Objective To verify the applicability of AGREE-China and select high-quality clinical practice guidelines (CPGs) or consensus for the management of fragility fractures (FF) in China by evaluating their methodological quality. Methods CBM, CNKI, WanFang Data, VIP databases and related CPGs websites were electronically searched. Two reviewers independently screened literature, extracted data, and checked each other. Quality appraisal of CPGs or consensus were evaluated by AGREE Ⅱ and AGREE-China, and weighted Kappa value and intraclass correlation coefficients (ICC) were calculated to illustrate the consistency of the two tools. Results Nine CPGs and sixteen consensuses were included. Among the six domains in AGREE Ⅱ, "scope and purpose" domain (62.22%) scored higher than "clarity of presentation" domain (45.67%). The "stakeholder involvement" domain (34.89%) and "applicability" domain (38.17%) both exceeded 30%, while "rigor of development" domain (18.79%) and "editorial independence" domain (13.33%) were lower. Among the five domains in AGREE-China, "conflict of interest" domain (72.80%) was higher, followed by "usability/feasibility" domain (49.87%), while "scientificity/preciseness" domain (20.36%), "effectiveness/safety" domain (25.20%) and "economic efficiency" domain (14.40%) were lower. The weighted Kappa value of recommendations from the two tools was 0.694 (P<0.001), showing moderate consistency. ICC values of the same items and two evaluators were all greater than 0.85 (P<0.001) with high consistency. Three high-quality CPGs were consistently selected by the two tools. Conclusion AGREE Ⅱ holds high consistency with AGREE-China; however, AGREE-China is more suitable for the quality appraisal of Chinese CPGs or consensus. The methodological quality of CPGs or consensus for the management of FF in China needs to be further improved.
ObjectiveTo systematically review the prevalence of elder abuse in China.MethodsPubMed, EMbase, Web of Science, CNKI, VIP and WanFang Data databases were electronically searched to collect cross-sectional studies on the prevalence of elder abuse in China from inception to June 2019. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies; then, meta-analysis was performed by R 3.5.1 software.ResultsA total of 11 cross-sectional studies involving 23 020 subjects were included. The results of meta-analysis showed that the prevalence of abuse among the elderly in China was 20.29% (95%CI 12.9% to 28.9%). The highest prevalence of elder abuse subtype was psychological abuse with 15.06% (95%CI 10.2% to 20.6%). The prevalence rates were 20.1% in male and 23.64% in female. The prevalence rates in individuals aged between 60 to 70, 70 to 80 and above 80 were 19.76%, 22.24% and 29.19%, respectively. Illiterates and non-illiterates were 29.39% and 22.52% respectively. Normal marital status was 28.24%, and abnormal status was 31.38%. The elderly living alone was the highest (50.67%), compared with family residents (39.42%) and elderly living in pension institutions (29.94%). The elderly without chronic diseases (16.05%) was lower than elderly with chronic diseases (25.49%), and elderly having normal capability of daily living (26.89%) was lower than elderly having reduced capability of daily living (48.78%). Urban residents were 18.46%, while rural residents were 19.69%.ConclusionsThere is a high incidence of elder abuse in China, and it tends to increase with the increase of age. There are certain differences in the prevalence of elder maltreatment among different genders, ages, educational levels, marital status, living forms and spaces, and health conditions. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.
ObjectiveTo retrospectively investigate the drug use of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011, and to compare with outpatients with lung cancer concurrently, so as to evaluate the rationality of drug use among over-60-year inpatients with lung cancer in the West China Hospital. MethodsThe information of over-60-year inpatients with lung cancer as initial diagnosis in the West China Hospital in 2011 was collected from the hospital information system (HIS), including patient information, drug use information, cost information, etc. Data rearrangement and analysis by classes and costs were carried out using Microsoft Excel 2010 software. Resultsa) There was 2 215 person-times of over-60-year inpatients with lung cancer in the West China Hospital of Sichuan University in 2011. A total of 5 classes, 63 kinds of anti-tumor and adjuvant therapy drugs were involved. The total drug use frequency was 12 398 person-times. The average medicine cost was 774.93 yuan. b) The ratio of patients using 1 to 4 kinds of drugs was 34.31%, 5 to 10 kinds was 41.9%, and 11 to 15 kinds was 12.63%. c) For etiological treatment, the ratio of chemotherapy drugs was 99.45%, and the most used was cisplatin. d) For symptomatic treatment, the ratio of analgesics was 66.69%; the ratio of antitussive drugs was 21.33%; and the ratio of skeletal related events prevention drugs was 11.98%. e) For anti-ADR treatment, the ratio of antiemetic drugs was 55.07%; the ratio of stomach protection drugs was 32.63%; and the ratio of hepatic protection drugs was 12.30%. f) For other treatment, the ratio of immunopotentiating drugs was 59.46%; and the ratio of hematopoietic growth factor was 25.42%. g) For Chinese patent medicine, drugs used over 400 person-times were Diyushengbai tablet, Javanica oil emulsion injection, Aidi injection, and Huisheng oral liquid. h) For single/combined treatment, the ratio of two-drug combined chemotherapy was 78.38%, one analgesics drug treatment was 66.21%, one hepatic protection drug treatment was 83.41%, two-drug combined antanacathartic treatment was 45.88%, one stomach protection drug treatment was 90.53%, one immunopotentiating drug treatment was 90.53%, one hematopoietic growth factor treatment was 82.31%, and one Chinese patent medicine treatment was 37.39%, respectively; and antitussive and skeletal related events prevention drugs were used alone. i) The use frequency of the top 10 drugs were: pantoprazole, tropisetron, ondansetron, diphenhydramine, thymopentin, cisplatin, Diyushengbai tablet, tramadol, Javanica oil emulsion injection, and Aidi injection. j) Compared with outpatients, inpatients drug use frequency was higher in chemotherapy, analgesics, antiemetic, stomach protection, hepatic protection drugs, and Chinese patent medicine; but lower in skeletal related events prevention drug; and similar to the drug use situation of outpatients in immunopotentiating drugs and hematopoietic growth factor drugs. ConclusionThe antitumor therapies were mainly the combination of two chemotherapy drugs or single drug regimen for over-60-year inpatients with lung cancer in the West China hospital of Sichuan University in 2011. The most frequently used adjuvant therapies are antalgic, antiemetic and stomach protection drugs. Chinese patent medicine and immunopotentiating drugs are in common use as well.
The quality of clinical trials is key to determine the value of a clinical research and whether it can transform achievements. In this paper, the characteristics and direction of the implementation of quality control in clinical trials in China, and the characteristics of quality control in clinical trials of Chinese medicine are discussed, and the development direction of quality control in clinical trials in China is explored in order to improve the overall level of clinical trials in China.
In recent years, clinical research shows the trend of globalization. Due to characteristics of the huge number and relative concentration of patients, the wide variety of diseases, a high patient enrolment rate, lower trials costs, and so on, China and India become a focus of this trend. However, China and India also have their own advantages in the aspects of diseases, infrastructure, policies, regulations, regulatory environment, language, and culture. The key question to address is: how to increase the shares in the trial market in the future and to enhance the international status of China’s clinical research? Before we answer this question, we must understand the present situations of clinical research resources in China and India. So, we searched the relevant literature at home and abroad by computer and hand to analyze advantages and efficiency of clinical research resources in China and India.
ObjectiveTo evaluate the developing methodologies of Essential Medicines Lists for Children (EMLcs) in global, in order to provide reference in developing EMLc of China. MethodsWe searched ProQuest, ScienceDirect, SpringerLink and MEDLINE databases, World Health Organization (WHO) official website, and 67 websites of National Ministry of Health and Drug Administration Section, to collect literature about selection methodology of children and/or adult essential medicines list (EML). A descriptive analysis was conducted. ResultsA total of fourteen literatures were included. Of which, 6 were about the essential medicines selection methodology in children, and the other 8 were about the essential medicines selection methodology in adult. The WHO had established independent EMLc selection committee. Paediatricians were involved in the selection of EMLc in the WHO and India. There was no selection criteria and process for EMLc globally. The WHO, India, and South Africa selected their EMLcs referring to the WHO EML selection criteria. The WHO and South Africa had their own updating time, period and process for EMLc. The WHO EMLc was updated per 2 years, which in high frequency and conducts in rigorous process. However, the EMLc of India had not been updated yet. ConclusionIt is suggested that China could build a national EMLc selection committee involving paediatricians and evidence-based medicine experts etc. in referring to the framework of the WHO Child Health Working Group. The EMLc selection criteria and process of China could be established referring to the one of the WHO, based on the disease burden, drug accessibility and medical insurance of children of China. The EMLc of China should be simultaneously updated with the adult EML of China.
In recent years, CRO has developed rapidly in China, and has played an important role in improving the level of Chinese clinical trials and drug development. However, the development of CRO industry also has problems. This paper discusses the beneficial factors of the main problems and the future direction of CRO, in attempt to attract the attention of government supervision and management departments and CRO industries.
After Wenchuan earthquake on May 12, West China Medical School/ West China Hospital of Sichuan University organized a youth volunteer team for earthquake rescue and relief. A volunteer network was formed and relevant service regulations were formulated immediately. Volunteers have played an important role in post-earthquake evacuation of patients, emergency reception, ward care, on-call service, a service to help people find family members, telecommunications and some other major tasks.
Objective To analyze the epidemic trend of prostate cancer in China from 1992 to 2021, and predict its epidemic trends from 2022 to 2032. Methods Based on the data of Chinese population and prostate cancer incidence and mortality from Global Burden of Disease Database, the Joinpoint log-linear model was used to analyze the trends of prostate cancer incidence and mortality, use the age-period-cohort model to analyze the effects of age, period and cohort on changes in incidence and mortality, and the gray prediction model was used to predict the trends of prostate cancer. Results From 1992 to 2021, the incidence and mortality of prostate cancer in China showed an upward trend, with AAPC of 5.652% (P<0.001) and 3.466% (P<0.001), and the AAPC of age-standardized incidence decreased to 1.990% (P<0.001), the age-standardized mortality showed a downward trend and was not statistically significant. The results of the age-period-cohort model showed that the net drift values of prostate cancer incidence and mortality were 3.03% and ?1.06%, respectively, and the risk of incidence and mortality gradually increased with age and period. The results of the grey prediction model showed that the incidence and mortality of prostate cancer showed an upward trend from 2022 to 2032, and the incidence trend was more obvious. Conclusion The incidence and mortality of prostate cancer in China showed an increasing trend, with a heavy disease burden and severe forms of prevention and control, so it is necessary to do a good job in monitoring the incidence and mortality of prostate cancer, and strengthen the efficient screening, early diagnosis and treatment of prostate cancer.