Ulcerative colitis (UC), a chronic and nonspecific inflammatory disease of the intestine, has become a prevalent global health concern. This guideline aims to equip clinicians and caregivers with effective strategies for the treatment and management of adult UC patients using traditional Chinese medicine (TCM). The guideline systematically evaluated contemporary evidence through the Grading of Recommendations Assessment, Development, and Evaluation framework. Additionally, it incorporated insights from ancient Chinese medical sources, employing the evidence grading method found in traditional TCM literature. The development process involved collaboration with multidisciplinary experts and included input from patients with UC. The guideline, based on a comprehensive review of available evidence, present 40 recommendations. They offer a condensed overview of TCM's role in understanding the pathogenesis, diagnosis, and treatment of UC, along with an assessment of the efficacy of various TCM-based treatments. TCM exhibits promising outcomes in the treatment of UC. However, to establish its efficacy conclusively, further high-quality clinical studies on TCM for UC are essential.

Background and objectives:Smoking is responsible for 9 out of 10 deaths related to chronic obstructive pulmonary disease, and this number can be reduced by quitting smoking. In this study, the effect of different interventions on smoking cessation of patients with chronic obstructive pulmonary disease was assessed through a network meta-analysis. Methods:Eight databases were searched to obtain randomized controlled trials involving different interventions for smoking cessation in chronic obstructive pulmonary disease patients. The Cochrane Handbook tool was employed to assess the risk bias of included studies. Network meta-analysis was performed using STATA software. Results:A total of 23 studies involving 13,480 patients were included. Eight studies were rated as having a high risk of bias, seven studies had a low risk, and in eight studies, the risk was unclear. All studies employed 13 different interventions, including eight monotherapies and five combination therapies. Network meta-analysis showed that a combination of behavioral therapy and pharmacotherapy was superior in achieving patients' smoking cessation compared to monotherapy. Moreover, varenicline was more helpful for smoking cessation than other single interventions. The final surface under the cumulative ranking curve value indicated that cognitive behavior therapy combined with bupropion achieved the best smoking cessation effect. Conclusions:The obtained results indicate that a combination of behavioral therapy and pharmacotherapy is most powerful in helping chronic obstructive pulmonary disease patients to quit smoking. Researchers should focus more on the safety of pharmacotherapeutic interventions. Moreover, more high-quality trials investigating the stability of evidence levels of different interventions on abstinence must be conducted.

Background Malaria is one of the most serious global problems. The objective of this study is to assess whether intermittent preventive treatment (IPT) using artemisinin-based combination therapies (ACTs) was a promising alternative to IPT with sulphadoxine-pyrimethamine (IPT-SP). Methods We searched the following sources up to 12 August 2020: PubMed, The Cochrane Library, Embase, Web of Science, CNKI, CBM, VIP and WanFang Database from inception. The randomized controlled trials comparing SP with ACTs for malaria were included. Data were pooled using Stata.14 software. We performed subgroup analysis based on the different types of ACTs groups and participants. Results A total of 13 studies comprising 5180 people were included. The meta-analysis showed that ACTs had the lower risk of number of any parasitemia (RR=0.46; 95% CI 0.22 to 0.96, p=0.039; I-2=90.50%, p<0.001), early treatment failure (RR=0.17; 95% CI 0.06 to 0.48, pI(2)=66.60%, p=0.011) and late treatment failure (RR=0.34; 95% CI 0.13 to 0.92, pI(2)=87.80%, p<0.001) compared with SP. There was no significant difference in adequate clinical response, average hemoglobin and adverse neonatal outcomes. Conclusion Combinations with ACTs appear promising as suitable alternatives for IPT-SP.

OBJECTIVE: Continuing care, which is an extension of post-discharge care, is recognized as a crucial element of high-quality health services and is essential to patients. This systematic review aims to identify the effectiveness of continuing care for patients with stomas. METHODS: PubMed, EMBASE, Cochrane Trial Register and Web of Science databases were searched. Study selection and quality appraisal were performed independently by two reviewers. We calculated the mean differences (MD) or the relative risk (RR) with 95% confidence intervals and assessed heterogeneity. RESULTS: Nine studies (1134 participants) met the inclusion criteria. This meta-analysis revealed that, in the continuous care group, the stoma self-efficacy (MD = 6.46; 95% CI = 3.81-9.11; P < 0.001; I 2 = 0%), and the quality of life (MD = 7.48; 95% CI = 5.13-9.82; P < 0.001; I 2 = 0%) increased significantly 1 month after discharge; stoma adjustment and care satisfaction also showed a trend toward improvement while stoma complications (RR = 0.71; 95% CI = 0.58-0.87; P = 0.001; I 2 = 25%) decreased significantly. Continuing care did not decrease hospital readmission rates or medical costs. CONCLUSIONS: Continuing care showed beneficial effects in improving health outcomes and care satisfaction for patients with stomas compared with routine care. We proposed an integrated continuing care program with different elements and recommendations for its implementation.

Objective To update and evaluate the recurrence rate of Helicobacter pylori (H. pylori) eradication therapy in recent 10 years. Methods A systematic search of PubMed, Embase, Cochrane library, and Web of science was performed to identify the studies of recurrence rate of H. pylori published from 2010 to 2019. Stata 15.0 was used for analysis. Results A total of 31 studies (16,797 participants) were analyzed. The recurrence rate of H. pylori was 9% (95% CI, 8–11%), and it showed an upward trend with the time elapsed after eradication. The annual recurrence rate was 4%, and there was a stable trend with the time elapsed after eradication. Subgroup analyses showed that the recurrence rate of H. pylori eradication by triple therapy was higher than that of quadruple therapy (14% [95% CI, 9–19] vs 12% [95% CI, 7–17]); urban was higher than that of rural (8% [95% CI, 1–14] vs 5% [95% CI, 1–9]); males were higher than that of females (11% [95% CI, 8–14] vs 10% [95% CI, 7–14]); Europe had the highest recurrence rate (16% [95% CI, −1 to 42]), and Africa had the lowest (1% [95% CI, 0–2]). The recurrence rate ofH. pylori was inversely related to the human development index. Conclusions The recurrence rate of H. pylori showed an increasing trend in recent 10 years, and it is still a knotty public health problem worldwide. The recurrence rate of H. pylori showed an upward trend with the time elapsed after eradication, and the recurrence rate of H. pylori varies by area, gender, and eradication methods.

Introduction Primary healthcare (PHC) serves as the cornerstone for the attainment of universal health coverage (UHC). Efforts to promote UHC should focus on the expansion of access and on healthcare quality. However, robust quality evidence has remained scarce in China. Common quality assessment methods such as chart abstraction, patient rating and clinical vignette use indirect information that may not represent real practice. This study will send standardised patients (SP or healthy person trained to consistently simulate the medical history, physical symptoms and emotional characteristics of a real patient) unannounced to PHC providers to collect quality information and represent real practice. Methods and analysis 1981 SP-clinician visits will be made to a random sample of PHC providers across seven provinces in China. SP cases will be developed for 10 tracer conditions in PHC. Each case will include a standard script for the SP to use and a quality checklist that the SP will complete after the clinical visit to indicate diagnostic and treatment activities performed by the clinician. Patient-centredness will be assessed according to the Patient Perception of Patient-Centeredness Rating Scale by the SP. SP cases and the checklist will be developed through a standard protocol and assessed for content, face and criterion validity, and test-retest and inter-rater reliability before its full use. Various descriptive analyses will be performed for the survey results, such as a tabulation of quality scores across geographies and provider types. Ethics and dissemination This study has been reviewed and approved by the Institutional Review Board of the School of Public Health of Sun Yat-sen University (#SYSU 2017-011). Results will be actively disseminated through print and social media, and SP tools will be made available for other researchers.

The role of nurse participation (NP) in colonoscopy observation for polyp and adenoma detection is unclear. This study aimed to evaluate whether nurse participation can improve polyp and adenoma detection. Patients and Methods. The PUBMED, EMBASE, and Cochrane Library databases were searched for randomized controlled trials (RCTs) published in English. The outcome measurements included (1) the polyp and adenoma detection rate (PDR and ADR); (2) the advanced lesions detection rate; and (3) the mean polyp and adenoma detection rate per colonoscopy. Results. Three RCTs with a total of 1676 patients were included. The pooled data showed a significantly higher ADR in the NP group than colonoscopist alone (CA) (45.7% versus 39.3%; RR 1.16; 95% CI, 1.04-1.30). And it showed no significant difference in the PDR and advanced lesions detection rate between the two groups (RR: 1.14, 95% CI: 0.95-1.37; RR: 1.35, 95% CI: 0.91-2.00; resp.). Conclusions. Nurse participation during a colonoscopy can improve the ADR, whereas no benefit for the PDR and advanced lesions detection rate was observed. All RCTs included in the meta-analysis had high risk of bias. Thus, there is a need for new research that uses sound methodology to definitively address the research question under study

Background Mobile health interventions utilising telephone calls are promising tools for diabetes management. However, there is still a lack of convincing evidence demonstrating their beneficial effects on cardiovascular risk factors. The aim of this meta-analysis of randomised controlled trials was to assess the effect of telephone calls on glycaemic control and other cardiovascular risk factors in type 2 diabetes mellitus patients. Methods Two independent reviewers searched three online databases (PubMed, the Cochrane Library and EMBASE) to identify relevant English-language randomised controlled trials up to September 2017. Randomised controlled trials that assessed the effects of telephone calls on glycaemic control and other cardiovascular risk factors in type 2 diabetes mellitus patients were included. Effect size was calculated for changes in glycosylated haemoglobin A1c, weight, blood pressure and lipid levels using fixed- or random-effects models. Results Eighteen studies involving 3954 patients were included in the meta-analysis. Compared with usual care, telephone calls significantly decreased glycosylated haemoglobin A1c, by 0.12% (95% confidence interval: -0.22% to -0.02%). Univariate regression analysis showed that none of the covariates (number of participants, baseline age, baseline glycosylated haemoglobin A1c, duration of diabetes, call maker, number of calls and duration of study) had an impact on glycosylated haemoglobin A1c. For other cardiovascular risk factors, telephone calls significantly reduced systolic blood pressure by 0.19 mm Hg (95% confidence interval: -0.34% to -0.03%) but non-significantly changed diastolic blood pressure, body mass index, low-density lipoprotein cholesterol, total cholesterol, triglyceride or high-density cholesterol levels. Conclusions This meta-analysis supports the hypothesis that telephone calls offer moderate benefits for glycosylated haemoglobin A1c and systolic blood pressure reduction among type 2 diabetes mellitus patients. However, the data remain insufficient regarding the association of telephone calls with lowered diastolic blood pressure, body mass index or improved lipoprotein profiles