaterial principles such as tailored multisize porosity,antibacterial properties,and angiogenic properties.All these previously mentioned properties put bioceramics on top of the hierarchy of biomaterials utilized to stimulate tissue regeneration in soft and hard tissue wounds.Multiple clinical applications registered the use of these materials in triggering soft tissue regeneration in healthy and diabetic patients such as bioactive glass nanofibers.The results were promising and opened new frontiers for utilizing these materials on a larger scale.The same results were mentioned when using different forms and formulas of bioceramics in hard defect regeneration.Some bioceramics were used in combination with other polymers and biological scaffolds to improve their regenerative and mechanical properties.All this progress will enable a larger scale of patients to receive such services with ease and decrease the financial burden on the government.展开更多
Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Metho...Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.展开更多
基金Special scientific research plan project of Shaanxi Provincial Department of Education(Project No.20JK0343).
文摘Objective:Based on the six-step curriculum development process proposed by Professor Schneiderhan et al.,the course needs,the cognition,and course summative assessment results,combined with the career preferences and work value orientation of clinical medical students undertaking the course“Introduction to General Medicine”were surveyed.Methods:A self-designed questionnaire was used to collect information on the course cognition,course summative evaluation,and professional inclination of 233 junior medical students majoring in clinical medicine undertaking the course“Introduction to General Practice.”An analysis was conducted to provide a basis for curriculum revision in accordance with the structured composition of the curriculum development process.Results:(i)In terms of course cognition,before the course,67.0%of students were unaware of general medicine and general practitioners,73.0%of students had never participated in practical activities(including volunteer work),and 53.6%of students expressed interest in the course;there were significant differences in the growth environment,the frequency of participation in club activities,the cognition of general medicine/general practitioners before the course,participation in practical activities(including volunteer work),attentiveness to the current situation of medical treatment,and the interest toward the course(P<0.05);multi-factor logistics analysis showed that the factors influencing the interest toward the course include growth environment,frequency of participation in club activities,course cognition,participation in practical activities,and attentiveness to the current status of development of medical treatment.(ii)The course summative assessment results showed that 91.8%of students felt that it is necessary to learn this course,33.9%of students felt that the most important thing in the course is to learn the theoretical knowledge of general medicine and related diagnosis and treatment skills,53.2%of students felt that the most unfavorable factor affecting the learning of this course is the lack of interest in general medicine,and 64.4%of students hoped for more clinical practice to understand and participate in the work of general practitioners;paired t-test revealed differences in career preferences before and after the course(P<0.05);after the course,more students thought that general practitioner is an ideal career option.(iii)The results showed that 58.8%of students had considered their future specialty but did not have specific goals or plans,while 21.9%had considered their future specialty and had clear goals;there was a significant difference in professional inclination between genders as well as those who were attentive to the current state and development of medical treatment in our country and those who were not(P<0.05);with regard to the scores of importance in terms of the influencing factors of professional inclination,interest and possibility of professional development scored 3.92,ranking first,followed by income,which scored 3.91,and career prestige,which scored the lowest(3.62).Conclusion:Based on the needs assessment of clinical medical students,it is important to focus on improving students’interest in general medicine,especially their cognition and professional understanding of the course before the course itself,in addition to the development of relevant practical activities,and their attentiveness to the current state and development of medical treatment.The summative assessment results suggest that the implementation of this course has a positive influence on the career preferences of clinical medical students to a certain extent.Therefore,it is necessary to combine the course content with the development of general medicine,so as to stimulate students’interest in self-driven learning and in general medicine.This will attract more students whose work value orientation is influenced by interest and possibility of professional development to choose general practitioner as their future professional inclination.
文摘Introduction: Haemolytic anaemia (HA) is defined as a decrease in haemoglobin (Hb) levels below baseline due to excessive and premature destruction of red blood cells (RBCs) in the periphery resulting in a shortened life span of less than 120 days. Haemolysis can be corpuscular or extra-corpuscular. The aim of our study was to investigate the factors associated with it for optimal management of patients hospitalised in internal medicine at the Douala General Hospital (DGH). Methodology: We conducted an analytical cross-sectional study, including all patients admitted to the internal medicine department of the DGH from 11 February to 20 May 2022, and excluding patients with non-compliant samples. The search for haemolytic anaemia was carried out by means of blood count, reticulocyte count, blood smear, unconjugated bilirubin, lactate dehydrogenase and direct Coombs test. Sociodemographic, clinical and biological parameters were collected and analysed. Correlation was defined for a p value 0.05. Results: This study included 147 patients, 50.34% of whom were men, for a sex ratio of 1.01. The mean age was 52 ± 17.9 years. The most represented age group was 56 - 70 years (n = 49;33%) with extremes from 15 to 90 years. We counted 29.3% cases of haemolytic anaemia (HA) and 13.9% cases of autoimmune haemolytic anaemia (AIHA). Haemolytic anaemia (HA) was present in 54.14% of men for a sex ratio of 1.38;the most represented age group was 40 - 55 years, 37.2%. HA was associated with jaundice (OR: 3.74, CI: [1.70 - 8.22], p = 0.001), HIV - AIDS (OR: 2.72, CI: [0.98 - 7.53], p = 0.05), thrombocytopaenia (OR: 3.53, CI: [1.58 - 7.89], p = 0.02). LDH was elevated (OR: 2.86, CI: [1.30 - 6.26], p = 0.00) as well as elevated reticulocyte count (OR: 3.84, CI: [1.75 - 8.44], p = 0.01). Unconjugated bilirubin was elevated in all these patients. In multivariate analysis, factors associated with HA were a history of HIV/AIDS, jaundice, thrombocytopaenia and elevated reticulocyte count. Conclusion: Hemolytic anaemia is common in internal medicine and is significantly associated with thrombocytopenia, HIV/AIDS infection and jaundice.
文摘Ever since the introduction of Western biomedicine into China, there has been friction between proponents of this new approach, and proponents of the traditional medical practices that had evolved over thousands of years in China. For the most part, this friction has been couched in the unexamined assumption that Western medicine is based on science, while Chinese medicine is not. This article will examine that assumption, which in this author’s opinion is unjustified and incorrect. Having practiced acupuncture for the past 50 years, after receiving my doctoral degrees in medicine and physiology, my thinking on this topic has also evolved over time. I will begin this article with some historical information that bears on the topic under discussion, followed by my personal ideas about how to resolve the confiicts that have arisen.
文摘Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disposed of. In Burkina Faso, there are as yet no guidelines for the disposal of unused medicines in households. The aim of this study was to estimate the extent of household possession of unused or expired medicines, and to describe attitudes and disposal practices. Methods: This was a descriptive cross-sectional study covering households in the Ouagadougou commune conducted from June to August 2021. Two-stage stratified sampling was used: selection of Enumeration Zones (EZs) and selection of households, with each EZ comprising several households. Data collection was based on direct interviews using a structured questionnaire. Data were processed using Epi Info software version 7.2.4.0. Results: In total, 417 household residents were surveyed out of the planned 423 households, corresponding to a completion rate of 98.58% compared with the initial sample. Among the respondents, 79.62% had unused and/or expired medicines in their household. A total of 2562 drug packaging units were counted, for a total weight of 121.90 kg. Nearly 75% were aware that improper disposal was a danger to the environment. Some respondents kept their unused medicines at home until they expired (43.41%), and disposed of them mainly by throwing them in the household garbage (75.58%). The majority (79%) were in favor of the government setting up a take-back program for these medicines. Conclusion: The introduction of a take-back program for unused or out-of-date medicines will ensure safer disposal of medicines, and better protection for households and the environment.
文摘In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of normalizing constants.It is shown that M_(n)^(p),when v=1,converges to the Frechet extreme value distribution at the rate of 1/n,and if v>1 then M_(n)^(p)converges to the Gumbel extreme value distribution at the rate of(loglogn)^(2)=(log n)^(1-1/v).
文摘This interview was conducted on August 21st, 2022 by Charles Buck and Ioannis Solos. Peter Deadman has worked in the field of health promotion for 50 years. He co-founded Infinity Foods(an organic and natural foods workers co-op) in 1971, followed by the Brighton Natural Health Centre-a charity dedicated to teaching ways to improve personal, community and planetary health and wellbeing. He qualified as an acupuncturist in 1978 and in Chinese herbal medicine in 1990. He founded The Journal of Chinese Medicine(UK) in 1979(Fig. 1), and co-authored A Manual of Acupuncture(published in 1998). He is the author of Live Well Live Long: Teachings from the Chinese Nourishment of Life Tradition. He has taught Chinese medicine and health promotion internationally for decades and is a dedicated practitioner and teacher of Qi Gong(气功).
文摘Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has earned his Master of Medicine in Traditional Diagnosis at the Beijing University of Chinese Medicine,and his Medical Ph.D.in Chinese and Western Integrative Medicine at the Jinan University in Guangzhou.He practices and teaches integrative clinical medicine,Jing Fang(经方TCM formulas),martial lineage acupuncture,and his personalized style of“tendon and fascia reconditioning manipulations for bone and joint disease”.
文摘In this editorial we comment on the article“Potential and limitations of ChatGPT and generative artificial intelligence in medial safety education”published in the recent issue of the World Journal of Clinical Cases.This article described the usefulness of artificial intelligence(AI)in medial safety education.Herein,we focus specifically on the use of AI in the field of pain medicine.AI technology has emerged as a powerful tool,and is expected to play an important role in the healthcare sector and significantly contribute to pain medicine as further developments are made.AI may have several applications in pain medicine.First,AI can assist in selecting testing methods to identify causes of pain and improve diagnostic accuracy.Entry of a patient’s symptoms into the algorithm can prompt it to suggest necessary tests and possible diagnoses.Based on the latest medical information and recent research results,AI can support doctors in making accurate diagnoses and setting up an effective treatment plan.Second,AI assists in interpreting medical images.For neural and musculoskeletal disorders,imaging tests are of vital importance.AI can analyze a variety of imaging data,including that from radiography,computed tomography,and magnetic resonance imaging,to identify specific patterns,allowing quick and accurate image interpretation.Third,AI can predict the outcomes of pain treatments,contributing to setting up the optimal treatment plan.By predicting individual patient responses to treatment,AI algorithms can assist doctors in establishing a treatment plan tailored to each patient,further enhancing treatment effectiveness.For efficient utilization of AI in the pain medicine field,it is crucial to enhance the accuracy of AI decision-making by using more medical data,while issues related to the protection of patient personal information and responsibility for AI decisions will have to be addressed.In the future,AI technology is expected to be innovatively applied in the field of pain medicine.The advancement of AI is anticipated to have a positive impact on the entire medical field by providing patients with accurate and effective medical services.
文摘In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs targeting the receptors,and species variability.Some scientists have focused on natural medicines,especially herbal medicines in traditional Chinese medicine.New drugs with excellent anxiolytic activity are hoped to be found in herbal medicines with anxiolytic effects.This mini-review summarised three Chinese herbal medicines with anxiolytic effects and anxiolytic herbal formulas used in the traditional Chinese medicine clinic.Several key issues that block the development of new anxiolytic drugs are also discussed.We hope to provide some ideas for researching and developing new anxiolytic drugs and studying anxiolytic components in traditional Chinese medicine.
文摘Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previously untreatable,most research in this field has focused on the early phase of incomplete injury.However,the majority of patients have chronic severe injuries;therefore,treatments for these situations are of fundamental importance.The reason why the treatment of complete spinal cord injury has not been studied is that,unlike in the early stage of incomplete spinal cord injury,there are various inhibitors of neural regeneration.Thus,we assumed that it is difficult to address all conditions with a single treatment in chronic complete spinal cord injury and that a combination of several treatments is essential to target severe pathologies.First,we established a combination therapy of cell transplantation and drug-releasing scaffolds,which contributes to functional recovery after chronic complete transection spinal cord injury,but we found that functional recovery was limited and still needs further investigation.Here,for the further development of the treatment of chronic complete spinal cord injury,we review the necessary approaches to the different pathologies based on our findings and the many studies that have been accumulated to date and discuss,with reference to the literature,which combination of treatments is most effective in achieving functional recovery.
基金supported by grants from the National Natural Science Foundation of China(Grant No.82173182)the Sichuan Science and Technology Program(Grant No.2021YJ0117 to Weiya Wang+1 种基金Grant No.2023NSFSC1939 to Dan Liu)the 1·3·5 project for Disciplines of Excellence–Clinical Research Incubation Project,West China Hospital,Sichuan University(Grant Nos.2019HXFH034 and ZYJC21074)。
文摘Lung cancer is the most common and fatal malignant disease worldwide and has the highest mortality rate among tumor-related causes of death.Early diagnosis and precision medicine can significantly improve the survival rate and prognosis of lung cancer patients.At present,the clinical diagnosis of lung cancer is challenging due to a lack of effective non-invasive detection methods and biomarkers,and treatment is primarily hindered by drug resistance and high tumor heterogeneity.Liquid biopsy is a method for detecting circulating biomarkers in the blood and other body fluids containing genetic information from primary tumor tissues.Bronchoalveolar lavage fluid(BALF)is a potential liquid biopsy medium that is rich in a variety of bioactive substances and cell components.BALF contains information on the key characteristics of tumors,including the tumor subtype,gene mutation type,and tumor environment,thus BALF may be used as a diagnostic supplement to lung biopsy.In this review,the current research on BALF in the diagnosis,treatment,and prognosis of lung cancer is summarized.The advantages and disadvantages of different components of BALF,including cells,cell-free DNA,extracellular vesicles,and micro RNA are introduced.In particular,the great potential of extracellular vesicles in precision diagnosis and detection of drug-resistant for lung cancer is highlighted.In addition,the performance of liquid biopsies with different body fluid sources in lung cancer detection are compared to facilitate more selective studies involving BALF,thereby promoting the application of BALF for precision medicine in lung cancer patients in the future.
文摘目的研究Aerospace Medicine and Human Performance更名前后的主要报道方向、国别、发文机构的变化情况等,以期为国内同行提供参考。方法主要利用CiteSpace的共词网络功能来对期刊报道方向、发刊国别、发文机构等变化进行分析。数据来自Web of Science核心合集的SCI拓展版,以期刊名“Aviation Space and Environmental Medicine”检索,时间跨度为1991年1月1日至2014年12月31日,剔除征稿启事、会议通知等非学术文献。导入NoteExpress软件进行去重,共有4830篇文章。该刊于2015年更名为“Aerospace Medicine and Human Performance”,检索策略为:时间跨度为2015年1月1日至2023年6月13日,数据清洗方法同上,共检索到1076篇文章。结果(1)主要发文机构:更名前主要供稿机构为美国空军(160篇)、美国国防部(93篇)和美国宇航局(NASA,77篇);更名后主要供稿机构未发生变化,但发文数量均较更名前减少,美国空军47篇,美国国防部24篇,NASA 24篇。(2)主要关键词对比:更名后主要关键词与飞行、航天相关的连接强度显著增加,而对一般健康问题的关注相对减少,出现了spaceflight、air travel等直接与飞行行为相关的内容。(3)主要国别:更名前美国发文2411篇(49.91%)、加拿大发文314篇(6.50%)、英国发文279篇(5.77%)、法国发文167篇(3.45%)、德国发文160篇(3.31%);更名后美国发文501篇(46.56%)、英国发文98篇(9.10%)、中国发文54篇(5.01%)、加拿大发文53篇(4.92%)、法国发文42篇(3.90%)。(4)年均发文量:根据检索结果,更名前共24年,年均发文201篇;更名后从2015年至本文检索截止时间共8.5年,年均发文127篇,年均报道量下降较多。(5)影响因子:截止2014年更名前共发文164篇,影响因子1.0051(含自引);2016年是该刊更名有影响因子等统计数据的第一年,共发文132篇,影响因子0.8250;2022年发文109篇,影响因子1.0001(含自引)。综合考量发文量和影响因子,该刊的综合影响力更名后并无显著提升。结论该刊在更名后,对于飞行环境的影响报道有所减少,主要讨论范围从之前的所有飞行类型聚焦为以太空飞行为主,关于飞行行为对人体健康的影响和绩效表现的报道大幅增长,同时也增加了关于飞行装备对飞行安全影响的讨论。随着航空航天技术的进步和航空装备的发展,更深入地探讨航空活动中环境因素对人体长时间复合作用的影响是必然。在该刊更名后,我国的发文数量排名第三,也在一定程度上说明存在高质量原创性成果外流的情况。我国期刊在坚持刊物原有特色的前提下,根据领域研究的发展,与时俱进,探索可持续发展的办刊模式;要进一步明确期刊定位与服务对象,以国家重大需求为导向,聚焦航空航天领域前沿、热点,适时调整栏目设置,提升期刊的学术质量和学科影响力,打造高质量的学术交流平台。
基金The work described in this paper was partially supported by grants from the Research Grant Council of the Hong Kong Special Administrative Region,China(Project Nos.HKU 17207518 and R5037-18).
文摘The traditional standard wet sieving method uses steel sieves with aperture?0.063 mm and can only determine the particle size distribution(PSD)of gravel and sand in general soil.This paper extends the traditional method and presents an extended wet sieving method.The extended method uses both the steel sieves and the nylon filter cloth sieves.The apertures of the cloth sieves are smaller than 0.063 mm and equal 0.048 mm,0.038 mm,0.014 mm,0.012 mm,0.0063 mm,0.004 mm,0.003 mm,0.002 mm,and 0.001 mm,respectively.The extended method uses five steps to separate the general soil into many material sub-groups of gravel,sand,silt and clay with known particle size ranges.The complete PSD of the general soil is then calculated from the dry masses of the individual material sub-groups.The extended method is demonstrated with a general soil of completely decomposed granite(CDG)in Hong Kong,China.The silt and clay materials with different particle size ranges are further examined,checked and verified using stereomicroscopic observation,physical and chemical property tests.The results further confirm the correctness of the extended wet sieving method.
文摘In 2012, traditional Chinese medicine(TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold Rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd.(AACMA), also developed a framework of professional selfregulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans Affairs.
基金supported by the National Natural Science Foundation of China(82003808)the Open Project of Jiangsu Provincial Science and Technology Resources(Clinical Resources)Coordination Service Platform(No.TC2022B015)the Shuangchuang Doctor Project of Jiangsu Province(No.JSSCBS20220147)。
文摘Vitiligo has a significant impact on a substantial number of individuals worldwide.Traditional Chinese medicine has a long history of serving as a therapeutic treatment for vitiligo.Nevertheless,given the increasing volume of research on the utilization of traditional Chinese medicine for vitiligo treatment,it is imperative to conduct a comprehensive review that elucidates the efficacy of Chinese traditional medicine and other active ingredients in the treatment of vitiligo.This paper presents a comprehensive overview of the clinical preparations used to treat vitiligo,while also highlighting the potential monomers and extracts derived from traditional Chinese medicine for vitiligo treatment.A thorough analysis of the pharmacological effects of traditional Chinese medicine on vitiligo treatment will provide valuable insights and reliable information for the development of new treatment strategies.
基金Supported by Rumah Program 2024 of Research Organization for Health,National Research and Innovation Agency of Indonesia2023 Grant of The Fondazione Veronesi,Milan,Italy(Caecilia H C Sukowati)2023/2024 Postdoctoral Fellowship of The Manajemen Talenta,Badan Riset dan Inovasi Nasional,Indonesia(Sri Jayanti).
文摘Hepatitis B virus(HBV)infection is a major player in chronic hepatitis B that may lead to the development of hepatocellular carcinoma(HCC).HBV genetics are diverse where it is classified into at least 9 genotypes(A to I)and 1 putative genotype(J),each with specific geographical distribution and possible different clinical outcomes in the patient.This diversity may be associated with the precision medicine for HBV-related HCC and the success of therapeutical approaches against HCC,related to different pathogenicity of the virus and host response.This Editorial discusses recent updates on whether the classification of HBV genetic diversity is still valid in terms of viral oncogenicity to the HCC and its precision medicine,in addition to the recent advances in cellular and molecular biology technologies.
基金This research was self-funded as part of an Education Doctorate at the Institute of Education,University College London.
文摘In Chinese medicine, practitioners assess patients’ complaints, analyze their underlying problems, identify causes and come to a diagnosis, which then directs treatment. What is not obvious and not recorded in a consultation is the clinical reasoning process that practitioners use. The research filmed three practitioners in the UK while they conducted a consultation and treatment on new patients. The practitioners and researchers viewed the films and used them as aide-memoirs while the reasoning process throughout was discussed. In order to determine the pattern, practitioners used the four examinations to gather information from the patient in an iterative process;their aesthetic reasoning was highly developed. Through triangulation they checked the information they received against a detailed understanding of the qi-dynamic. They used highly analytical strategies of forward(inductive) and backward(deductive) reasoning against the prototypes of the signs and symptoms that indicate a specific Zheng. This was achieved through an abductive process that linked description with explanation and causal factors with pathological mechanisms. The feedback loop with the patient continued through the consultation and into the treatment. A process of translation and interpretation was needed to turn the patient’s story into the practitioner’s story of qi-dynamics that then directed the treatment. Awareness of our clinical reasoning process will mitigate against biases, improve our diagnoses and treatment choices and support the training of students.
文摘The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alterations and their functional significance were unveiled in cancer cells,which led to the development of molecular targeted therapies in the 2000s and beyond.Although CGM is still a relatively new discipline and it is difficult to predict to what extent CGM will benefit the diverse pool of cancer patients,the National Cancer Center(NCC)of Japan has already contributed considerably to CGM advancement for the conquest of cancer.Looking back at these past achievements of the NCC,we predict that the future of CGM will involve the following:1)A biobank of paired cancerous and non-cancerous tissues and cells from various cancer types and stages will be developed.The quantity and quality of these samples will be compatible with omics analyses.All biobank samples will be linked to longitudinal clinical information.2)New technologies,such as whole-genome sequencing and artificial intelligence,will be introduced and new bioresources for functional and pharmacologic analyses(e.g.,a patient-derived xenograft library)will be systematically deployed.3)Fast and bidirectional translational research(bench-to-bedside and bedside-to-bench)performed by basic researchers and clinical investigators,preferably working alongside each other at the same institution,will be implemented;4)Close collaborations between academia,industry,regulatory bodies,and funding agencies will be established.5)There will be an investment in the other branch of CGM,personalized preventive medicine,based on the individual's genetic predisposition to cancer.
文摘In this editorial,we comment on the hard and soft tissue applications of different ceramic-based scaffolds prepared by different mechanisms such as 3D printing,sol-gel,and electrospinning.The new concept of regenerative medicine relies on biomaterials that can trigger in situ tissue regeneration and stem cell recruitment at the defect site.A large percentage of these biomaterials is ceramic-based as they provide the essential requirements of biomaterial principles such as tailored multisize porosity,antibacterial properties,and angiogenic properties.All these previously mentioned properties put bioceramics on top of the hierarchy of biomaterials utilized to stimulate tissue regeneration in soft and hard tissue wounds.Multiple clinical applications registered the use of these materials in triggering soft tissue regeneration in healthy and diabetic patients such as bioactive glass nanofibers.The results were promising and opened new frontiers for utilizing these materials on a larger scale.The same results were mentioned when using different forms and formulas of bioceramics in hard defect regeneration.Some bioceramics were used in combination with other polymers and biological scaffolds to improve their regenerative and mechanical properties.All this progress will enable a larger scale of patients to receive such services with ease and decrease the financial burden on the government.
基金supported by the Evidence-based Capacity Building Project of Traditional Chinese medicine of the National Administration of Traditional Chinese Medicine(60102)the Fundamental Research Funds for the Central Public Welfare Research Institutes(49425).
文摘Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.
