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In recent years, the number of clinical practice guidelines for the integration of traditional Chinese medicine (TCM) and western medicine(WM) has been increasing year by year. However, there are obvious problems of "knot without compatibility". The recommendations of TCM and WM are mostly independent, inconsistent with the actual clinical diagnoses and treatment processes, and lacking in important information. All the above issues are unable to bring the role of the cooperation between TCM and WM in improving clinical practice. In order to achieve the organic integration of Chinese and western medicine, the research team has carried out methodological research in response to the above-mentioned problems. In November 2023, China Association for Standardization released the Specifications for Developing Clinical Practice Guidelines for Organic Integration of Traditional Chinese and Western Medicine at the 6th-8th Academic Annual Meeting of the Clinical Research Branch of China Information Association of Traditional Chinese Medicine. Therefore, this paper interprets the formulation process, scope of application and main content of the specification, with the aim of improving the overall quality of related research and promoting the collaborative development of the integration of TCM and WM.

In the era of evidence-based medicine, it is necessary to explore the unique advantages of traditional Chinese medicine (TCM) based on standardized technical methods and operating procedures in order to achieve the modernization and internationalization of TCM and benefit all humanity. The proposal of a three-pronged evidence system combining TCM theory, human experience and experimental evidence marks an important progress in the thinking method of the TCM evaluation system. The multi-evidence body integrated through appropriate methods provides a strong support for the clinical guideline recommendations and evidence-based health decision-making in TCM. Based on the current methodological progress of international evidence synthesis and grading, this paper proposes a novel approach for integrating multi-evidence in TCM: the MERGE framework. The aim is to establish a solid foundation for the development of this methodology and provide guidance for the advancement of evidence-based medicine framework in TCM.

Clinical practice guidelines are an important basis for clinical decision-making, but there are still many factors that prevent physicians from following the guidelines. One of the problems, the limited external validity of the guidelines, ultimately prevents the guidelines from providing an adequate basis for clinical decision-making, thus forming the gap between the guidelines and clinical decisions. Real-world research can enhance the external validity of the guidelines, provide a basis for clinical decision-making, and offer localized evidence for the guidelines, evidence of cost-effectiveness and other evidence for the guidelines. It can also monitor the implementation of the guidelines and help to make up for the lack of evidence in the formulation of traditional guidelines. Therefore, high-quality real-world studies and real-world evidence may be considered in the guideline development process to facilitate guideline optimization and serve as an aid to guideline quality improvement.

Although the incidence of rare diseases is extremely low, 6% to 8% of the global population are affected by more than 7000 rare diseases. Rare diseases guidelines are playing an increasingly important role as guiding documents in improving the health outcomes of patients with rare diseases. Therefore, we aim to systematically elaborate on the status quo, challenges and opportunities of rare disease guidelines at home and abroad, and put forward thoughts and suggestions on promoting the development of rare diseases guidelines in the future.

As an important guidance of medical practice, clinical practice guideline of integrative Chinese medicine (ICM-CPG) plays an extremely important role in showing the respective advantages of Chinese and Western medicine and in promoting the integrated Chinese and Western medicine. However, the research status on ICM-CPG is faced with the problem of emphasizing development but neglecting implementation. The establishment of ICM-CPG implementation model based on the theoretical framework of implementation science is conducive to promoting the implementation of ICM-CPG and advancing the integration and development of Chinese and Western medicine. In this paper, by sorting out and analyzing the knowledge to action (KTA) framework, we discuss the implementation framework development of ICM-CPG in order to provide reference for future research.

More and more scholars have paid attention to traditional Chinese medicine since the concept of translational medicine was introduced into this field. Most scholars believe that it is of great benefit to the inheritance and development of traditional Chinese medicine by the integration of translational medicine concepts and traditional Chinese medicine research. By reviewing the connotation and development of translational medicine, this paper explained the similarities between translational medicine and the basic theories of traditional Chinese medicine, and further described the content and practice of translational research on traditional Chinese medicine. It points out that the research foundation of traditional Chinese medicine was weak, the evidence was scattered, and the overall evaluation of efficacy needed to be strengthened. Finally, the viewpoints and strategies of strengthening the transformation research of TCM were put forward, such as strengthening the integration of resources, focusing on the areas of advantage and improving the overall evaluation, so as to provide new ideas for the future research of TCM transformation.

Traditional Chinese medicine (TCM) is the treasure of Chinese civilization. Its advantage lies in clinical practice. It takes the concept of holism and treatment based on syndrome differentiation as the guiding ideology, emphasizes the people-oriented concept, and has the dual attributes of science and humanity. The clinical efficacy reflects the vitality of TCM. In recent years, the researchers focus on the TCM clinical regnant diseases and therapies, master the evidence-based medicine method, establish new methods and technologies for clinical efficacy evaluation in line with the characteristics of TCM, integrate with the international clinical research mode so as to gain consensus and recognition.Using the ideas and methods of translational medicine, starting from the needs and efficacy, to build a clinical and basic transformation platform, improve the quality of clinical services, and promote the development of new drugs and new technologies. In general, the development of TCM clinical research should adhere to the principles of Chinese Learning, carry forward original thinking, be fully inclusive and equitable, learn mutually, collaborate with each other, and cooperate in multi-disciplinarity, so as to welcome a new era of high concepts, big data, integration of information and intelligence under the background of big science and health, grasp the hard-won development trend of TCM from integration of TCM and western medicine to placing equal emphasis on TCM and western medicine, and realize the inheritance and innovation of TCM led by us.

Objective To evaluate the efficacy and safety of yinqiao qingre tablet in treating common cold with wind-heat type.Methods The randomized, double-blind, placebo, parallel control research were applied to this study. The eligible subjects were divided into a experimental group, a positive control group and a placebo control group. The test drug was yinqiao qingre tablet, positive control drug was yinqiao jiedu tablet, and simulation drugs were yinqiao qingre simulation tablet and yinqiao jiedu simulation tablet. The experimental group was given yinqiao qingre tablet and yinqiao jiedu simulation tablet, the positive control group was given yinqiao qingre simulation tablet and yinqiao jiedu tablet, and the placebo control group was given yinqiao qingre simulation tablet and yinqiao jiedu simulation tablet.The course of treatment for each group was 3 days. Before and after treatment, the disappearance rate of major symptoms, individual symptom scores, efficacy of TCM syndrome, change of temperature, used of antipyretic analgesics and safety were evaluated. Results The disappearance rate of major symptoms was 62.12% in experimental group, was the highest among three groups(P

Background: Patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) are at high risk of thrombosis. However, bleeding-related complications during antithrombotic therapy remain a major barrier to effective treatment and can often lead to adverse outcomes. This meta-analysis aimed to determine the efficacy and safety of bivalirudin and heparin in patients with ACS after PCI. Methods: Randomized controlled trials (RCTs) on the efficacy and safety of bivalirudin versus heparin in patients with ACS after PCI were identified from the PubMed, Embase, Cochrane Library, CBM, CNKI, WanFang, and VIP database until August 2024. The outcomes included all-cause mortality, major adverse cardiovascular events (MACEs), incidence of recurrent myocardial infarction, stent thrombosis, short-term bleeding, revascularization, and retransfusion. Meta-analysis was performed using RevMan 5.3 and Stata 12.0 softwares. The included studies were assessed for risk of bias using the Cochrane risk-of-bias assessment tool. Results: A total of 70,199 patients from 27 randomized controlled trials (RCTs) were analyzed in this review. There were no significant differences between the bivalirudin and heparin groups in terms of all-cause mortality, major adverse cardiovascular events (MACEs), recurrent myocardial infarction, stent thrombosis within 30 days, or subacute stent thrombosis. Specifically, the incidence of short-term bleeding (P = 0.001) and retransfusion (P = 0.001) was significantly lower in the bivalirudin group compared to the heparin group. Conversely, the incidence of acute stent thrombosis (P < 0.0001) and revascularization (P = 0.009) was significantly higher in the bivalirudin group. Conclusions: Compared with heparin, bivalirudin has definite anticoagulant effect in patients with acute myocardial infarction after PCI, and the risk of bleeding and the incidence of retransfusion were lower in the bivalirudin group. This review helps doctors in PCI management choose bivalirudin or heparin more precisely based on patients' conditions for better treatment and fewer adverse events. [ABSTRACT FROM AUTHOR]

Large language models (LLMs) have the potential to enhance evidence synthesis efficiency and accuracy. This study assessed LLM-only and LLM-assisted methods in data extraction and risk of bias assessment for 107 trials on complementary medicine. Moonshot-v1-128k and Claude-3.5-sonnet achieved high accuracy (≥95%), with LLM-assisted methods performing better (≥97%). LLM-assisted methods significantly reduced processing time (14.7 and 5.9 min vs. 86.9 and 10.4 min for conventional methods). These findings highlight LLMs' potential when integrated with human expertise. [ABSTRACT FROM AUTHOR]

Background: Lumbar spinal stenosis (LSS) is a common cause of low back pain, especially in the elderly, and accurate diagnosis is critical for effective treatment. However, manual diagnosis using MRI images is time consuming and subjective, leading to a need for automated methods. Objective: This study aims to develop a convolutional neural network (CNN)-based deep learning model integrated with multiple attention mechanisms to improve the accuracy and robustness of LSS classification via MRI images. Methods: The proposed model is trained on a standardized MRI dataset sourced from multiple institutions, encompassing various lumbar degenerative conditions. During preprocessing, techniques such as image normalization and data augmentation are employed to enhance the model's performance. The network incorporates a Multi-Headed Self-Attention Module, a Slot Attention Module, and a Channel and Spatial Attention Module, each contributing to better feature extraction and classification. Results: The model achieved 95.2% classification accuracy, 94.7% precision, 94.3% recall, and 94.5% F1 score on the validation set. Ablation experiments confirmed the significant impact of the attention mechanisms in improving the model's classification capabilities. Conclusion: The integration of multiple attention mechanisms enhances the model's ability to accurately classify LSS in MRI images, demonstrating its potential as a tool for automated diagnosis. This study paves the way for future research in applying attention mechanisms to the automated diagnosis of lumbar spinal stenosis and other complex spinal conditions. [ABSTRACT FROM AUTHOR]

Objective: Clinical practice guidelines (CPGs) for Integrated Traditional Chinese and Western Medicine (TCM and WM) are important medical documents used to assist medical decision‐making and are of great significance for standardizing clinical pathways. However, due to the constraints of text format, it is difficult for Integrated TCM and WM CPGs to play a real role in medical practice. In addition, how to standardize the structure and semantic relationships between Integrated TCM and WM CPG knowledge, and realize the construction of computable, sharable and reliable CPGs, remains an urgent issue to be addressed. Therefore, we are proposing an ontology of CPGs for Integrated TCM and WM. Methods: We first initialized domain concepts and relationships to ensure the accuracy of the ontology knowledge structure. We then screened CPGs that meet the standards for Integrated TCM and WM, analyzed and classified the contents, and extracted the common structures. Based on the seven‐step ontology construction method combined with inference‐complement, referring to the representation methods and hierarchical relationships of terms and concepts in MeSH, ICD‐10, SNOMED‐CT, and other ontologies and terminology sets, we formed the concept structure and semantic relationship tables for the ontology. We also achieved the matching and mapping between the ontology and reference ontologies and term sets. Next, we defined the aspects and constraints of properties, selected multiple Integrated TCM and WM CPGs as instances to populate, and used ontology reasoning tools and formulated defined inference rules to reason and extend the ontology. Finally, we evaluated the performance of the ontology. Results: The content of the Integrated TCM and WM CPGs is divided into nine parts: basic information, background, development method, clinical question, recommendation, evidence, conclusion, result, and reason for recommendations. The Integrated TCM and WM CPG ontology has 152 classes and defines 90 object properties and 114 data properties, with a maximum classification depth of 4 layers. The terms of disease, drug and examination item names in the ontology have been standardized. Conclusions: This study proposes an Integrated TCM and WM CPG ontology. The ontology adopts a modular design, which has both sharing and scaling ability, and can express rich guideline knowledge. It provides important support for the semantic processing and computational application of guideline documents. [ABSTRACT FROM AUTHOR]