Chinese herbal compounds containing scorpion in the treatment of epilepsy: A protocol for systematic review and meta-analysis

Background:Epilepsy is 1 of the common neurodevelopmental diseases. It can affect about 0.5% to 1.0% of the population regardless of their race and social class. Despite the development of a wide range of treatments, there remaining about one-third of patients still experience seizures. Chinese herbal compounds containing scorpion (CHCCS) have shown an outstanding curative effect on nerve protection and epilepsy. But there''s no study to assess its clinical efficacy and safety.Methods:Each data of CHCCS in treating epilepsy from related English and Chinese databases will be searched. The primary outcome is the efficacy of the CHCCS on epilepsy. And the secondary outcomes include recurrence rate and side effects. The risk of bias will be assessed, and RevMan5.3 and Stata14.0 will be performed for meta-analysis. Finally, we will assess the level of the resulting evidence.Results:The results of the study will be combined with current evidence and published in a peer-reviewed journal.Conclusions:This study will specifically investigate the effectiveness and safety of CHCCS in treating epilepsy.INPLASY registration number:INPLASY202120056.     

External treatment of traditional Chinese medicine for myasthenia gravis: A protocol for systematic review and meta-analysis

Background:Myasthenia gravis (MG) is an archetypal autoimmune disorder. The conventional treatments for this disease are drugs, plasma exchange, surgical, and so on. However, this disease is difficult to cure. A mass of studies revealed that the external treatment of traditional Chinese medicine (TCM) for MG is a safe and economical approach. The present study conducted a meta-analysis to compare TCM external treatment combined with modern medicine with modern medicine for MG, in order to determine which TCM external treatment intervention has the best relative efficacy, safety, and provide the best evidence for clinical practice.Methods:PubMed, Cochrane Library, EMBASE, Web of Science, Springer, China National Knowledge Infrastructure (CNKI), Wan-fang database, VIP Chinese Science and Technique Journals Database, the Chinese Bio Medical Database (CBM), and Baidu Scholar were searched. The time of publication was limited from inception to February 28, 2021. Two reviewers independently searched for the selected articles and extract the data. The RevMan V.5.3 statistical software (Cochrane Collaboration) and Stata V.16.0 software were used to conduct the meta-analysis.Results:The results of the systematic review and meta-analysis will be published in a peer-reviewed journal.Conclusion:The present study provides a protocol that can be used in the systematic review and meta-analysis, with the intent to inform professionals on the external treatment of TCM for MG. These would lead to investigations on the use of the most external treatment of TCM for MG.Trial registration number:INPLASY202110083     

Precision Medicine Approaches to Vascular Disease: JACC Focus Seminar 2/5

In this second of a 5-part Focus Seminar series, we focus on precision medicine in the context of vascular disease. The most common vascular disease worldwide is atherosclerosis, which is the primary cause of coronary artery disease, peripheral vascular disease, and a large proportion of strokes and other disorders. Atherosclerosis is a complex genetic disease that likely involves many hundreds to thousands of single nucleotide polymorphisms, each with a relatively modest effect for causing disease. Conversely, although less prevalent, there are many vascular disorders that typically involve only a single genetic change, but these changes can often have a profound effect that is sufficient to cause disease. These are termed “Mendelian vascular diseases,” which include Marfan and Loeys-Dietz syndromes. Given the very different genetic basis of atherosclerosis versus Mendelian vascular diseases, this article was divided into 2 parts to cover the most promising precision medicine approaches for these disease types.     

A concise guide to clinical reasoning

What constitutes clinical reasoning is a disputed subject regarding the processes underlying accurate diagnosis, the importance of patient‐specific versus population‐based data, and the relation between virtue and expertise in clinical practice. In this paper, I present a model of clinical reasoning that identifies and integrates the processes of diagnosis, prognosis, and therapeutic decision making. The model is based on the generalized empirical method of Bernard Lonergan, which approaches inquiry with equal attention to the subject who investigates and the object under investigation. After identifying the structured operations of knowing and doing and relating these to a self‐correcting cycle of learning, I correlate levels of inquiry regarding what‐is‐going‐on and what‐to‐do to the practical and theoretical elements of clinical reasoning. I conclude that this model provides a methodical way to study questions regarding the operations of clinical reasoning as well as what constitute significant clinical data, clinical expertise, and virtuous health care practice.