ObjectiveTo compare the similarities and differences in procedures between Western medicine (WM) and traditional Chinese medicine (TCM) guidelines. MethodsWe systematically searched China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc and PubMed from inception to May 17, 2022. Supplementary search of reputable medical institutions and organizations, as well as retrospective references were conducted and screened. We extracted and analyzed the basic information and guideline development procedure of the included handbooks. ResultsA total of 10 handbooks published from 2013 to 2022 were included, with four WM handbooks and six TCM handbooks. The median completeness of handbooks was 53.3%, with a maximum of 93.3% and a minimum of 43.3%. There are six handbooks with less than 60.0% completeness. The median reporting rate of the key steps was 65.0%, and the reporting rate of 5/8 of the key steps was more than 80.0%. Among the key reporting steps, role of funders, update methods, and conflict of interest management were reported at a low rate. Compared with WM handbooks, TCM handbooks reflected TCM characteristics in the procedure of topic selection, working groups, conflict of interest declaration and management, clinical questions, evidence, recommendations, report guideline, and external review. ConclusionThe completeness and reporting rate of the key steps need to be improved. TCM characteristics need to be further integrated when developing TCM guideline handbooks. We highly recommend that guideline stakeholders actively participate in handbook development to promote the quality of handbooks.
The national policy on high-quality development of hospitals proposes to strengthen information technology support and actively promote the multi-disciplinary team (MDT) model. How to use the “Internet Plus” technology and operation mode to promote MDT communication and improve the efficiency of diagnosis and treatment in the digital and intelligent information age is a direction worthy of attention and research. This paper systematically reviews the current development status of MDT informatization construction at home and abroad. Based on the current challenges and opportunities, it makes prospects for the future development of MDT informatization construction from the aspects of strengthening the digital and intelligent support of MDT operation, connecting MDT “information silos”, and deepening the construction of MDT supervision and effect evaluation system, etc.
PURPOSES:To investigate the time of neuronie apoptosis in the retinas of Imman fetuses,and its relations with neuronie proliferation and differentiation, METHODS:The retinas of 27 human fetuses from 8th to 38th week of R,~til- ization age and 3 adults were studied by TdT-mediated dUTP nick end labelling(TUNEL) method. RESULTS:Tbe nuctei of labeled apoptotic cells were charaeterised by nuclear marginization,ehromatln condensation and cleseent shape,and some apoptotie bodies were visible in the specimens. The apoptosis of neuroepithelium of fetal rclina took place during 8th to 18th week, Apoptosis of ganglion cells were observed from 1256 to 18th week. The apoptos[s of pholorec, plors were formd from 14th to 2Ist week ,while thai of bipolar neurones and M~ller cells were found from ldth to 28th week. No apoptosb of ocstones were observed in the retinas after 28th week of fertilization age and within the retinas of adults. CONCLUSION:The proliferating cells of neuroepithelium and Ihe neurones which just differetiated from fetal retina might partly undergo apoptosis. The time of apoptosls of differentiated neurones was consistent with the time of the synapses formation between neurones and their targel cells. （Chin J Ocul Fundus Dis,1997,13:67 -69 ）
Objective To investigate effects of neural retina on development of the structure of outer blood retinal barrier in embryogenesis. Methods The retinal neural epithelium (RNE) and pigment epithelium (RPE) layers of 150, 120 and 90 embryonic chicken eyes incubated for 7,10, and 14 days were peeled off. RNE was used to prepare the culture medium with different conditions (7drcSF3, 10drcSF3, 14drcSF3). RPE cells of 7- and 14-incubated chicken embryos were cultured on laminin-coated transwell filter. The SF3, 7drcSF3, 10drcSF3 , 14drcSF3 medium were used respectively in the apical chamber and SF2 was used in basolateral chamber. After the formation of monolayer, the transepithelial electrical resistance of the RPE was detected. After the fixation of RPE cells, the condition of the tight junction among the cells was observed by immunohis tochemistry and transmission electron microscopy. Results For the RPE cells of 7-and 14-day incubated embryonic eyes, the difference of TER in various medium of SF3/SF2, 7drcSF3/SF2, 10drcSF3/SF2, 14drcSF3/SF2 was statistically significant (P＜0.01). The polarity of RPE cells was induced and the netlike tight junctional strands was urged in the retina-conditioned medium. Conclusion The neural retina may actively promote the formation of the structure of outer blood retinal barrier. (Chin J Ocul Fundus Dis，2004，20：237-240)
ObjectiveTo determine the retinal thickness of normal children 3-6 years old and its relationship with the age and gender. MethodsIn a cross-sectional study, 480 eyes of 240 normal preschool children including 115 male and 125 female, ages 3 to 6 years in the urban of Beijing, China were included. The average age was (4.93±0.77) years old. The visual acuity, slit-lamp microscopy and frequency domain optical coherence tomography (FD-OCT, Optvue, Inc. USA) were examined. The retinal thickness of the macular fovea and 500, 750, 1500 μm from temporal and nasal side around the fovea were measured. 32 eyes were excluded from the study because they couldn't cooperate. Pearson correlation analysis was used to determine the correlation between age and macular retinal thickness. Independent samples group t-test was used to compare the differences between boys and girls. ResultsThe mean thickness of macular fovea was (169.10±20.587) μm. The mean macular thickness of boys was significantly higher than girls (t=-4.549, -6.167, -5.492, -5.163, -6.749, -7.494, -6.874; P≤0.001). The mean thickness of 500 μm and 750 μm from nasal side of macular fovea were significantly higher than temporal side (t=5.594, 15.778, 7.678, 18.180; P < 0.001). There was no significant relevance between macular thickness and age. ConclusionsThe mean macular thickness of boys is significantly higher than girls in normal children in the urban of Beijing. There is no significant relevance between macular thickness and age.
Objective To explore the application of multi-disciplinary team (MDT) clinics in fetal developmental abnormalities. Methods A retrospective analysis method was used to collect case data of fetal developmental abnormalities and completion of prenatal MDT clinics diagnosis and treatment in pregnant women who were registered in the Department of Obstetrics of West China Second Hospital, Sichuan University between December 2021 and November 2022. The situation of pregnant women and fetuses was summarized and analyzed. Results There were 19362 registered pregnant women, of which 1125 (5.8%) had abnormal fetal development. Among them, 272 (24.2%) received prenatal MDT clinics diagnosis and treatment. Fetal developmental abnormalities were mainly characterized by structural abnormalities (208 cases, 76.5%), with the top three being central nervous system abnormalities, circulatory system abnormalities, and multiple malformations. There were 202 pregnant women who continue to conceive, and 70 cases had undergone induced labor, with an induced labor rate of 25.7%. The top three main causes of induced abortion were multiple malformations, central nervous system abnormalities, and circulatory system abnormalities. After prenatal MDT clinics diagnosis and treatment, the diagnosis of fetal developmental abnormalities in 46 pregnant women were corrected. Conclusion Prenatal MDT clinics are helpful for the early comprehensive evaluation of fetal developmental abnormalities and the determination of diagnosis and treatment plans.
Retina is composed of a heterogeneous population of cell types, each with a unique biological function. Even if the same type of cells, due to genetic heterogeneity will lead to cell function differences. In the past, traditional molecular biological methods cannot resolve variations in their functional roles that arise from these differences, and some cells are difficult to define due to the lack of specific molecular markers or the scarcity of numbers, which hindered the understanding and research of these cells. With the development of biotechnology, single-cell RNA sequencing can analyze and resolve differences in single-cell transcriptome expression profiles, characterize intracellular population heterogeneity, identify new and rare cell subtypes, and more definitely define the characteristics of each cell type. It clarifies the origin, function, and variations in cell phenotypes. Other attributes include pinpointing both disease-related characteristics of cell subtypes and specific differential gene expression patterns, to deepen our understanding of the causes and progression of diseases, as well as to aid clinical diagnosis and targeted therapy.
Objective To observe the effect of epithelial-mesenchymal transdifferentiation (EMT) of human retinal pigment epithelial (RPE) cells induced by vitreous humor in vitro. Methods The third to fifth passage cultured RPE cells were divided into two groups of treatment by 10% serum containing Dulbecco minimum essential medium (DMEM)/F12 medium (group A), or the same medium supplemented with 25% human vitreous (group B). The morphological changes were observed with a phase contrast microscrope. Cell migration, invasion and contractility were tested using a scratch wound assay, Transwell invasion assay and collagen gel contraction analysis. The expression levels of alpha;-smooth muscle actin (SMA) and Snail1 were detected by reverse transcriptase polymerase chain reaction (RT-PCR). Results The RPE cells in group A were flat and gathered together. The RPE cells in group B grew as a fan-shaped projection at one edge and cone-shaped tail at the opposite edge, or spindle-shaped, and appeared to separate. In group A, filamentous actin distributed mainly at the margin of the cells with the distribution an oval shape. In group B, filamentous actin reorganized and formed fan-like flat pseudopodia at one edge of the cells. Compared to group A, the migration and invasion of the cells increased significantly (t=14.190, 22.630; P＜0.05), but contractility decreased remarkably (t=6.221, P＜0.05) in group B. Compared to group A, the expression level of Snail1 mRNA increased significantly (t=3.218, P=0.032), but the expression level of alpha;-SMA mRNA decreased (t=3.990, P=0.016). Conclusions Vitreous humor can induce the EMT of RPE cells. Increasing cell migration, cell invasion, and expression of Snail1 mRNA as well as up-regulated cellsprime; contractility and expression of alpha;-SMA mRNA may be the mechanism.
In recent years, day surgery has developed rapidly in China. Day surgery management has shifted from extensive to refined, but there are still many problems in the service system of day surgery in Chinese hospitals. In order to further optimize the allocation of medical resources, improve the level of medical service capacity, and build a “patient-centered, safe, efficient, and orderly” day surgery service system, Northern Jiangsu People’s Hospital has integrated big data, mobile internet, and artificial intelligence since 2019, creating a smart information big data platform. This paper summarizes the experience of Northern Jiangsu People’s Hospital in promoting the high-quality development of day surgery services in the whole hospital from five aspects of top-level design, diagnostic and therapeutic process, medical quality and safety, medical supporting services, and supervision mechanism, with a view to providing reference for the implementation of overall management of day surgery in the hospital.
Objective To explore the methods used for developing evidence-based clinical practice guidelines for acupuncture. Methods Based on the characteristics of acupuncture in traditional Chinese medicine,and principles of evidence-based medicine, this article introduces and summarizes the processes and methods for developing an evidence-based clinical practice guideline for acupuncture. We analyzed similarities and differences between clinical practice guidelines for acupuncture and for other interventions. We used an evidence-based clinical practice guideline of acupuncture for depression as an example to illustrate the methods of literature search, grading of evidence and recommendations, evidence evaluation and consensus formation. Results Preliminary recommendations on the methods for developing evidence-based clinical practice guidelines for acupuncture were made. Conclusion Based on the optimized rational methodology for developing clinical guidelines, evidence-based high-quality clinical practice guidelines for acupuncture could be established.