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简介：1ThebackgroundofthedevelopmentofInternationalTravelMedicineinChina1.1Thenumberofexitpersonsin1993is93000000,duetotheexpansionofopenesstotheoutside,internationaltravelandthedevelopmentofforeigntrade.1.2Fitforthedevelopmentofthesocialistmarketeconomyandmeettheneedsofdaily—risinginternationaltravelhealthcareatdifferentlevels.

简介：AbstractBackground:Urbanization in China is rapidly proceeding, but rural-to-urban migration and its association with overweight and obesity is not well studied. This study aimed to explore the age at arrival, duration of migration, and the corresponding association with overweight/obesity in Yi migrants in China.Methods:A cross-sectional study was conducted in rural and urban areas in 2015 in Sichuan province, China. Demographic characteristics, lifestyle factors, and anthropometry were collected. General linear regression models were used to assess the effect of duration of migration (1-10, 11-20, 21-30, and >30 years) on body mass index (BMI). Multi-variable logistic regression was used to examine the association between duration of migration and overweight/obesity (BMI ≥ 25 kg/m2).Results:A total of 3056 Yi people (1894 Yi farmers and 1162 Yi migrants) aged 20 to 80 years were enrolled. After adjusting for age, sex, and other potential confounders, Yi migrants had 1.71 kg/m2 (95% confidence interval [CI]: 1.36-2.06) higher BMI and a 2.13-fold (95% CI: 1.71-2.65) higher risk of overweight/obesity than Yi farmers. In Yi migrants, stratified by age at arrival, no significant association between duration of migration and overweight/obesity was observed in those who were 0 to 20 years old at arrival. In comparison, in migrants >20 years old at arrival, compared with the reference group (1-10 years), long-term migration (>30 years) was found to be associated with overweight/obesity after adjustment (odds ratio: 1.85, 95% CI: 1.04-3.29).Conclusions:Yi migrants were observed to have greater risk of overweight/obesity than Yi farmers. In Yi migrants, the risk of overweight/obesity increased according to the duration of migration, especially in those who were older upon their arrival.

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简介：Overthedecade,ChineseBiomedicalEngineeringhasmaderemarkleprogressandaccumulatedmuchexperience.Animportantproblemfacingusishowtotaketheroadaheadofus.Firstofall,weshouldchangeourconventionalconceptandheadforthenewroad.Aboutthreeyearsago,wemadeaspecialreviewontheconnotationandchar-acteristicsofbiomedicalengineeringandpointedoutthatBiomedicalEngineeringwas

简介：针灸学属于传统经验医学，循证医学是新兴的医学方法学，是经验医学的发展。自上个世纪90年代以来，中国从事针灸学研究的工作者已开始吸收和借鉴循证医学的方法和原理，用于指导针灸临床研究与医疗实践，现在国内已有越来越多的针灸临床工作者采用和遵循循证医学的原则和方法。从目前Cochrane图书馆发表的与针灸有关的系统评价来看，以往认为有效的针灸疗法却没有足够的证据表明有效，这与目前国内RCT质量不高直接有关。今后，发展并形成针灸临床研究专业化队伍和针灸临床研究中心，才能从根本上提高针灸临床研究和评价的水平。同时，发展中国循证针灸学，应结合中国针灸学的自身特点，如重视古籍中的原始研究证据，开展高质量的随机对照试验，重视非随机研究的系统评价等等。

简介：AbstractObjective:Clinical practice guidelines can improve healthcare processes and patient outcomes; however, the quality of these guidelines varies greatly in China. The aim of this study was to construct a comprehensive instrument for the appraisal of clinical practice guidelines in China (AGREE-CHINA), and to validate its reliability as a tool for helping potential guideline users in assessing guideline quality.Methods:First, an interdisciplinary working group was established for developing the methods. They also created a checklist as a tool according to the Appraisal of Guidelines, Research and Evaluation II (AGREE II) standards, considering the particularity of Chinese clinical practice. Next, the first draft of AGREE-China was developed by vote, modification, preliminary trial, and cross-verification. To ensure the objectivity, credibility, and reproducibility of the draft assessment, all of the checklists and standards were cross-reviewed fairly widely. Finally, AGREE-CHINA and AGREE II were used to assess the Chinese guidelines published in the past five years, and the results were compared.Results:The presented AGREE-CHINA covered five main checkpoints (science and rigor, effectiveness and safety, economy, usability and feasibility, and conflicts of interest) with each point divided into several more specific checkpoints. Definitions and rationales for each main checkpoint appear in the Appendix. The quality ratings based on the total scores of AGREE-China and AGREE II were consistent (r = 0.508, P = 0.020). Compared with AGREE II, the study showed a higher level of interrater-reliability for AGREE-CHINA overall (ICC = 0.957, P < 0.001). The mean time required for AGREE-CHINA was less than that for AGREE II; this was approximately 30 minutes for every assessment. User satisfaction was generally high.Conclusions:This paper has presented the first edition of the AGREE-CHINA appraisal tool for clinical guidelines. It is quick and easy to use; it assesses and performs well in comparison to AGREE II. This first version of AGREE-CHINA will require further development and validation.

简介：AbstractBiosafety equipment is the key barrier enabling high containment laboratories to handle high risk agents that may cause serious and potentially lethal infections. This perspective thoroughly analyzes the development of many kinds of key biosafety technologies, and equipment for protection of laboratory workers and for high containment laboratory facilities in China. Over more than ten years of rapid development, China has had remarkable achievements in key biosafety technologies and equipment in high containment laboratories. These technologies basically meet the needs of high containment laboratories construction in China. Furthermore, according to the current global situation regarding the prevention and control of infectious diseases and the technical development level of biosafety equipment, this paper proposes targeted suggestions and notes that China still needs to increase investment in scientific research to provide further technical and equipment support enabling us to build a community with a bright future in terms of human biosafety.

简介：AbstractBackground:Tuberculosis (TB) poses a severe public health challenge in China and worldwide. This study evaluated the effects of age, period, and birth cohort on reported incidence trends of TB based on population and refined the characteristics of high-risk groups.Methods:Aggregate data that reported pulmonary tuberculosis (PTB) cases from China Tuberculosis Management Information System (TBIMS) from 2006 to 2020 were used to analyze effect coefficients through the age-period-cohort (APC) model based on intrinsic estimator (IE) method, and converted them into relative risk (RR) to estimate trends.Results:A total of 14.82 million cases of PTB were reported in China from 2006 to 2020, showing a continuous downward trend. The reporting rate increased with age by age group, with 70-74 years old being 2-3 times higher than that in 20-24 years old. APC analysis model showed that age effects were bimodal in 20-24 years old [RR= 2.29, 95% confidence interval (CI): 1.73-3.03] and 70-74 years old (RR= 1.95, 95% CI: 1.67-2.27), and lower than the overall average in the groups under 15 years old. Stratified results showed that the risk was higher for women under age 40 than men and higher for men over 40. The risk was higher in urban than in rural areas under 30 years old and slightly higher in rural than in urban between 30 and 64 years old. The risk for 15-34 years old was significantly higher in the east than in other regions. The period effects showed a decreasing trend, and the risk was higher in rural in recent years. Except for cohorts born in 1961-1965 and 2001-2005, where the RR increased, the later the cohort was born, the lower the risk. The cohort 1926-1930 in eastern had the highest risk (RR= 3.49, 95% CI: 2.44-4.98).Conclusions:The reported incidence of PTB continued to decline in China from 2006 to 2020. The young (20-24 years old) and the elderly (70-74 years old) were equally at high risk. There were differences in the age, period and cohort effects on PTB incidence among gender, urban-rural and regions. Our findings better reflected the characteristics of high-risk populations, thus contributing to the development of timely and effective intervention strategies, and providing clues for etiological research.

简介：AbstractSince the coronavirus disease 2019 (COVID-19) pandemic, major innovative-oriented countries have adopted various science and technology innovation (STI) policies to address global public health challenges. Using data from the Organization for Economic Co-operation and Development STI Database, this study analyzed international STI policies in response to the COVID-19 pandemic. The findings revealed that the pandemic has dramatically stimulated the application of STI policies, and there are commonalities and differences in the STI policies of different countries. Meanwhile, COVID-19 has disrupted planning for allocating resources for STIs, leading to duplication and inefficiency. Based on the findings, this study recommends increasing research investment to address the long-term challenges of major infectious diseases, strengthening support for enterprises, promoting data sharing and openness, enhancing the internationalization of scientific research, strengthening scientific consultation and communication, and devoting more policy attention to vulnerable groups.

简介：AbstractBackground:Acute myeloid leukemia (AML) is a common type of hematological malignancy in elderly people. Geriatricians have developed comprehensive geriatric assessment (CGA) methods for elderly patients; however, the tools used for CGA in AML are not uniform. Thus, we aimed to validate the instrumental activities of daily living (IADL) scales, age, comorbidities (Charlson Comorbidity Index), and albumin (IACA) index, which is a new tool for CGA, in elderly patients with AML.

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简介：AbstractBackground:Though the utilization of traditional medicine has been proposed for modern drug research and development (R&D), limited research has discussed its feasible paths. In this commentary, we summarized key factors for new drug R&D under limited resources by reviewing China’s discovery of artemisinin, and raised suggestions to utilize traditional medicines in low-and middle-income countries (LMICs).Main text:We suggested that systematic utilization of traditional medicine, outstanding synergy of research units at all levels and timely information-sharing mechanism should be achieved to establish a comprehensive and efficient R&D system, especially under low-resource settings. In the case of artemisinin discovery, Chinese scientists integrated documented traditional medicine experiences and modern approaches to develop drug candidates timely. Due to limited R&D resources, China adopted a collaborative way, motivating nearly all domestic research units at different levels, to develop antimalarial products. Moreover, the excellent synergy among all units through efficient information-sharing mechanisms greatly avoided work repetition and accelerated the R&D process.Conclusion:Traditional medicines inspires drug discoveries in LMICs, while a comprehensive and efficient R&D system could accelerate its R&D process and save investment. The discovery of artemisinin in China gave a reliable pattern to promote sustainable development of traditional medicines and a good example to realize R&D of traditional medicine under low-resource settings.

简介：AbstractBackground:Osteoarthritis (ΟΑ) is characterized by cartilage breakdown and subchondral sclerosis. Micro-fractures of the calcified tissues have been, also, detected, but their exact role has not been elucidated yet. This study was to examine the frequency of cracks during OA progression and to correlate them with the underlying cellular modifications and matrix metalloproteinase-2 (MMP-2) expression using histological/immunohistological methods.Methods:Overall, 20 patients and 3 controls (9 specimens per patient), aged 60-89 years, diagnosed with hip/knee OA were included. The development of cracks was examined in 138 sections, whereas the expression of MMP-2 was examined in 69 additional sections.Results:Based on Mankin score, three groups of OA severity were analyzed: Group I (mild) was constituted of sections with score 1-5 while Groups II (moderate) and III (severe) with score 6-7 and greater or equal to 8, respectively. Demographic characteristics did not reveal any association between the number of microdefects and age or body mass index (BMI). Cartilage micro-cracks were increased during moderate and severe OA, while bone cracks were increased during mild and severe OA. In knee OA, cartilage cracks were not correlated with Mankin score, whereas in hip OA they appeared association with severity score. Bone cracks were positively correlated with matrix apoptotic osteocytes and osteoblastic cells, but not with osteoclasts. MMP-2 immunostaining was increasing by OA severity in the osteochondral unit. Similarly, MMP-2 was expressed on the microcracks’ wall mainly in Group III.Conclusion:Our data displayed that bone cracks during primary OA stages, represent an early adaptative mechanism aiming to maintain cartilage integrity. Accumulation of bone defects and concomitant increase of apoptotic osteocytes activated an abnormal remodeling due to osteoblastic activity, in which MMP-2 played a pivotal role, leading to subchondral sclerosis promoting further osteochondral deformities.

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简介：AbstractBackground:China’s two-child policy has led to a trend of aging in pregnancy which was associated with adverse outcomes. This study aimed to identify the clinically cutoff maternal age for adverse obstetric outcomes in China.Methods:This secondary analysis of a multicenter retrospective cohort study included data of childbearing women from 39 hospitals collected in urban China during 2011 to 2012. Logistic regression was used to assess the adjusted odds ratios (aOR) of adverse outcomes in different age groups in comparison to women aged 20 to 24 years. The adjustments included the location of the hospital, educational level, and residence status. Clinically cutoff age was defined as the age above which the aOR continuously become both statistically (P < 0.05) and clinically (aOR > 2) significant.Results:Overall, 108,059 women were recruited. In primiparae, clinically cutoff maternal ages for gestational diabetes (aOR: 2.136, 95% confidence interval [CI]: 1.856-2.458, P < 0.001), placenta previa (aOR: 2.400, 95% CI: 1.863-3.090, P < 0.001), cesarean section (aOR: 2.511, 95% CI: 2.341-2.694, P < 0.001), hypertensive disorder (aOR: 2.122, 95% CI: 1.753-2.569, P < 0.001), post-partum hemorrhage (aOR: 2.129, 95% CI: 1.334-3.397, P < 0.001), and low birth weight (aOR: 2.174, 95% CI: 1.615-2.927, P < 0.001) were 27, 31, 33, 37, 41, and 41 years, respectively. In multiparae, clinically cutoff ages for gestational diabetes (aOR: 2.977, 95%CI: 1.808-4.904, P < 0.001), hypertensive disorder (aOR: 2.555, 95% CI: 1.836-3.554, P < 0.001), cesarean section (aOR: 2.224, 95% CI: 1.952-2.534, P < 0.001), post-partum hemorrhage (aOR: 2.140, 95% CI: 1.472-3.110, P < 0.001), placenta previa (aOR: 2.272, 95% CI: 1.375-3.756, P < 0.001), macrosomia (aOR: 2.215, 95% CI: 1.552-3.161, P < 0.001), and neonatal asphyxia (aOR: 2.132, 95% CI: 1.461-3.110, P < 0.001) were 29, 31, 33, 35, 35, 41, and 41 years, respectively.Conclusions:Early cutoff ages for gestational diabetes and cesarean section highlight a reasonable childbearing age in urban China. The various optimized cutoff ages for different adverse pregnancy outcomes should be carefully considered in childbearing women.

简介：Sincethe1970s,outcomestudiesforchildrenwithhearinglossexpandedfromfocusingonassessingauditoryawarenessandspeechperceptionskillstoevaluatinglanguageandspeechdevelopment.Sincetheearly2000s,themulti-centerlargescaleresearchsystematicallystudiedoutcomesintheareasofauditoryawareness,speech-perception,languagedevelopment,speechdevelopment,educationalachievements,cognitivedevelopment,andpsychosocialdevelopment.Thesestudiesadvocatedtheestablishmentofbaselineandregularfollow-upevaluationswithacomprehensiveframeworkcenteredonlanguagedevelopment.Recentresearchinterestsalsoincludeunderstandingthevastdifferencesinoutcomesforchildrenwithhearingloss,understandingtherelationshipsbetweenneurocognitivedevelopmentandlanguageacquisitioninchildrenwithhearingloss,andusingoutcomestudiestoguideevidence-basedclinicalpractice.AftertheestablishmentofstandardizedMandarinlanguageassessments,outcomesresearchinMainlandChinahasthepotentialtoexpandbeyondauditoryawarenessandspeechperceptionstudies.

简介：AbstractBackground:Twin pregnancies continue to increase worldwide; however, the current clinical prenatal evaluation for the intrauterine growth of twins still relies on the growth standards of singletons. We attempted to establish a set of fetal biometric references for Chinese twin pregnancies, stratified by chorionicity and conception mode as spontaneously conceived monochorionic diamniotic (SC-MCDA), spontaneously conceived dichorionic diamniotic (SC-DCDA), and assisted reproductive technology dichorionic diamniotic (ART-DCDA) twins.Methods:From 2016 to 2019, the ultrasonographic fetal biometric measurements were longitudinally collected in pregnant women, including fetal weight, biparietal diameter, head circumference, abdominal circumference, femur length, and humerus length. The linear mixed models were used to test the difference of growth patterns between groups, and the growth curve of each biometric parameter was modeled by a generalized additive model for location scale and shape.Results:A total of 929 twin pregnant women and 2019 singleton pregnant women, met the inclusion criteria. Among twin pregnancies, 148 were SC-MCDA, 215 were SC-DCDA, and 566 were ART-DCDA twins. Overall, SC-DCDA twins grew faster than SC-MCDA twins, while slower than ART-DCDA twins (all P < 0.05), and all of the three groups showed significant differences comparing with singletons, especially during the third trimester. Hence, the customized fetal growth charts of each fetal biometric parameter were, respectively, constructed for SC-MCDA, SC-DCDA, and ART-DCDA twins.Conclusions:The fetal biometric trajectories demonstrated characteristic patterns according to chorionicity and conception mode. To fill the gap, we modeled fetal biometric parameters for Chinese SC-MCDA, SC-DCDA, and ART-DCDA twin pregnancies, hoping to provide a reference for the further establishment of fetal growth reference values for Chinese twin fetuses.

简介：NewZealandersareincreasinglyembracingAcupunctureandChineseMedicine.AsurveyofGeneralPractitionersin2006showedthatnearly80%ofthosesurveyedwouldrefertheirpatientsontoanAcupuncturistfortreatment.ThenationalinjuryinsuranceschemethroughtheAccidentCompensationCommission(ACC)hasfundedpartialpaymentofAcupuncturetreatmentsince1990.In2007,theMinisterofHealthapprovedAcupuncturetoberecognizedundertheHealthPractitionersCompetenceAssurance(HPCA)ActbutfollowingareviewoftheAct,thedecisionwasoverturned.TheNewZealandGovernmenthasdecidedtoadoptthesamecriteriaforregistrationofhealthprofessionsasAustraliaandourprofessionhasbeenaskedtoresubmitshowingthatwemeetthenewcriteria.Althoughdisappointing,wenowhavetheopportunitytotakeChinesemedicine,includingbothAcupunctureandChineseHerbalMedicinethroughtoregistration,thesameasourcolleaguesinAustralia.ChineseMedicinehasbeenapprovedfornationalregistrationinAustraliaandtheschemewillbegininJuly2012.ItishopedthatweinNewZealandwillbeabletofollowasimilartimeline.Inthepast,thoseNewZealanderswishingtostudyAcupunctureorChineseMedicinehadtotraveloverseastodoso.Wenowhavetwowellestablishedschools,eachwithtwocampuses,deliveringaBachelorDegreeinHealthScience.TheNewZealandRegisterofAcupuncturistsisthelargestandlongestestablishedprofessionalbodyrepresentingAcupuncturistsandpractitionersofChineseMedicineinNewZealand.Themajorityofourmemberstrainedoverseas-largelyinChinabutalsoinAustralia,Korea,AmericaortheUK-butthisdemographicisrapidlychangingasmorestudentsgraduatefromourlocalschools.Withincreasingnumbersofpractitionersandgreaterawarenessbythegeneralpublic,AcupunctureandChineseMedicinearefirmlyestablishedaspartofthehealthcaresysteminNewZealand.Registrationoftheprofessionisthenextimportantstepinensuringthatst