Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the esse...Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the essential components in quality assurance and improvement processes.One of the most necessary steps in this process to improve pain management is to analyze the existing situation.This study aimed to determine the compliance of critical care unit(CCU)nurses’care performance in angina management with evidence-based guidelines(EBGs).Methods:In this observational cross-sectional study,69 nurses working in the CCU departments of public hospitals in Bushehr province participated using the full number method,and their performance was observed 207 times.The data collection tool in this study included a demographic profile form and a 29-item checklist of nurses’performance in angina management.The performance of each nurse was evaluated three times in three different shifts.Descriptive and analytical independent t-tests and Spearman and Pearson correlation were used to analyze the data.SPSS 19 software was used to perform statistical tests.The significance level was considered to be<0.05 in all cases.Results:The findings showed that 85.5%of the participants were female and 14.5%were male,with an average age of 33.87±7.14 years.The average score for performing care functions according to the evidence-based pain management guidelines was 71.42±19.31.The highest(73.60±19.45)and lowest(63.51±28.27)average scores were related to the investigation and evaluation area,respectively.The results showed a significant negative correlation between age and care performance(p<0.03;r=−0.265).Conclusions:The results of this study showed that the average performance score of nurses in angina management based on the guidelines was higher than average.Considering that some items had little compliance,the health system planners are recommended to put the annual training methods to obtain and use the latest guidelines for pain management,especially angina,in the education program of nurses.展开更多
AIM: To study statements and recommendations on psychosocial issues as presented in international evidence-based guidelines on the management of inflammatory bowel diseases (IBD).
The important contributions of urban trees and green spaces to for example,climate moderation and public health have been recognized.This paper discusses guidelines and norms that promote the benefi ts of viewing gree...The important contributions of urban trees and green spaces to for example,climate moderation and public health have been recognized.This paper discusses guidelines and norms that promote the benefi ts of viewing green,living amongst green,and having easy access to green spaces for recreational use.Having trees and other vegetation in sight from one’s home,place of work,or school has important mental health and performance benefi ts.Local tree canopy cover is positively associated with cooling and other aspects of climate moderation.With public green spaces in proximity to one’s home stimulates regular use of these areas and results in positive impacts on mental,physical,and social health.After analyzing existing guidelines and rules for urban green space planning and provision,a new,comprehensive guideline is presented,known as the‘3–30–300 rule’for urban forestry.This guideline aims to provide equitable access to trees and green spaces and their benefi ts by setting the thresholds of having at least 3 well-established trees in view from every home,school,and place of work,no less than a 30%tree canopy in every neighbourhood;and no more than 300 m to the nearest public green space from every residence.Current implementation of this new guideline is discussed,as well as the advantages and disadvantages of using this evidence-based but also clear and simple rules.展开更多
Design: Cross-sectional. Objective: Aim 1 was to preliminarily explore the contributions of the following factors to adherence to LBP practice guidelines using regression modeling: 1) the credential qualification of M...Design: Cross-sectional. Objective: Aim 1 was to preliminarily explore the contributions of the following factors to adherence to LBP practice guidelines using regression modeling: 1) the credential qualification of Mechanical Diagnosis and Therapy (MDT);2) balance of biomedical and behavioral (i.e. biopsychosocial) oriented approach for low back pain (LBP);3) demographics;4) academic degree and 5) the attitude towards updating information for evidence-based clinical practice. Aim 2 was to investigate whether therapists credentialed in MDT (Cred.MDT) were more behavioral oriented and less biomedical oriented than general physical therapists. Summary of Background Data: LBP practice guidelines are not adhered to by every physical therapist. MDT is a behavioral modification approach. Thus, it was hypothesized that the Cred.MDT therapist was more behavioral oriented and more adherent to LBP practice guidelines compared with general physical therapists. Methods: One-hundred-twenty Cred.MDT therapists and 2000 general physical therapists in Japan were contacted. For regression modeling, the dependent variable was adherent to guidelines using a questionnaire with a vignette. Independent variables included balance of biomedical and behavioral perspectives for LBP using the Pain Attitudes and Beliefs Scale for Physiotherapist (PABS-PT), demographics, academic degree and the attitude towards updatinginformation for evidence-based clinical practice. The ratio of the two mean scores of the biomedical and behavioral subscales in the PABS-PT was compared between the Cred.MDT therapist group and the general physical therapists group. Results: Data of 46 general physical therapists and 44 Cred.MDT therapists were available. The Cred.MDT therapist group was significantly (P < 0.05) more behavioral oriented and more adherent to LBP practice guidelines compared with the general physical therapist group. The regression indicated significance of the two predictors of adherence to guidelines, Cred.MDT (β = 0.58, P < 0.001) and academic degree (β = 0.19, P = 0.03). Conclusions: Cred.MDT therapists are more guideline-consistent and have a more biopsychosocial treatment orientation than general physical therapists in Japan.展开更多
Thrombosis disease since the majority of doctors who agree to be harmful,increasing emphasis on the applica- tion of antithrombotic drugs．However,the organization always treatment,the dose of medication and treatment...Thrombosis disease since the majority of doctors who agree to be harmful,increasing emphasis on the applica- tion of antithrombotic drugs．However,the organization always treatment,the dose of medication and treatment method based only on the efficacy of clinical展开更多
Allergic rhinitis(AR)is a prevalent chronic inflammatory disorder that significantly impairs quality of life worldwide.In 2024,the World Federation of Chinese Medicine Societies(WFCMS)released the International Clinic...Allergic rhinitis(AR)is a prevalent chronic inflammatory disorder that significantly impairs quality of life worldwide.In 2024,the World Federation of Chinese Medicine Societies(WFCMS)released the International Clinical Practice Guidelines of Chinese Medicine:Allergic Rhinitis(SCM 80-2024),the first globally standardized evidence-based clinical practice guidelines for comprehensive TCM management of AR.Developed through a transparent,prospectively registered process on the PREPARE platform(Registration No.2023CN081),the guidelines synthesized data from 351 randomized controlled trials involving 43,276 patients and applied the GRADE-TCM framework,which integrates four categories of TCM-specific evidence.32 rec-ommendations were established through five rounds of Delphi consensus,covering four major TCM syndromes and both internal and external therapeutic interventions.This article presents the English interpretation of the guidelines.Beyond summarizing the core recommen-dations,it focuses on the methodological innovations underpinning the guidelines,the epistemological dis-tinctions between Chinese and Western medical paradigms,and the regulatory and practical challenges associated with its implementation in predominantly Western healthcare contexts.展开更多
Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was ...Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was conducted with 190 clinical nurses recruited from an oncology hospital in Central Vietnam.The self-administered Evidence-Based Practice Questionnaire(EBPQ)was employed to assess the nurses'knowledge/skills,attitudes,and implementation of EBP.Data analysis utilized descriptive statistics,the Mann-Whitney test,the Kruskal-Wallis test,and Spearman's rho correlation.Results:The mean total score for EBP implementation among the nurses was 29.52(SD=7.14)out of 42 scores.The most frequently undertaken activity was sharing evidence with colleagues,whereas finding relevant evidence was the least performed.The level of EBP implementation significantly varied based on the nurses'role types and their participation in related courses(P<0.05).Moreover,a strong positive correlation was observed between EBP implementation and both knowledge/skills(r=0.703,P<0.001)and attitudes toward EBP(r=0.536,P<0.001).Conclusions:The implementation of EBP by oncology nurses is generally moderate and is significantly positively correlated with their knowledge/skills and attitudes toward EBP.These findings underscore the importance of enhancing educational programs and facilitating suppor tive institutional policies to fur ther encourage the adoption of EBP among nurses.展开更多
With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative...With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.展开更多
Objective:To explore the application effect of evidence-based nursing in the postoperative care of patients with ureteral calculi undergoing holmium laser lithotripsy,analyze its impact on the incidence of postoperati...Objective:To explore the application effect of evidence-based nursing in the postoperative care of patients with ureteral calculi undergoing holmium laser lithotripsy,analyze its impact on the incidence of postoperative complications,the degree of stress response,and nursing satisfaction,and provide evidence-based support for optimizing clinical nursing practices.Methods:A total of 100 patients with ureteral calculi who underwent holmium laser lithotripsy in our hospital from January 2023 to June 2025 were selected and divided into an observation group(50 cases)and a control group(50 cases)using a random number table method.The control group received routine nursing interventions,while the observation group adopted an evidence-based nursing model.The incidence of postoperative complications(hematuria,urinary tract infection,renal colic,ureteral stricture),stress response indicators(heart rate,systolic blood pressure,diastolic blood pressure,Self-Rating Anxiety Scale(SAS)score,Self-Rating Depression Scale(SDS)score)before surgery and 24 hours after surgery,and nursing satisfaction were compared between the two groups.Results:The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(p<0.05).At 24 hours after surgery,the heart rate,systolic blood pressure,diastolic blood pressure,SAS score,and SDS score in the observation group were significantly lower than those in the control group(all p<0.01).Nursing satisfaction in the observation group was significantly higher than that in the control group(p<0.01).Conclusion:Evidence-based nursing can effectively reduce the incidence of postoperative complications in patients with ureteral calculi undergoing holmium laser lithotripsy,alleviate patients’stress responses,and improve nursing satisfaction,demonstrating significant clinical application value.展开更多
Objective: To develop an evidence-based plan for cleaning operating room and evaluate the impact on high-frequency contact surfaces. Method: The evidence application model of the JBI Evidence-Based Nursing Center was ...Objective: To develop an evidence-based plan for cleaning operating room and evaluate the impact on high-frequency contact surfaces. Method: The evidence application model of the JBI Evidence-Based Nursing Center was utilized to create a strategy, which was implemented in a tertiary-level hospital in Yunnan Province. The adenosine triphosphate (ATP) biological biofluorescence detection method was used to assess the quality of cleaning before and after the intervention. Results: A total of 17 quality review indicators were established in this study. Following the application of evidence, the implementation rate for 16 quality review indicators increased significantly, from a range of 0-65.8% to 81.5-100%. Moreover, the pass rate of ATP bioluminescence detection on high-frequency contact surfaces increased from 14.07% to 47.19%, with significant difference (p < 0.05). Conclusion: The evidence-based environmental cleaning program proved to enhance the overall cleanliness of operating room and reduce the risk of surgical infections. This strategy holds promise for effective cleaning of operating room.展开更多
Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before...Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.展开更多
The rapid progress of human organoid toolkits presents unprecedented opportunities in disease modeling,drug discovery,and personalized therapy,alongside profound bioethical challenges and concerns.On April 29th,2025,C...The rapid progress of human organoid toolkits presents unprecedented opportunities in disease modeling,drug discovery,and personalized therapy,alongside profound bioethical challenges and concerns.On April 29th,2025,China’s National Science and Technology Ethics Committee(Life Science Ethics Subcommittee)issued the Human Organoid Research Ethical Guidelines[1],establishing the world’s first comprehensive governance framework,especially focusing on brain organoids,embryo models,and chimeric research.This Guidelines represent a pioneering governance model in emerging biotechnology.This commentary offers an in-depth analysis to examine the policy’s innovative three-tiered structure,contrast it with current global regulatory standards,evaluate its domestic impacts as well as potential implications for international biotechnology governance,and provide recommendations for future directions.展开更多
This study evaluated the accuracy,completeness,and comprehensibility of responses from mainstream large language models(LLMs)to hepatitis C virus(HCV)-related questions,aiming to assess their performance in addressing...This study evaluated the accuracy,completeness,and comprehensibility of responses from mainstream large language models(LLMs)to hepatitis C virus(HCV)-related questions,aiming to assess their performance in addressing patient queries about disease and lifestyle behaviors.The models selected were ChatGPT-4o,Gemini 2.0 Pro,Claude 3.5 Sonnet,and DeepSeek V3,with 12 questions chosen by two HCV experts from the domains of prevention,diagnosis,and treatment.展开更多
The aim of this study was to establish clinical practice guidelines for acupuncture-moxibustion by retrieving relevant literature and adopting the best current national and international evidence, according to experts...The aim of this study was to establish clinical practice guidelines for acupuncture-moxibustion by retrieving relevant literature and adopting the best current national and international evidence, according to experts＇ experience and patients＇ values. This was achieved using the Grade of Recommendations Assessment, Development and Evaluation（GRADE） system combined with a wide range of national experts＇ consensus, in order to provide reliable evidence for acupuncture-moxibustion treatment of scapulohumeral periarthritis, and to ensure the safety and effectiveness of the treatment.展开更多
Objective: To assess the quality of the first batch of Chinese evidence-based clinical practice guidelines (CPGs) in Traditional Chinese Medicine (TCM) using the Appraisal of Guidelines for Research and Evaluation (AG...Objective: To assess the quality of the first batch of Chinese evidence-based clinical practice guidelines (CPGs) in Traditional Chinese Medicine (TCM) using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Methods: Evidence-based CPGs in TCM supported by the World Health Organization Western Pacific Regional Office (WHO/WPRO) and whose development was organized by the China Academy of Chinese Medical Sciences were identified and manually retrieved. CPGs were assessed using the AGREE instrument, and the data in each CPG were analyzed in terms of the six domains in the AGREE instrument: scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, applicability, and editorial independence. Results: Twenty-eight CPGs were identified, of which 26 were included in the study. The AGREE instrument rated the 26 CPGs in terms of the six domains. The assessment results showed the following average scores: for editorial independence, 84.16%; for rigor of development, 80.95%; for scope and purpose, 79.96%; for clarity and presentation, 70.88%; for stakeholder involvement, 61.28%; for applicability, the average score was only 27.09%. In summary, nine CPGs were rated as "strongly recommended", six as "recommended with provision or alternation", and 11 as "unsure". Conclusion: Most of the first batch of Chinese evidence-based CPGs in TCM had significant shortcomings in applicability. It is suggested that special attention be paid to enhancing the quality of applicability when developing evidence-based CPGs in TCM.展开更多
Semantic representation of evidence-based medical guidelines provides the support for the data inter-operability and has been found many applications in the medical domain. In this paper, we describe a semantic repres...Semantic representation of evidence-based medical guidelines provides the support for the data inter-operability and has been found many applications in the medical domain. In this paper, we describe a semantic representation approach of evidence-based medical guidelines, which is based on the Semantic Web Technology standards. We discuss several use cases of that semantic representation of evidence-based medical guideline, and show that they are potentially useful for medical applications.展开更多
Current guidelines for managing ulcer bleeding state that patients with major stigmata should be managed by dual endoscopic therapy(injection with epinephrine plus a thermal or mechanical modality) followed by a high ...Current guidelines for managing ulcer bleeding state that patients with major stigmata should be managed by dual endoscopic therapy(injection with epinephrine plus a thermal or mechanical modality) followed by a high dose intravenous infusion of proton pump inhibitors(PPIs).This paper aims to review and critically evaluate evidence supporting the purported superiority of a continuous infusion over less intensive regimens of PPIs administration and the need for adding a second hemostatic endoscopic procedure to epinephrine injection.Systematic searches of PubMed,EMBASE and the Cochrane library were performed.There is strong evidence for an incremental benefit of PPIs over H2receptor antagonists or placebo for the outcome of patients with peptic ulcer bleeding following endoscopic hemostasis.However,the benefit of PPIs is unrelated to either the dosage(intensive vs standard regimen) or the route of administration(intravenous vs oral).There is significant heterogeneity among the 15 studies that compared epinephrine with epinephrine plus a second modality,which might preclude the validity of reported summary estimates.Studies without second look endoscopy plus re-treatment of re-bleeding lesions showed a signif icant benef it of adding a second endoscopic modality for hemostasis,while studies with second-look and re-treatment showed equal efficacy between endoscopic mono and dual therapy.Inconclusive experimental evidence supports the current recommendation of the use of dual endoscopic hemostatic means and infusion of high-dose PPIs as standard therapy for patients with bleeding peptic ulcers.Presently,the combination of epinephrine monotherapy with standard doses of PPIs constitutes an appropriate treatment for the majority of patients.展开更多
Lumbar disc herniation with radiculopathy refers to a localized displacement of disc material beyond the normal margins of the intervertebral disc space resulting in pain,weakness or numbness in a myotomal or dermatom...Lumbar disc herniation with radiculopathy refers to a localized displacement of disc material beyond the normal margins of the intervertebral disc space resulting in pain,weakness or numbness in a myotomal or dermatomal distribution.North American Spine Society(NASS)released a new version of clinical guidelines for diagnosis and treatment of lumbar disc herniation with radiculopathy.For providing the best and effective diagnosis and treatment plan,this guidelines use a systematic review of literature and evidence-based medical evidence analysis to identify different recommended intensities,focus on the common problems of diagnosis and treatment.This article gives a brief explanation of guidelines with the clinical practice in China,so as to provide a reference for clinicians and researchers.展开更多
Knee osteoarthritis(KOA)is the highest incidence of osteoarthritis,which seriously affects the quality of life of patients.In order to update the understanding of the disease,clear diagnostic criteria and appropriate ...Knee osteoarthritis(KOA)is the highest incidence of osteoarthritis,which seriously affects the quality of life of patients.In order to update the understanding of the disease,clear diagnostic criteria and appropriate treatment were proposed.In 2018 and 2019,the European Society for Clinical and Economic Aspects of Osteoporosis,Osteoarthritis and Musculoskeletal Diseases(ESCEO),the Association of the Scientific Medical Societies in Germany(AWMF)and Brazil successively formulated guidelines for knee osteoarthritis,which determined different guidance suggestions through systematic evaluation of a large number of literatures and evidence-based medical evidence analysis.This paper compares and interprets the guidelines,and discusses them according to the actual situation of our country for the reference of clinicians.展开更多
Isthmic spondylolisthesis in adults is a common clinical disease that causes lower back pain. In order to provide the best and effective diagnosis and treatment plan, in 2014, the North American Spine Association (NAS...Isthmic spondylolisthesis in adults is a common clinical disease that causes lower back pain. In order to provide the best and effective diagnosis and treatment plan, in 2014, the North American Spine Association (NASS) formulated the guidelines for the diagnosis and treatment of isthmic spondylolisthesis in adult (hereinafter referred to as the guideline). Through the systematic review of literature, evidence-based medical evidence analysis was conducted to identify different recommended intensities, to discuss the clinical diagnosis and treatment plan mainly from two aspects of diagnosis and treatment. This article gives a brief explanation of the guidelines and discusses them in combination with the clinical practice in China, so as to provide a reference for clinicians.展开更多
文摘Objective:Pain management is an integral part of nursing practice.In this respect,angina management can be a serious clinical problem for nurses.The evaluation of pain management based on guidelines is one of the essential components in quality assurance and improvement processes.One of the most necessary steps in this process to improve pain management is to analyze the existing situation.This study aimed to determine the compliance of critical care unit(CCU)nurses’care performance in angina management with evidence-based guidelines(EBGs).Methods:In this observational cross-sectional study,69 nurses working in the CCU departments of public hospitals in Bushehr province participated using the full number method,and their performance was observed 207 times.The data collection tool in this study included a demographic profile form and a 29-item checklist of nurses’performance in angina management.The performance of each nurse was evaluated three times in three different shifts.Descriptive and analytical independent t-tests and Spearman and Pearson correlation were used to analyze the data.SPSS 19 software was used to perform statistical tests.The significance level was considered to be<0.05 in all cases.Results:The findings showed that 85.5%of the participants were female and 14.5%were male,with an average age of 33.87±7.14 years.The average score for performing care functions according to the evidence-based pain management guidelines was 71.42±19.31.The highest(73.60±19.45)and lowest(63.51±28.27)average scores were related to the investigation and evaluation area,respectively.The results showed a significant negative correlation between age and care performance(p<0.03;r=−0.265).Conclusions:The results of this study showed that the average performance score of nurses in angina management based on the guidelines was higher than average.Considering that some items had little compliance,the health system planners are recommended to put the annual training methods to obtain and use the latest guidelines for pain management,especially angina,in the education program of nurses.
文摘AIM: To study statements and recommendations on psychosocial issues as presented in international evidence-based guidelines on the management of inflammatory bowel diseases (IBD).
文摘The important contributions of urban trees and green spaces to for example,climate moderation and public health have been recognized.This paper discusses guidelines and norms that promote the benefi ts of viewing green,living amongst green,and having easy access to green spaces for recreational use.Having trees and other vegetation in sight from one’s home,place of work,or school has important mental health and performance benefi ts.Local tree canopy cover is positively associated with cooling and other aspects of climate moderation.With public green spaces in proximity to one’s home stimulates regular use of these areas and results in positive impacts on mental,physical,and social health.After analyzing existing guidelines and rules for urban green space planning and provision,a new,comprehensive guideline is presented,known as the‘3–30–300 rule’for urban forestry.This guideline aims to provide equitable access to trees and green spaces and their benefi ts by setting the thresholds of having at least 3 well-established trees in view from every home,school,and place of work,no less than a 30%tree canopy in every neighbourhood;and no more than 300 m to the nearest public green space from every residence.Current implementation of this new guideline is discussed,as well as the advantages and disadvantages of using this evidence-based but also clear and simple rules.
文摘Design: Cross-sectional. Objective: Aim 1 was to preliminarily explore the contributions of the following factors to adherence to LBP practice guidelines using regression modeling: 1) the credential qualification of Mechanical Diagnosis and Therapy (MDT);2) balance of biomedical and behavioral (i.e. biopsychosocial) oriented approach for low back pain (LBP);3) demographics;4) academic degree and 5) the attitude towards updating information for evidence-based clinical practice. Aim 2 was to investigate whether therapists credentialed in MDT (Cred.MDT) were more behavioral oriented and less biomedical oriented than general physical therapists. Summary of Background Data: LBP practice guidelines are not adhered to by every physical therapist. MDT is a behavioral modification approach. Thus, it was hypothesized that the Cred.MDT therapist was more behavioral oriented and more adherent to LBP practice guidelines compared with general physical therapists. Methods: One-hundred-twenty Cred.MDT therapists and 2000 general physical therapists in Japan were contacted. For regression modeling, the dependent variable was adherent to guidelines using a questionnaire with a vignette. Independent variables included balance of biomedical and behavioral perspectives for LBP using the Pain Attitudes and Beliefs Scale for Physiotherapist (PABS-PT), demographics, academic degree and the attitude towards updatinginformation for evidence-based clinical practice. The ratio of the two mean scores of the biomedical and behavioral subscales in the PABS-PT was compared between the Cred.MDT therapist group and the general physical therapists group. Results: Data of 46 general physical therapists and 44 Cred.MDT therapists were available. The Cred.MDT therapist group was significantly (P < 0.05) more behavioral oriented and more adherent to LBP practice guidelines compared with the general physical therapist group. The regression indicated significance of the two predictors of adherence to guidelines, Cred.MDT (β = 0.58, P < 0.001) and academic degree (β = 0.19, P = 0.03). Conclusions: Cred.MDT therapists are more guideline-consistent and have a more biopsychosocial treatment orientation than general physical therapists in Japan.
文摘Thrombosis disease since the majority of doctors who agree to be harmful,increasing emphasis on the applica- tion of antithrombotic drugs．However,the organization always treatment,the dose of medication and treatment method based only on the efficacy of clinical
基金World Federation of Chinese Medicine Societies(WFCMS)International Standard Develop-ment Project(SCM NP 2020-0097)National Natural Science Foun-dation of China(No.82474587)+1 种基金Sichuan Natural Science Foundation Project(23NSFSC0668)Xinglin Scholars Scientific Research Pro-motion Plan of Chengdu University of Traditional Chinese Medicine(No.XKTD2021003).
文摘Allergic rhinitis(AR)is a prevalent chronic inflammatory disorder that significantly impairs quality of life worldwide.In 2024,the World Federation of Chinese Medicine Societies(WFCMS)released the International Clinical Practice Guidelines of Chinese Medicine:Allergic Rhinitis(SCM 80-2024),the first globally standardized evidence-based clinical practice guidelines for comprehensive TCM management of AR.Developed through a transparent,prospectively registered process on the PREPARE platform(Registration No.2023CN081),the guidelines synthesized data from 351 randomized controlled trials involving 43,276 patients and applied the GRADE-TCM framework,which integrates four categories of TCM-specific evidence.32 rec-ommendations were established through five rounds of Delphi consensus,covering four major TCM syndromes and both internal and external therapeutic interventions.This article presents the English interpretation of the guidelines.Beyond summarizing the core recommen-dations,it focuses on the methodological innovations underpinning the guidelines,the epistemological dis-tinctions between Chinese and Western medical paradigms,and the regulatory and practical challenges associated with its implementation in predominantly Western healthcare contexts.
文摘Objective:To describe the implementation of evidence-based practice(EBP)and identify the associated factors among clinical nurses working at an oncology hospital in Central Vietnam.Methods:A cross-sectional study was conducted with 190 clinical nurses recruited from an oncology hospital in Central Vietnam.The self-administered Evidence-Based Practice Questionnaire(EBPQ)was employed to assess the nurses'knowledge/skills,attitudes,and implementation of EBP.Data analysis utilized descriptive statistics,the Mann-Whitney test,the Kruskal-Wallis test,and Spearman's rho correlation.Results:The mean total score for EBP implementation among the nurses was 29.52(SD=7.14)out of 42 scores.The most frequently undertaken activity was sharing evidence with colleagues,whereas finding relevant evidence was the least performed.The level of EBP implementation significantly varied based on the nurses'role types and their participation in related courses(P<0.05).Moreover,a strong positive correlation was observed between EBP implementation and both knowledge/skills(r=0.703,P<0.001)and attitudes toward EBP(r=0.536,P<0.001).Conclusions:The implementation of EBP by oncology nurses is generally moderate and is significantly positively correlated with their knowledge/skills and attitudes toward EBP.These findings underscore the importance of enhancing educational programs and facilitating suppor tive institutional policies to fur ther encourage the adoption of EBP among nurses.
文摘With the intensification of population aging,knee and hip joint replacement surgeries have become core methods for treating end-stage joint diseases,with over a million cases performed globally each year.Postoperative rehabilitation nursing,as a crucial aspect of enhancing surgical outcomes,reducing complications,and facilitating patients’return to normal life,has its scientific and effective protocols directly influencing patient prognosis.This article systematically reviews the core research findings on rehabilitation nursing after joint replacement surgery based on the concept of evidence-based medicine,aiming to provide references for the formulation of standardized and personalized rehabilitation nursing plans in clinical settings.
文摘Objective:To explore the application effect of evidence-based nursing in the postoperative care of patients with ureteral calculi undergoing holmium laser lithotripsy,analyze its impact on the incidence of postoperative complications,the degree of stress response,and nursing satisfaction,and provide evidence-based support for optimizing clinical nursing practices.Methods:A total of 100 patients with ureteral calculi who underwent holmium laser lithotripsy in our hospital from January 2023 to June 2025 were selected and divided into an observation group(50 cases)and a control group(50 cases)using a random number table method.The control group received routine nursing interventions,while the observation group adopted an evidence-based nursing model.The incidence of postoperative complications(hematuria,urinary tract infection,renal colic,ureteral stricture),stress response indicators(heart rate,systolic blood pressure,diastolic blood pressure,Self-Rating Anxiety Scale(SAS)score,Self-Rating Depression Scale(SDS)score)before surgery and 24 hours after surgery,and nursing satisfaction were compared between the two groups.Results:The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(p<0.05).At 24 hours after surgery,the heart rate,systolic blood pressure,diastolic blood pressure,SAS score,and SDS score in the observation group were significantly lower than those in the control group(all p<0.01).Nursing satisfaction in the observation group was significantly higher than that in the control group(p<0.01).Conclusion:Evidence-based nursing can effectively reduce the incidence of postoperative complications in patients with ureteral calculi undergoing holmium laser lithotripsy,alleviate patients’stress responses,and improve nursing satisfaction,demonstrating significant clinical application value.
文摘Objective: To develop an evidence-based plan for cleaning operating room and evaluate the impact on high-frequency contact surfaces. Method: The evidence application model of the JBI Evidence-Based Nursing Center was utilized to create a strategy, which was implemented in a tertiary-level hospital in Yunnan Province. The adenosine triphosphate (ATP) biological biofluorescence detection method was used to assess the quality of cleaning before and after the intervention. Results: A total of 17 quality review indicators were established in this study. Following the application of evidence, the implementation rate for 16 quality review indicators increased significantly, from a range of 0-65.8% to 81.5-100%. Moreover, the pass rate of ATP bioluminescence detection on high-frequency contact surfaces increased from 14.07% to 47.19%, with significant difference (p < 0.05). Conclusion: The evidence-based environmental cleaning program proved to enhance the overall cleanliness of operating room and reduce the risk of surgical infections. This strategy holds promise for effective cleaning of operating room.
基金Hospital Quality Management Research Fund Project of China Medical Quality Management Association(Project No.:YLZG202511)。
文摘Objective:To explore the impact of evidence-based predictive nursing intervention on psychological stress and physiological indicator stability of elderly cataract patients during the perioperative period(1 day before surgery to 1 day after surgery),and to provide a basis for optimizing clinical nursing plans for elderly cataract surgery.Methods:A retrospective selection of 90 elderly patients(aged≥60 years)who underwent cataract surgery in the Ophthalmology Department of our hospital from August 2024 to December 2024 was conducted.They were divided into an observation group(n=45)and a control group(n=45)using a random number table method.The control group received routine nursing for cataract surgery,while the observation group implemented evidence-based predictive nursing intervention(including the establishment of a multidisciplinary evidence-based team,hierarchical psychological intervention,perioperative environment optimization,intraoperative personalized cooperation,and video-based health education).Psychological stress indicators[Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),General Self-Efficacy Scale(GSES)]on the 1st day before surgery and 1st day after surgery,and fluctuations of physiological indicators[Heart Rate(HR),Systolic Blood Pressure(SBP),Diastolic Blood Pressure(DBP)]on the 1st day before surgery and during surgery were compared between the two groups.Results:Before intervention,there were no statistically significant differences in SAS,SDS,GSES scores,HR,SBP,or DBP between the two groups(p>0.05);after intervention,the SAS score(33.62±5.72)and SDS score(32.14±4.86)of the observation group on the 1st day after surgery were significantly lower than those of the control group[(41.05±5.56),(43.59±4.75)],and the GSES score(31.15±3.28)was significantly higher than that of the control group(24.84±3.52)(all p<0.05);during surgery,the fluctuations of HR(74.0±6.0)beats/min,SBP(127.0±15.8)mmHg,and DBP(75.0±5.9)mmHg in the observation group were significantly smaller than those in the control group(all p<0.05).Conclusion:Evidence-based predictive nursing intervention can effectively alleviate anxiety and depression in elderly cataract patients during the perioperative period,improve self-efficacy,stabilize intraoperative physiological status,and enhance surgical cooperation,which is worthy of clinical promotion.
文摘The rapid progress of human organoid toolkits presents unprecedented opportunities in disease modeling,drug discovery,and personalized therapy,alongside profound bioethical challenges and concerns.On April 29th,2025,China’s National Science and Technology Ethics Committee(Life Science Ethics Subcommittee)issued the Human Organoid Research Ethical Guidelines[1],establishing the world’s first comprehensive governance framework,especially focusing on brain organoids,embryo models,and chimeric research.This Guidelines represent a pioneering governance model in emerging biotechnology.This commentary offers an in-depth analysis to examine the policy’s innovative three-tiered structure,contrast it with current global regulatory standards,evaluate its domestic impacts as well as potential implications for international biotechnology governance,and provide recommendations for future directions.
基金funded by the National Key Research and Development Program of China(No.2021YFA1100500)the National Natural Science Foundation of China(No.82370662)the Key Research&Development Plan of Zhejiang Province(No.2024C03051).
文摘This study evaluated the accuracy,completeness,and comprehensibility of responses from mainstream large language models(LLMs)to hepatitis C virus(HCV)-related questions,aiming to assess their performance in addressing patient queries about disease and lifestyle behaviors.The models selected were ChatGPT-4o,Gemini 2.0 Pro,Claude 3.5 Sonnet,and DeepSeek V3,with 12 questions chosen by two HCV experts from the domains of prevention,diagnosis,and treatment.
基金Supported by standardization of traditional Chinese medicine,State Administration of Traditional Chinese Medicine of the People’s Republic of China:ZYYS-2009-0009-8special project of construction of TCM Master CHENG Xin-nong’s Inheritance Studio,State Administration of Traditional Chinese Medicine of the People’s Republic of China
文摘The aim of this study was to establish clinical practice guidelines for acupuncture-moxibustion by retrieving relevant literature and adopting the best current national and international evidence, according to experts＇ experience and patients＇ values. This was achieved using the Grade of Recommendations Assessment, Development and Evaluation（GRADE） system combined with a wide range of national experts＇ consensus, in order to provide reliable evidence for acupuncture-moxibustion treatment of scapulohumeral periarthritis, and to ensure the safety and effectiveness of the treatment.
基金supported by projects from the China Academy of Chinese Medical Sciences (No.Z0135)the State Administration of Traditional Chinese Medicine (No. ZYYS-2008)the National Science Foundation of China (No. 30825047)
文摘Objective: To assess the quality of the first batch of Chinese evidence-based clinical practice guidelines (CPGs) in Traditional Chinese Medicine (TCM) using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Methods: Evidence-based CPGs in TCM supported by the World Health Organization Western Pacific Regional Office (WHO/WPRO) and whose development was organized by the China Academy of Chinese Medical Sciences were identified and manually retrieved. CPGs were assessed using the AGREE instrument, and the data in each CPG were analyzed in terms of the six domains in the AGREE instrument: scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, applicability, and editorial independence. Results: Twenty-eight CPGs were identified, of which 26 were included in the study. The AGREE instrument rated the 26 CPGs in terms of the six domains. The assessment results showed the following average scores: for editorial independence, 84.16%; for rigor of development, 80.95%; for scope and purpose, 79.96%; for clarity and presentation, 70.88%; for stakeholder involvement, 61.28%; for applicability, the average score was only 27.09%. In summary, nine CPGs were rated as "strongly recommended", six as "recommended with provision or alternation", and 11 as "unsure". Conclusion: Most of the first batch of Chinese evidence-based CPGs in TCM had significant shortcomings in applicability. It is suggested that special attention be paid to enhancing the quality of applicability when developing evidence-based CPGs in TCM.
基金Supported by the European Commission under the 7th Framework EURECA Project(FP7-ICT-2011-7,288048)the Key Projects of National Social Science Foundation of China(11ZD&189)the Natural Science Foundation of Hubei Province(2014CFB247)
文摘Semantic representation of evidence-based medical guidelines provides the support for the data inter-operability and has been found many applications in the medical domain. In this paper, we describe a semantic representation approach of evidence-based medical guidelines, which is based on the Semantic Web Technology standards. We discuss several use cases of that semantic representation of evidence-based medical guideline, and show that they are potentially useful for medical applications.
文摘Current guidelines for managing ulcer bleeding state that patients with major stigmata should be managed by dual endoscopic therapy(injection with epinephrine plus a thermal or mechanical modality) followed by a high dose intravenous infusion of proton pump inhibitors(PPIs).This paper aims to review and critically evaluate evidence supporting the purported superiority of a continuous infusion over less intensive regimens of PPIs administration and the need for adding a second hemostatic endoscopic procedure to epinephrine injection.Systematic searches of PubMed,EMBASE and the Cochrane library were performed.There is strong evidence for an incremental benefit of PPIs over H2receptor antagonists or placebo for the outcome of patients with peptic ulcer bleeding following endoscopic hemostasis.However,the benefit of PPIs is unrelated to either the dosage(intensive vs standard regimen) or the route of administration(intravenous vs oral).There is significant heterogeneity among the 15 studies that compared epinephrine with epinephrine plus a second modality,which might preclude the validity of reported summary estimates.Studies without second look endoscopy plus re-treatment of re-bleeding lesions showed a signif icant benef it of adding a second endoscopic modality for hemostasis,while studies with second-look and re-treatment showed equal efficacy between endoscopic mono and dual therapy.Inconclusive experimental evidence supports the current recommendation of the use of dual endoscopic hemostatic means and infusion of high-dose PPIs as standard therapy for patients with bleeding peptic ulcers.Presently,the combination of epinephrine monotherapy with standard doses of PPIs constitutes an appropriate treatment for the majority of patients.
基金Capital Health Research and Decelopment of Special(2018-2-4162).
文摘Lumbar disc herniation with radiculopathy refers to a localized displacement of disc material beyond the normal margins of the intervertebral disc space resulting in pain,weakness or numbness in a myotomal or dermatomal distribution.North American Spine Society(NASS)released a new version of clinical guidelines for diagnosis and treatment of lumbar disc herniation with radiculopathy.For providing the best and effective diagnosis and treatment plan,this guidelines use a systematic review of literature and evidence-based medical evidence analysis to identify different recommended intensities,focus on the common problems of diagnosis and treatment.This article gives a brief explanation of guidelines with the clinical practice in China,so as to provide a reference for clinicians and researchers.
基金International cooperation project of State Administration of traditional Chinese medicine(gzyygj2018032)Special cultural project of international cooperation of State Administration of traditional Chinese medicine(gzyygj2019054)+3 种基金Scientific research projects in key fields of the 13th five year plan of the Chinese Academy of traditional Chinese medicine(zz10-015,zz10-022)Independent topic selection of graduate innovation and Entrepreneurship(2019-jyb-xscxcy-05)NSFC project(201908110307)Doctoral innovation fund of Chinese Academy of traditional Chinese medicine(cx201905)
文摘Knee osteoarthritis(KOA)is the highest incidence of osteoarthritis,which seriously affects the quality of life of patients.In order to update the understanding of the disease,clear diagnostic criteria and appropriate treatment were proposed.In 2018 and 2019,the European Society for Clinical and Economic Aspects of Osteoporosis,Osteoarthritis and Musculoskeletal Diseases(ESCEO),the Association of the Scientific Medical Societies in Germany(AWMF)and Brazil successively formulated guidelines for knee osteoarthritis,which determined different guidance suggestions through systematic evaluation of a large number of literatures and evidence-based medical evidence analysis.This paper compares and interprets the guidelines,and discusses them according to the actual situation of our country for the reference of clinicians.
文摘Isthmic spondylolisthesis in adults is a common clinical disease that causes lower back pain. In order to provide the best and effective diagnosis and treatment plan, in 2014, the North American Spine Association (NASS) formulated the guidelines for the diagnosis and treatment of isthmic spondylolisthesis in adult (hereinafter referred to as the guideline). Through the systematic review of literature, evidence-based medical evidence analysis was conducted to identify different recommended intensities, to discuss the clinical diagnosis and treatment plan mainly from two aspects of diagnosis and treatment. This article gives a brief explanation of the guidelines and discusses them in combination with the clinical practice in China, so as to provide a reference for clinicians.
