Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced mus...Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced muscle damage,chronic pain syndromes,tendinopathies,and muscle atrophy.This review critically evaluates preclinical and clinical evidence for H2 therapy and identifies research gaps.A comprehensive search of PubMed,EMBASE,and Cochrane Library(up to April 2025)yielded 45 eligible studies:25 preclinical and 20 clinical trials.Preclinical models consistently showed reductions in reactive oxygen species,inflammatory cytokines,and improved cell viability.Clinical trials reported symptomatic relief in osteoarthritis,decreased Disease Activity Score 28 in rheumatoid arthritis,and accelerated clearance of muscle damage markers.Delivery methods varied-hydrogen-rich water,gas inhalation,and saline infusion-hindering direct comparison.Mechanistic biomarkers were inconsistently reported,limiting understanding of target engagement.Common limitations included small sample sizes,short durations,and protocol heterogeneity.Despite these constraints,findings suggest H2 may serve as a promising adjunctive therapy via antioxidant,anti-inflammatory,and cytoprotective mechanisms.Future research should prioritize standardized delivery protocols,robust mechanistic endpoints,and longer-term randomized trials to validate clinical efficacy and optimize therapeutic strategies.展开更多
Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsist...Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.展开更多
Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideli...Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.展开更多
Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now en...Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now encompasses large-scale electronic medical records(EMR)and experimental molecular data.Artificial intelligence(AI)has demonstrated its utility in medicine through the development of various expert systems(e.g.,MYCIN)since the 1970s.With the emergence of deep learning and large language models(LLMs),AI’s potential in medicine shows considerable promise.Consequently,the integration of AI and TCM from both clinical and scientific perspectives presents a fundamental and promising research direction.This survey provides an insightful overview of TCM AI research,summarizing related research tasks from three perspectives:systems-level biological mechanism elucidation,real-world clinical evidence inference,and personalized clinical decision support.The review highlights representative AI methodologies alongside their applications in both TCM scientific inquiry and clinical practice.To critically assess the current state of the field,this work identifies major challenges and opportunities that constrain the development of robust research capabilities—particularly in the mechanistic understanding of TCM syndromes and herbal formulations,novel drug discovery,and the delivery of high-quality,patient-centered clinical care.The findings underscore that future advancements in AI-driven TCM research will rely on the development of high-quality,large-scale data repositories;the construction of comprehensive and domain-specific knowledge graphs(KGs);deeper insights into the biological mechanisms underpinning clinical efficacy;rigorous causal inference frameworks;and intelligent,personalized decision support systems.展开更多
Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based supp...Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based support and establish levels of evidence for clinical application.Method:A comprehensive search was conducted to identify systematic reviews on acupuncture and mox-ibustion for the prevention and management of cancer-related conditions,covering databases including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chinese Biomedical Databases,China Science and Technology Journal Database,and Wanfang Data,from their in-ception to August 1,2024.The methodological quality of the included systematic reviews was assessed by using AMSTAR 2,and bubble plots were employed to visualize the evidence.Results:Overall,137 systematic reviews were included,with China being the most prolific country,with 117 reviews.These reviews addressed 21 cancer-related conditions,with the three most frequently stud-ied being cancer-related fatigue(25 reviews),nausea and vomiting(20 reviews),and cancer pain(19 re-views).The three most commonly used acupuncture modalities were manual acupuncture(81 reviews),electroacupuncture(55 reviews),and moxibustion(39 reviews).Quality assessment revealed that one systematic review was rated as“high quality,”eight as“low quality,”and 128 as“critically low quality,”primarily due to the absence of protocol registration and lists of excluded studies.Conclusion:Acupuncture and moxibustion have shown potential efficacy in alleviating cancer-related con-ditions and treatment-related adverse effects,and their clinical use has been widely reported.However,the overall methodological quality of the included systematic reviews was low,limiting the reliability and the strength of the evidence.Future high-quality studies are needed to improve the quality of evidence and support the standardized application and broader promotion of acupuncture and moxibustion clinical practice.展开更多
Background:Numerous systematic reviews and meta-analyses have been published that evaluate the association between periodontal disease and systemic diseases,many of which address similar topics.Moreover,their quality ...Background:Numerous systematic reviews and meta-analyses have been published that evaluate the association between periodontal disease and systemic diseases,many of which address similar topics.Moreover,their quality requires assessment.Therefore,we performed a cross-sectional analysis to examine the evidence on the relationship between periodontal disease and systemic diseases.Methods:The PubMed,Embase,Web of Science,and the Cochrane Library databases were systematically searched to identify relevant systematic reviews and meta-analyses.Only studies that considered periodontal disease as the exposure factor and various systemic diseases as the outcome were included.The basic characteristics and pertinent data from the selected studies were extracted.The modified version of A Measurement Tool to Assess Systematic Reviews 2(AMSTAR 2)was employed for quality assessment,while R software was used for statistical analysis.Results:Among the 212 relevant systematic reviews and meta-analyses,57 were finally included in our analysis.These studies involved 75 diseases and 81 disease-related outcomes,with cancer(19/81)being the most frequently addressed topic.Of the 81 outcomes,67 demonstrated a significant association.Notably,the highest risk estimate was found for head and neck cancer[odds ratio(OR)=3.17,95%confidence interval(CI)1.78-5.64],while the lowest was observed for premature rupture of the amniotic sac[relative risk(RR)=1.10,95%CI 1.08-1.12].The methodological quality ratings indicated that approximately 71.93%of included studies were classified as“Critically low”,with another 17.54%rated as“Low”,and only about 10.53%categorized as“Moderate”.Conclusions:Periodontal disease significantly elevates the risks associated with 15 cancer-related,8 cardiovascular-related,8 metabolic-related,and 5 neurological-related outcomes.However,the overall methodological quality of existing systematic reviews and meta-analyses is generally suboptimal and requires enhancement to generate higher-quality evidence in the future.展开更多
Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a com...Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a comprehensive qualitative synthesis of six studies meeting their inclusion criteria,we believe that additional quantitative analysis would strengthen the evidence base for foot reflexology in managing nausea and vomiting.We conducted a complementary meta-analysis to provide quantitative evidence supporting the qualitative findings presented in the systematic review.展开更多
Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of CO...Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of COPD.Methods:A descriptive nature research method was adopted.An interview outline was formulated based on the theoretical domain framework.From October to December 2024,15 medical staff from the respiratory department of a tertiary hospital in Shaanxi Province were selected for semi-structured interviews.The interview data were analyzed using the Colaizzi 7-step analysis method.Result:The analysis of this study found that the obstructive factors for medical staff to implement respiratory rehabilitation include five theoretical domains.The problems are respectively the lack of knowledge about respiratory rehabilitation and insufficient training intensity,the insufficient self-recognition of implementing respiratory rehabilitation,the low awareness rate of patients and the low cooperation degree,the insufficient provision of instruments and facilities,the lack of rehabilitation training venues and respiratory rehabilitation clinics,and the lack of scientific and standardized respiratory rehabilitation management processes.Conclusion:There are many obstructive factors affecting the implementation of respiratory rehabilitation by medical staff.Clinical managers should take corresponding measures,continuously improve the rehabilitation management strategies for COPD,and promote the clinical application of the best evidence for respiratory rehabilitation.展开更多
The biological species concept defines species as groups of actually or potentially interbreeding natural populations that are reproductively isolated from other such groups(Mayr,1942).Reproductive isolation,whether p...The biological species concept defines species as groups of actually or potentially interbreeding natural populations that are reproductively isolated from other such groups(Mayr,1942).Reproductive isolation,whether prezygotic or postzygotic,plays a central role in maintaining species boundaries.However,hybridization between closely related taxa can challenge these boundaries and provide insight into speciation,gene flow,and evolutionary processes(Coyne and Orr,2004).展开更多
High-quality clinical evidence is the basis of evidence-based medical practice.Acupuncture is the most widely used complementary and alternative medicine in the world.However,the improvement in the quality of acupunct...High-quality clinical evidence is the basis of evidence-based medical practice.Acupuncture is the most widely used complementary and alternative medicine in the world.However,the improvement in the quality of acupuncture clinical research does not match the rapid increase in the number of acupuncture clinical research in recent years.At present,the number of high-quality acupuncture clinical research in the world remains low.Taking the trial of acupuncture for chronic spontaneous urticaria published in Annals of Internal Medicine as an example,this paper discusses the factors that contribute to producing high-quality clinical evidence for acupuncture from the aspects of selecting the topic of study,formulating the study method,designing the study plan,controlling the study process,writing the study report,and selecting the journal in the process of before,during,and after the research.It emphasizes the necessity to start from the benefit of global people's health,take practical clinical problems as guidance,cleverly choose the research entry point,and conduct high-quality research with clinical value.After the accomplishment of the study,the results must be faithfully described,the scientific conclusions accurately sublimated,and appropriate scientific journals selected for publication.展开更多
Complex evidence theory is a generalized Dempster-Shafer evidence theory,which has the ability to express uncertain information.One of the key issues is the uncertainty measure of Complex Basic Belief Assignment(CBBA)...Complex evidence theory is a generalized Dempster-Shafer evidence theory,which has the ability to express uncertain information.One of the key issues is the uncertainty measure of Complex Basic Belief Assignment(CBBA).However,the research on the uncertainty measure of complex evidence theory is still an open issue.Therefore,in this paper,first,the Fractal-based Complex Belief(FCB)entropy as a generalization of Fractal-based Belief(FB)entropy,which has superiority in uncertainty measurement of CBBA,is proposed.Second,on the basis of FCB entropy,we propose Fractal-based Supremum Complex Belief(FSCB)entropy and Fractal-based Infimum Complex Belief(FICB)entropy,with FSCB entropy as the upper bound and FICB entropy as the lower bound.They are collectively called the proposed FCB entropy.Furthermore,we analyze the properties,physical interpretation and numerical examples to prove the rationality of the proposed method.Finally,a practical information fusion application is proposed to prove that the proposed FCB entropy can reasonably measure the uncertainty of CBBA.The results show that,the proposed FCB entropy can handle the uncertainty measure of CBBA,which can be a reasonable way for uncertainty measure in complex evidence theory.展开更多
Gastrointestinal(GI)cancers exact a staggering global toll through high incidence,mortality,and treatment costs,yet clinical research continues to be hampered by inadequate patient stratification,challenging recruitme...Gastrointestinal(GI)cancers exact a staggering global toll through high incidence,mortality,and treatment costs,yet clinical research continues to be hampered by inadequate patient stratification,challenging recruitment,suboptimal adherence,and time-consuming endpoint confirmations.Against this backdrop,artificial intelligence(AI)emerges as a powerful game-changer,offering streamlined trial design,predictive enrollment matching,dynamic endpoint assessment,and realworld data integration.This review synthesizes AI-driven advancements across the GI cancer research continuum.It covers precise patient stratification,automated efficacy evaluations,and remote compliance management.The analysis also addresses persistent challenges in data standardization,privacy protection,and regulatory oversight.We underscore the need for synergistic clinician–AI collaboration,alongside robust frameworks that ensure interpretability and ethical deployment.By illuminating the potential of AI to accelerate trial timelines,refine patient selection,and enhance outcome measurement,we aim to inspire new strategies that can significantly reduce the global burden of GI malignancies.Ultimately,this work provides a blueprint for stakeholders seeking to harness AI’s transformative capabilities,fostering a future in which GI cancer clinical research becomes more agile,personalized,and impactful for patients and healthcare systems alike.展开更多
With the civilization and modernization of human society,occupational health has emerged as a fundamental goal of social justice,as highlighted in the United Nations'Sustainable Development Goals(SDGs)since 2016.S...With the civilization and modernization of human society,occupational health has emerged as a fundamental goal of social justice,as highlighted in the United Nations'Sustainable Development Goals(SDGs)since 2016.Specifically,"SDG Goal 1:No Poverty","SDG 3:Good Health and Well-being",and"SDG 8:Decent Work and Economic Growth",are interconnected with other SDGs to support the pursuit of occupational health.展开更多
Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to ...Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.展开更多
Diabetic Gastroparesis(DGP)is one of the common chronic complications of diabetes mellitus,with main clinical manifestations such as nausea,vomiting,postprandial fullness,and delayed gastric emptying.It seriously affe...Diabetic Gastroparesis(DGP)is one of the common chronic complications of diabetes mellitus,with main clinical manifestations such as nausea,vomiting,postprandial fullness,and delayed gastric emptying.It seriously affects patients’quality of life and nutritional status.This paper systematically sorts out the application evidence of Traditional Chinese Medicine(TCM)nursing in DGP,verifies its effectiveness from three aspects:evidence from ancient literature,modern clinical studies,and results of Meta-analyses.It also elaborates on specific nursing methods including Syndrome Differentiation-Based Nursing,characteristic technical nursing,and health guidance,analyzes the existing problems in current research,and puts forward future development directions,so as to provide a reference for the clinical promotion and standardization of TCM nursing for DGP.展开更多
2025年8月6日,北京大学药学院药事管理与临床药学系管晓东研究员团队与美国耶鲁大学、哈佛大学、英国伦敦政治经济学院的合作研究成果Strength of evidence supporting cancer drug approvals in China, 2017–21:a retrospective analy...2025年8月6日,北京大学药学院药事管理与临床药学系管晓东研究员团队与美国耶鲁大学、哈佛大学、英国伦敦政治经济学院的合作研究成果Strength of evidence supporting cancer drug approvals in China, 2017–21:a retrospective analysis在国际肿瘤学权威期刊《柳叶刀·肿瘤学》(The Lancet Oncology)在线发表。该研究系统评估了2017年至2021年中国获批肿瘤药物的关键临床试验证据质量,是目前首个针对支持中国肿瘤药物监管决策证据强度的实证研究。展开更多
With the full implementation of the Code of Criminal Procedure, the application of the rules of the exclusion of the illegal evidences is more inclined to the protection of the human rights. However, in the process of...With the full implementation of the Code of Criminal Procedure, the application of the rules of the exclusion of the illegal evidences is more inclined to the protection of the human rights. However, in the process of the implementation of the new laws, the problems in view of the rules of the exclusion of the illegal evidences are also prominent, which are mainly reflected in the ambiguity of the scope of the application, the start of the program of the exclusion, and the formalization the trial certificates and other aspects. Therefore, in this article, the author starts from the concept of the illegal evidences, and expounds the principles of the exclusion and the abilities of the evidences, and especially explores the abilities of the evidences and the probative forces. From the differences between the two, the author strictly proves the virtualization of the standards, in order to provide the positive solutions for strengthening the exclusionary procedure of the illegal evidences.展开更多
Aiming at the problem that the traditional Dempster Shafer (D-S) evidence theory cannot deal with conflicted evidences effectively and correctly, this paper points out that the key issue of this problem is to measure ...Aiming at the problem that the traditional Dempster Shafer (D-S) evidence theory cannot deal with conflicted evidences effectively and correctly, this paper points out that the key issue of this problem is to measure the degree of conflict between evidences correctly after analyzing various improved methods. The existing evidence conflict measure methods are analyzed, and a new evidence conflict measure method called evidence similarity measure based on the Tanimoto measure is proposed, while a new evidence combination method is proposed on the basis of evidence similarity measure. Firstly, the conflict degrees between evidences are obtained through the evidence similarity measure. Then the evidence sources are modified based on the credibility of different evidences and the weights of conflicted parts of evidences on different focal elements are determined. Finally, the fusion result is obtained by this method. Numerical examples show that the proposed method can effectively fuse evidences when evidences are consistent or highly conflicted, and it has a fast convergence speed, a high degree of accuracy and good adaptability.展开更多
Based on the framework of evidence theory, data fusion aims at obtaining a single Basic Probability Assignment (BPA) function by combining several belief functions from distinct information sources. Dempster’s rule o...Based on the framework of evidence theory, data fusion aims at obtaining a single Basic Probability Assignment (BPA) function by combining several belief functions from distinct information sources. Dempster’s rule of combination is the most popular rule of combinations, but it is a poor solution for the management of the conflict between various information sources at the normalization step. Even when it faces high conflict information, the classical Dempster-Shafer’s (D-S) evidence theory can involve counter-intuitive results. This paper presents a modified averaging method to combine conflicting evidence based on the distance of evidences; and also gives the weighted average of the evidence in the system. Numerical examples showed that the proposed method can realize the modification ideas and also will provide reasonable results with good convergence efficiency.展开更多
In order to achieve the information fusion in the time domain based on the evidence theory, an evidence combination method in the time domain based on reliability and importance is proposed according to the idea of ev...In order to achieve the information fusion in the time domain based on the evidence theory, an evidence combination method in the time domain based on reliability and importance is proposed according to the idea of evidence discount. Firstly, the distortion of the time-domain evidence is judged based on single exponential smoothing. The real-time reliability of the evidence at the adjacent time is obtained by the real-time reliability assessment method of the evidence based on the credibility decay model.Then, the relative importance of the evidence at the adjacent time is obtained by comprehensively considering improved conflict degree and uncertainty. Finally, based on the criterion of evidence discount and the Dempster’s rule of combination, the evidence combination is carried out to achieve the sequential combination of time-domain evidence. The numerical simulation and analysis show that this method has fully embodied the dynamic characteristics of time-domain evidence combination, and it has strong processing ability for conflict information and anti-disturbing ability.The proposed method has good applicability to information fusion in the time domain.展开更多
文摘Molecular hydrogen(H2)demonstrates selective antioxidant and anti-inflammatory properties with therapeutic potential across musculoskeletal conditions including osteoarthritis,rheumatoid arthritis,exercise-induced muscle damage,chronic pain syndromes,tendinopathies,and muscle atrophy.This review critically evaluates preclinical and clinical evidence for H2 therapy and identifies research gaps.A comprehensive search of PubMed,EMBASE,and Cochrane Library(up to April 2025)yielded 45 eligible studies:25 preclinical and 20 clinical trials.Preclinical models consistently showed reductions in reactive oxygen species,inflammatory cytokines,and improved cell viability.Clinical trials reported symptomatic relief in osteoarthritis,decreased Disease Activity Score 28 in rheumatoid arthritis,and accelerated clearance of muscle damage markers.Delivery methods varied-hydrogen-rich water,gas inhalation,and saline infusion-hindering direct comparison.Mechanistic biomarkers were inconsistently reported,limiting understanding of target engagement.Common limitations included small sample sizes,short durations,and protocol heterogeneity.Despite these constraints,findings suggest H2 may serve as a promising adjunctive therapy via antioxidant,anti-inflammatory,and cytoprotective mechanisms.Future research should prioritize standardized delivery protocols,robust mechanistic endpoints,and longer-term randomized trials to validate clinical efficacy and optimize therapeutic strategies.
基金supported by the China Postdoctoral Science Foundation(Grant No.2021M703366)Shenzhen Science and Technology Program(Grant No.KQTD20190929172835662).
文摘Objective Observational studies have found associations between inflammatory bowel disease(IBD)and the risk of dementia,including Alzheimer’s dementia(AD)and vascular dementia(VD);however,these findings are inconsistent.It remains unclear whether these associations are causal.Methods We conducted a meta-analysis by systematically searching for observational studies on the association between IBD and dementia.Mendelian randomization(MR)analysis based on summary genome-wide association studies(GWASs)was performed.Genetic correlation and Bayesian colocalization analyses were used to provide robust genetic evidence.Results Ten observational studies involving 80,565,688 participants were included in this metaanalysis.IBD was significantly associated with dementia(risk ratio[RR]=1.36,95%CI=1.04-1.78;I2=84.8%)and VD(RR=2.60,95%CI=1.18-5.70;only one study),but not with AD(RR=2.00,95%CI=0.96-4.13;I^(2)=99.8%).MR analyses did not supported significant causal associations of IBD with dementia(dementia:odds ratio[OR]=1.01,95%CI=0.98-1.03;AD:OR=0.98,95%CI=0.95-1.01;VD:OR=1.02,95%CI=0.97-1.07).In addition,genetic correlation and co-localization analyses did not reveal any genetic associations between IBD and dementia.Conclusion Our study did not provide genetic evidence for a causal association between IBD and dementia risk.The increased risk of dementia observed in observational studies may be attributed to unobserved confounding factors or detection bias.
文摘Objective:To summarize evidence on the prevention and management of intradialytic hypotension in maintenance hemodialysis patients,providing reference for clinical practice.Method:Chinese and English databases,guideline websites,and professional society websites were systematically searched for literature on intradialytic hypotension guidance,including clinical decisions,guidelines,evidence summaries,systematic reviews,and expert consensuses,from database inception to October 1,2024.Evidence was extracted after literature quality evaluation.Results:A total of 11 publications were included:2 clinical decisions,7 guidelines,1 systematic review,and 1 expert consensus.38 pieces of evidence were summarized across 4 themes:pre-dialysis assessment and prevention,monitoring and management during dialysis,medication use,and patient self-management.Conclusion:The best evidence for prevention and management of intradialytic hypotension in maintenance hemodialysis patients is scientific and comprehensive.Healthcare professionals are advised to apply this evidence judiciously in conjunction with clinical realities to ensure patient safety.
基金supported by the National Key Research and Development Program (No.2023YFC3502604)the National Natural Science Foundation of China (Nos.U23B2062, 82274352,82174533, 82374302, 82204941)+3 种基金the Noncommunicable Chronic Diseases-National Science and Technology Major Project (No.2023ZD0505700)the Beijing-Tianjin-Hebei Basic Research Cooperation Project (No.22JCZXJC00070)the State Key Laboratory on Technologies for Chinese Medicine Pharmaceutical Process Control and Intelligent Manufacture (No.SKL2024Z0102)Key R&D project of Ningxia Autonomous Region (No.2022BEG02036).
文摘Traditional Chinese medicine(TCM)represents a paradigmatic approach to personalized medicine,developed through the systematic accumulation and refinement of clinical empirical data over more than 2000 years,and now encompasses large-scale electronic medical records(EMR)and experimental molecular data.Artificial intelligence(AI)has demonstrated its utility in medicine through the development of various expert systems(e.g.,MYCIN)since the 1970s.With the emergence of deep learning and large language models(LLMs),AI’s potential in medicine shows considerable promise.Consequently,the integration of AI and TCM from both clinical and scientific perspectives presents a fundamental and promising research direction.This survey provides an insightful overview of TCM AI research,summarizing related research tasks from three perspectives:systems-level biological mechanism elucidation,real-world clinical evidence inference,and personalized clinical decision support.The review highlights representative AI methodologies alongside their applications in both TCM scientific inquiry and clinical practice.To critically assess the current state of the field,this work identifies major challenges and opportunities that constrain the development of robust research capabilities—particularly in the mechanistic understanding of TCM syndromes and herbal formulations,novel drug discovery,and the delivery of high-quality,patient-centered clinical care.The findings underscore that future advancements in AI-driven TCM research will rely on the development of high-quality,large-scale data repositories;the construction of comprehensive and domain-specific knowledge graphs(KGs);deeper insights into the biological mechanisms underpinning clinical efficacy;rigorous causal inference frameworks;and intelligent,personalized decision support systems.
基金Supported by WFAS 2023 International Standard Project of Acupuncture-Moxibustion:WFASRP2023-SC05Tianjin Nankai District Pilot Demonstration Project for Integrated Inheritance and Innovation of Traditional Chinese Medicine:20250102001Beijing Natural Science:7252224。
文摘Objective:In this study,we evaluated the methodological quality of systematic reviews on acupuncture and moxibustion for the prevention and management of cancer-related conditions,aiming to provide evidence-based support and establish levels of evidence for clinical application.Method:A comprehensive search was conducted to identify systematic reviews on acupuncture and mox-ibustion for the prevention and management of cancer-related conditions,covering databases including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chinese Biomedical Databases,China Science and Technology Journal Database,and Wanfang Data,from their in-ception to August 1,2024.The methodological quality of the included systematic reviews was assessed by using AMSTAR 2,and bubble plots were employed to visualize the evidence.Results:Overall,137 systematic reviews were included,with China being the most prolific country,with 117 reviews.These reviews addressed 21 cancer-related conditions,with the three most frequently stud-ied being cancer-related fatigue(25 reviews),nausea and vomiting(20 reviews),and cancer pain(19 re-views).The three most commonly used acupuncture modalities were manual acupuncture(81 reviews),electroacupuncture(55 reviews),and moxibustion(39 reviews).Quality assessment revealed that one systematic review was rated as“high quality,”eight as“low quality,”and 128 as“critically low quality,”primarily due to the absence of protocol registration and lists of excluded studies.Conclusion:Acupuncture and moxibustion have shown potential efficacy in alleviating cancer-related con-ditions and treatment-related adverse effects,and their clinical use has been widely reported.However,the overall methodological quality of the included systematic reviews was low,limiting the reliability and the strength of the evidence.Future high-quality studies are needed to improve the quality of evidence and support the standardized application and broader promotion of acupuncture and moxibustion clinical practice.
基金supported by the Lanzhou Science and Technology Project(2022-3-8)the Natural Science Foundation of Chongqing(CSTB2024NSCQMSX0043 and cstc2020jcyj-msxmX0079)the Key Scientific Research Project of Education Department of Henan Province(22A320038).
文摘Background:Numerous systematic reviews and meta-analyses have been published that evaluate the association between periodontal disease and systemic diseases,many of which address similar topics.Moreover,their quality requires assessment.Therefore,we performed a cross-sectional analysis to examine the evidence on the relationship between periodontal disease and systemic diseases.Methods:The PubMed,Embase,Web of Science,and the Cochrane Library databases were systematically searched to identify relevant systematic reviews and meta-analyses.Only studies that considered periodontal disease as the exposure factor and various systemic diseases as the outcome were included.The basic characteristics and pertinent data from the selected studies were extracted.The modified version of A Measurement Tool to Assess Systematic Reviews 2(AMSTAR 2)was employed for quality assessment,while R software was used for statistical analysis.Results:Among the 212 relevant systematic reviews and meta-analyses,57 were finally included in our analysis.These studies involved 75 diseases and 81 disease-related outcomes,with cancer(19/81)being the most frequently addressed topic.Of the 81 outcomes,67 demonstrated a significant association.Notably,the highest risk estimate was found for head and neck cancer[odds ratio(OR)=3.17,95%confidence interval(CI)1.78-5.64],while the lowest was observed for premature rupture of the amniotic sac[relative risk(RR)=1.10,95%CI 1.08-1.12].The methodological quality ratings indicated that approximately 71.93%of included studies were classified as“Critically low”,with another 17.54%rated as“Low”,and only about 10.53%categorized as“Moderate”.Conclusions:Periodontal disease significantly elevates the risks associated with 15 cancer-related,8 cardiovascular-related,8 metabolic-related,and 5 neurological-related outcomes.However,the overall methodological quality of existing systematic reviews and meta-analyses is generally suboptimal and requires enhancement to generate higher-quality evidence in the future.
文摘Dear Editor,We read with a great interest the recently published systematic review by Shamsikhani and Hosseini titled,“Foot reflexology on nausea and vomiting:A systematic review.”[1]While the authors provided a comprehensive qualitative synthesis of six studies meeting their inclusion criteria,we believe that additional quantitative analysis would strengthen the evidence base for foot reflexology in managing nausea and vomiting.We conducted a complementary meta-analysis to provide quantitative evidence supporting the qualitative findings presented in the systematic review.
基金Shaanxi Provincial People’s Hospital Science and Technology Development Incubation Fund Program 2023(Project No.:2023HL-12)。
文摘Objective:To explore the obstructive factors in the behavior of medical staff during the implementation of respiratory rehabilitation process,and to provide a basis for the rehabilitation management intervention of COPD.Methods:A descriptive nature research method was adopted.An interview outline was formulated based on the theoretical domain framework.From October to December 2024,15 medical staff from the respiratory department of a tertiary hospital in Shaanxi Province were selected for semi-structured interviews.The interview data were analyzed using the Colaizzi 7-step analysis method.Result:The analysis of this study found that the obstructive factors for medical staff to implement respiratory rehabilitation include five theoretical domains.The problems are respectively the lack of knowledge about respiratory rehabilitation and insufficient training intensity,the insufficient self-recognition of implementing respiratory rehabilitation,the low awareness rate of patients and the low cooperation degree,the insufficient provision of instruments and facilities,the lack of rehabilitation training venues and respiratory rehabilitation clinics,and the lack of scientific and standardized respiratory rehabilitation management processes.Conclusion:There are many obstructive factors affecting the implementation of respiratory rehabilitation by medical staff.Clinical managers should take corresponding measures,continuously improve the rehabilitation management strategies for COPD,and promote the clinical application of the best evidence for respiratory rehabilitation.
基金supported by the National Natural Science Foundation of China(No.32161143024,31970405)Iran National Science Foundation,Iran-China(INSF-NSFC)joint project(No.4002006).
文摘The biological species concept defines species as groups of actually or potentially interbreeding natural populations that are reproductively isolated from other such groups(Mayr,1942).Reproductive isolation,whether prezygotic or postzygotic,plays a central role in maintaining species boundaries.However,hybridization between closely related taxa can challenge these boundaries and provide insight into speciation,gene flow,and evolutionary processes(Coyne and Orr,2004).
基金Supported by Sichuan Province science and technology education joint fund project:2024NSFSC1976Science and Technology Research Project of Sichuan Ad-ministration of Traditional Chinese Medicine:2021MS320.
文摘High-quality clinical evidence is the basis of evidence-based medical practice.Acupuncture is the most widely used complementary and alternative medicine in the world.However,the improvement in the quality of acupuncture clinical research does not match the rapid increase in the number of acupuncture clinical research in recent years.At present,the number of high-quality acupuncture clinical research in the world remains low.Taking the trial of acupuncture for chronic spontaneous urticaria published in Annals of Internal Medicine as an example,this paper discusses the factors that contribute to producing high-quality clinical evidence for acupuncture from the aspects of selecting the topic of study,formulating the study method,designing the study plan,controlling the study process,writing the study report,and selecting the journal in the process of before,during,and after the research.It emphasizes the necessity to start from the benefit of global people's health,take practical clinical problems as guidance,cleverly choose the research entry point,and conduct high-quality research with clinical value.After the accomplishment of the study,the results must be faithfully described,the scientific conclusions accurately sublimated,and appropriate scientific journals selected for publication.
基金supported by the National Natural Science Foundation of China (No. 62473067)Chongqing Talents: Exceptional Young Talents Project, China (No. cstc2022ycjh-bgzxm0070)Chongqing Overseas Scholars Innovation Program, China (No. cx2022024)
文摘Complex evidence theory is a generalized Dempster-Shafer evidence theory,which has the ability to express uncertain information.One of the key issues is the uncertainty measure of Complex Basic Belief Assignment(CBBA).However,the research on the uncertainty measure of complex evidence theory is still an open issue.Therefore,in this paper,first,the Fractal-based Complex Belief(FCB)entropy as a generalization of Fractal-based Belief(FB)entropy,which has superiority in uncertainty measurement of CBBA,is proposed.Second,on the basis of FCB entropy,we propose Fractal-based Supremum Complex Belief(FSCB)entropy and Fractal-based Infimum Complex Belief(FICB)entropy,with FSCB entropy as the upper bound and FICB entropy as the lower bound.They are collectively called the proposed FCB entropy.Furthermore,we analyze the properties,physical interpretation and numerical examples to prove the rationality of the proposed method.Finally,a practical information fusion application is proposed to prove that the proposed FCB entropy can reasonably measure the uncertainty of CBBA.The results show that,the proposed FCB entropy can handle the uncertainty measure of CBBA,which can be a reasonable way for uncertainty measure in complex evidence theory.
文摘Gastrointestinal(GI)cancers exact a staggering global toll through high incidence,mortality,and treatment costs,yet clinical research continues to be hampered by inadequate patient stratification,challenging recruitment,suboptimal adherence,and time-consuming endpoint confirmations.Against this backdrop,artificial intelligence(AI)emerges as a powerful game-changer,offering streamlined trial design,predictive enrollment matching,dynamic endpoint assessment,and realworld data integration.This review synthesizes AI-driven advancements across the GI cancer research continuum.It covers precise patient stratification,automated efficacy evaluations,and remote compliance management.The analysis also addresses persistent challenges in data standardization,privacy protection,and regulatory oversight.We underscore the need for synergistic clinician–AI collaboration,alongside robust frameworks that ensure interpretability and ethical deployment.By illuminating the potential of AI to accelerate trial timelines,refine patient selection,and enhance outcome measurement,we aim to inspire new strategies that can significantly reduce the global burden of GI malignancies.Ultimately,this work provides a blueprint for stakeholders seeking to harness AI’s transformative capabilities,fostering a future in which GI cancer clinical research becomes more agile,personalized,and impactful for patients and healthcare systems alike.
文摘With the civilization and modernization of human society,occupational health has emerged as a fundamental goal of social justice,as highlighted in the United Nations'Sustainable Development Goals(SDGs)since 2016.Specifically,"SDG Goal 1:No Poverty","SDG 3:Good Health and Well-being",and"SDG 8:Decent Work and Economic Growth",are interconnected with other SDGs to support the pursuit of occupational health.
文摘Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.
文摘Diabetic Gastroparesis(DGP)is one of the common chronic complications of diabetes mellitus,with main clinical manifestations such as nausea,vomiting,postprandial fullness,and delayed gastric emptying.It seriously affects patients’quality of life and nutritional status.This paper systematically sorts out the application evidence of Traditional Chinese Medicine(TCM)nursing in DGP,verifies its effectiveness from three aspects:evidence from ancient literature,modern clinical studies,and results of Meta-analyses.It also elaborates on specific nursing methods including Syndrome Differentiation-Based Nursing,characteristic technical nursing,and health guidance,analyzes the existing problems in current research,and puts forward future development directions,so as to provide a reference for the clinical promotion and standardization of TCM nursing for DGP.
文摘2025年8月6日,北京大学药学院药事管理与临床药学系管晓东研究员团队与美国耶鲁大学、哈佛大学、英国伦敦政治经济学院的合作研究成果Strength of evidence supporting cancer drug approvals in China, 2017–21:a retrospective analysis在国际肿瘤学权威期刊《柳叶刀·肿瘤学》(The Lancet Oncology)在线发表。该研究系统评估了2017年至2021年中国获批肿瘤药物的关键临床试验证据质量,是目前首个针对支持中国肿瘤药物监管决策证据强度的实证研究。
文摘With the full implementation of the Code of Criminal Procedure, the application of the rules of the exclusion of the illegal evidences is more inclined to the protection of the human rights. However, in the process of the implementation of the new laws, the problems in view of the rules of the exclusion of the illegal evidences are also prominent, which are mainly reflected in the ambiguity of the scope of the application, the start of the program of the exclusion, and the formalization the trial certificates and other aspects. Therefore, in this article, the author starts from the concept of the illegal evidences, and expounds the principles of the exclusion and the abilities of the evidences, and especially explores the abilities of the evidences and the probative forces. From the differences between the two, the author strictly proves the virtualization of the standards, in order to provide the positive solutions for strengthening the exclusionary procedure of the illegal evidences.
基金supported by the National Natural Science Foundation of China(61573283)
文摘Aiming at the problem that the traditional Dempster Shafer (D-S) evidence theory cannot deal with conflicted evidences effectively and correctly, this paper points out that the key issue of this problem is to measure the degree of conflict between evidences correctly after analyzing various improved methods. The existing evidence conflict measure methods are analyzed, and a new evidence conflict measure method called evidence similarity measure based on the Tanimoto measure is proposed, while a new evidence combination method is proposed on the basis of evidence similarity measure. Firstly, the conflict degrees between evidences are obtained through the evidence similarity measure. Then the evidence sources are modified based on the credibility of different evidences and the weights of conflicted parts of evidences on different focal elements are determined. Finally, the fusion result is obtained by this method. Numerical examples show that the proposed method can effectively fuse evidences when evidences are consistent or highly conflicted, and it has a fast convergence speed, a high degree of accuracy and good adaptability.
基金Project (No. 51476040103JW13) supported by the National DefenseKey Laboratory of Target and Environment Feature of China
文摘Based on the framework of evidence theory, data fusion aims at obtaining a single Basic Probability Assignment (BPA) function by combining several belief functions from distinct information sources. Dempster’s rule of combination is the most popular rule of combinations, but it is a poor solution for the management of the conflict between various information sources at the normalization step. Even when it faces high conflict information, the classical Dempster-Shafer’s (D-S) evidence theory can involve counter-intuitive results. This paper presents a modified averaging method to combine conflicting evidence based on the distance of evidences; and also gives the weighted average of the evidence in the system. Numerical examples showed that the proposed method can realize the modification ideas and also will provide reasonable results with good convergence efficiency.
基金supported by the National Natural Science Foundation of China(71571190 71601183+1 种基金 L1534031)the Shanxi Province Natural Science Foundation of China(2014JQ2-7045)
文摘In order to achieve the information fusion in the time domain based on the evidence theory, an evidence combination method in the time domain based on reliability and importance is proposed according to the idea of evidence discount. Firstly, the distortion of the time-domain evidence is judged based on single exponential smoothing. The real-time reliability of the evidence at the adjacent time is obtained by the real-time reliability assessment method of the evidence based on the credibility decay model.Then, the relative importance of the evidence at the adjacent time is obtained by comprehensively considering improved conflict degree and uncertainty. Finally, based on the criterion of evidence discount and the Dempster’s rule of combination, the evidence combination is carried out to achieve the sequential combination of time-domain evidence. The numerical simulation and analysis show that this method has fully embodied the dynamic characteristics of time-domain evidence combination, and it has strong processing ability for conflict information and anti-disturbing ability.The proposed method has good applicability to information fusion in the time domain.
