ObjectiveTo systematically evaluate the methodological quality of traditional Chinese medicine (TCM) guidelines and expert consensuses for the diagnosis and treatment of coronary heart diseases (CHD).MethodsDatabases including PubMed, CNKI, CBM, WanFang Data and the official websites of the China Association of Traditional Chinese Medicine, and the Chinese Association of Integrated Traditional and Western Medicine were electronically searched to collect guidelines (or expert consensus) of TCM for CHD from January 1st, 2010 to January 1st, 2021. Methodological evaluation of the included guidelines was conducted by 3 researchers independently using the AGREE Ⅱ instrument.ResultsA total of 16 guidelines were included. The AGREE Ⅱ scores for each domain were: clarity and presentation (63.89%), followed by scope and purpose (55.90%), stakeholder involvement (42.13%), the rigor of development (41.42%), editorial independence (32.12%), and applicability (21.99%). Nine guidelines were rated as level B (recommended after being revised), and 7 were rated as level C (not recommended).ConclusionsGuidelines and expert consensuses of TCM for CHD provide a standard for clinical practice, however, the methodological quality remains to be improved. It is suggested that future guidelines be formulated in accordance with international standards and using the methods of evidence-based medicine to improve the quality of guidelines further and promote international acceptability.
Objective To survey the current difficulties and guidance expectations of postgraduate students of traditional Chinese medicine (TCM) in writing and publishing international journal papers, in order to optimize the teaching mode of international journal articles for TCM postgraduates. Methods By means of a questionnaire survey, TCM postgraduate students in China were selected as the survey objects from four aspects: basic information, current situation of thesis publication and writing, paper writing difficulties and current situation and expectation of course offering. SPSS 26.0 software was used for data analysis. Results A total of 2 874 valid questionnaires were collected. A total of 1 365 postgraduate students had plans to write international journal papers; 324 postgraduate students had published international journal papers as the first author. The degree of difficulty in writing was generally rated high by postgraduate students, and lack of writing skills and time were the main reasons for the low motivation of thesis writing. A total of 2 547 graduate students felt that guidance on writing papers for international journals was urgently needed, with literature search methods and clinical research methods and experimental design as the most needed guidance, and reviewers and supervisors as the most desired guides. Conclusion The number of TCM postgraduates who have plans to write international journal papers is small, the proportion of publications is low, and the demand for international journal paper guidance courses is high. It is suggested that standardized international journal paper guidance courses be offered to improve the system of cultivating scientific research ability.
ObjectiveTo analyze the causal relationship between obstructive sleep apnea (OSA) with its typical symptoms (daytime sleepiness and snoring) and cardiovascular diseases (hypertension, coronary heart disease, myocardial infarction, heart failure) by using Mendelian randomization. MethodsWe used the instrumental variables (IV) in the FINNGen database and the UK Biobank to perform two-sample Mendelian randomization (TSMR) analysis. The results of random-effects inverse variance weighting method (IVW) were the main results. MR-Egger method was used for pleiotropic analysis and sensitivity analysis was performed by the leave-one-out method to verify the reliability of the data. ResultsOSA could lead to hypertension (IVW β=0.043, 95%CI 0.012 to 0.074, P=0.006) and heart failure (IVW β=0.234, 95%CI 0.015 to 0.452, P=0.036). Daytime sleepiness also had a pathogenic effect on heart failure (IVW β=1.139, 95%CI 0.271 to 2.006, P=0.010). There was no causal association between OSA and CHD or MI, snoring and the four CVDs. There was no causal association between daytime sleepiness and hypertension, CHD or MI.ConclusionOSA and daytime sleepiness have pathogenic effects on hypertension and heart failure, with heart failure being the most affected.
Diabetic panvasculopathy refers to a clinical syndrome in which a wide range of blood vessels (including heart, brain, kidney, eye, peripheral and other large vessels and microvessels) in diabetic patients have atherosclerosis as the common pathological feature, cardiovascular and cerebrovascular events as the main outcome, and active intervention of metabolic abnormalities is helpful to improve the prognosis. Early diagnosis, early prevention and active exploration of clear therapeutic targets are very important to prevent and delay the occurrence and development of diabetic panvasculopathy, but they are also challenges at present. The cardiorenal benefit of new hypoglycemic drugs is independent of blood glucose control, which has attracted increasing academic attention. The concept of panvasculopathy in diabetes plays an important role in improving the comprehensive management of the disease and multidisciplinary collaborative diagnosis and treatment, which is helpful to promote the vigorous development of the subspecialty of panvasculopathy and the continuous improvement of the comprehensive prevention and treatment level.
ObjectiveTo evaluate the methodological quality of clinical practice guidelines and expert consensus of chronic heart failure domestically and abroad.MethodsPubMed, EMbase, SinoMed, CNKI, WanFang Data, and VIP databases, and related websites were searched to collect guidelines and expert consensus on chronic heart failure published from January 1st, 2011 to December 31st, 2020. Four reviewers evaluated the methodological quality of the guidelines and expert consensus with the AGREE Ⅱ tool after the consistency evaluation training.ResultsA total of 17 studies were included (consisting of 11 English and 6 Chinese studies). The recommended levels were B level (recommend after modification) for 10 studies and C level (not recommended) for 7 studies. The AGREE Ⅱ standardized mean scores for various fields were 69.61% (scope and purpose), 34.20% (stakeholder involvement), 33.13% (rigor of development), 84.53% (clarity and presentation), 42.40% (applicability), and 37.09% (editorial independence). The methodological quality of English guidelines was generally high (level B for 10 and level C for 1), while all scores of Chinese guidelines or consensus in the 6 fields were mostly lower than the average (level C for 6).ConclusionsThe guidelines for the diagnosis and treatment of chronic heart failure requires further improvement in terms of stakeholder involvement and rigor of development. It should develop standards and methods to improve the quality for Chinese guidelines and expert consensus to better serve clinical practice.