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Coronavirus disease 2019 (COVID‐19) has widely spread all over the world and the numbers of patients and deaths are increasing. According to the epidemiology, virology, and clinical practice, there are varying degrees of changes in patients, involving the human body structure and function and the activity and participation. Based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) and its biopsychosocial model of functioning, we use the WHO Family of International Classifications (WHO‐FICs) framework to form an expert consensus on the COVID‐19 rehabilitation program, focusing on the diagnosis and evaluation of disease and functioning, and service delivery of rehabilitation, and to establish a standard rehabilitation framework, terminology system, and evaluation and intervention systems based the WHO‐FICs.

The study aims to evaluate the effectiveness of different durations of aerobic exercise on hypertensive patients. Four electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) were searched from their inception until July 2018. English publications and randomized controlled trials involving aerobic exercise treatment for hypertensive population were included. Two reviewers independently extracted the data. The Cochrane's Risk of Bias tool was used to assess the quality of included studies. In this systematic review, a total of 14 articles were included, involving 860 participants. The quality of the included studies ranged from moderate to high. The results of the meta‐analysis showed that compared with the control group, significant effects of aerobic exercise were observed on reducing systolic blood pressure (SBP) (mean difference [MD] = −12.26 mm Hg, 95% confidence interval [CI] = −15.17 to −9.34, P

Objective: To evaluate the impact of the duration of breastfeeding on the intelligence of children. Materials and Methods: Eight electronic databases were searched to identify studies that investig...

Background Acupuncture analgesia has been evaluated by a number of randomised controlled trials (RCTs); however, a systematic summary of reporting quality of RCTs in this specific field is lacking. Objective To examine the reporting characteristics and risk of bias of RCTs of acupuncture analgesia indexed in the PubMed database. Methods A PubMed search of RCTs of acupuncture analgesia was conducted through November 2015. The Cochrane Collaboration Risk of Bias Tool was used to assess the risk of bias of each trial. Results 206 articles were identified across 59 journals (impact factor 0.4–20), of which 56% of articles and 86% of journals were Science Citation Index (SCI)-indexed. Nearly half of the articles were published in China. The next most represented countries of origin were the UK (22%) and USA (21%). Of the included trials, postoperative pain was the most prevalent phenotype, and manual acupuncture was the most frequently applied type of stimulation (46%). A total of 12% of articles reported on analgesic mechanisms. The most frequently used acupuncture points were LI4, ST36, PC6, SP6 and Shenmen. The overwhelming majority of trials were considered to be at high risk of bias (84%). Furthermore, 79% of trials enrolled Conclusions RCTs of acupuncture analgesia indexed in PubMed journals generally exhibited poor reporting of methodological and treatment details. Future studies should provide more information regarding clinical trial registration, blinding of participants (including sham procedures where applicable) and outcome assessors, as well as the training and qualification of acupuncturists.

ObjectiveTo assess the methodological quality of animal studies published in China and abroad using the SYRCLE’s risk of bias tool, and to provide references to improve the methodological quality of animal studies to encourage high quality preclinical studies.MethodsAn electronic search was performed in the Chinese Scientific Citation Database (CSCD) and Web of Science from 2014 to October 2018. Document screening and data extraction were performed independently by four researchers. The methodological quality of the included studies was assessed using the SYRCLE’s risk of bias tool. Statistical analysis was performed using SPSS23.ResultsA total of 2764 animal studies were included. Of the studies, 984 were published in English and 1780 were in Chinese. The citation frequency of more than 90% of the included studies was less than 5. The results of methodological quality assessment showed that 36.36% (8/22) of the sub-items were rated as “low risk” in more than 50% of the included studies, of which 75% (6/8) were rated as “low risk” in more than 80% of the included studies. A total of 59.09% (13/22) of the sub-items were rated as “low risk” in less than 30% of the included studies, of which 92.31% (12/13) were rated as “low risk” in less than 10% of the included studies. The incidence of “low risk” Chinese studies regarding performance bias, detection bias and reporting bias were lower than English studies. For foreign studies, more attention should be paid to selection bias, attrition bias, and reporting bias.ConclusionWe identified limitations in the methodological quality of animal experiment studies published in China and abroad. We therefore suggest that it is necessary to take targeted measures to popularize the SYRCLE’s risk of bias tool to effectively improve the design and implementation of animal experiments, and guide study development.

To assess the effectiveness of music therapy on the quality of life, anxiety, depression and pain of patients with cancer.Systematic review.Five electronic databases were searched in September 2018 for randomized controlled trials evaluating music therapy for patients with cancer.The quality of the studies was assessed using the risk of bias tool recommended by the Cochrane Handbook Version 5.1.0 and the Revman version 5.3 software was used to perform the meta-analysis. The outcomes were overall quality of life, anxiety, depression and pain.A total of 19 trials evaluating 1,548 patients were included in this study, of which 765 were in the control group and 783 in the experimental group. Compared with standard care, music therapy can significantly increase the score of the overall quality of life in patients with cancer. In addition, music therapy was found to be more effective for decreasing the score of anxiety, depression and pain.Music therapy can improve the overall quality of life of patients with cancer, with an observed optimal intervention duration of 1-2 months. Meanwhile, anxiety, depression and pain are improved as well. Nevertheless, high-quality trials are still needed to further determine the effects of music intervention in supportive cancer care.目的: 评估音乐疗法对癌症患者生活质量、焦虑、抑郁情绪以及疼痛感受的效果。 设计: 系统评估。 数据来源: 2018年9月对五大电子数据库进行检索,以获取评价音乐疗法对癌症患者影响的随机对照试验。 评估方法: 采用Cochrane手册(5.1.0版)所推荐的偏倚风险评估工具对研究质量进行评估,同时使用Revman 5.3版软件进行荟萃分析。结果采用整体生活质量、焦虑、抑郁情绪和疼痛感受。 结果: 本研究共纳入19项试验,包括1,548 例患者的评价结果,其中对照组765例,实验组783例。与标准护理相比,音乐疗法能显著提高癌症患者的整体生活质量评分。此外,音乐疗法对降低焦虑、抑郁情绪和疼痛感受的评分也更为有效。 结论: 音乐疗法能提高癌症患者的整体生活质量,且据观察,最佳干预时间为1-2个月。同时,焦虑、抑郁情绪和疼痛感受也有所改善。然而,未来仍需开展更多高质量的试验,以进一步确定音乐干预在癌症支持性治疗中的作用。.

Background Existing meta-analysis have shown that the miR-200 family can be taken as a prognostic biomarker for many tumors. However, great heterogeneity was shown in predicting overall survival (OS) and progression-free survival (PFS). Emerging studies indicate that the expression levels of members of the miR-200 family are tissue-specific among various tumor tissues, which may be the main reason of the heterogeneity in predicting survival prognosis of tumor patients with the miR-200 family as biomarkers. By further analysis of heterogeneity of the miR-200 family as a biomarker for predicting survival prognosis of patients with different tumors, we expected to provide an accurate basis for the clinical application of the miR-200 family to predict the prognosis of patients with different tumors. Methods Eligible published studies were identified by searching the databases of PubMed, Embase and Web of Science. The clinical data of patients in the studies were pooled, and pooled hazard ratios (HR) with 95% confidence intervals (95% CI) were used to calculate the strength of this association. The expressions of miRNAs were extracted from The Cancer Genome Atlas (TCGA). We presented the expressions of each member in miR-200 family in 15 types of cancer by boxplot, and analyzed the correlation among the members of miR-200 family by Spearman method. Different subgroup analyses were then performed based on the correlation among the members of miR-200 family, and the publication bias was assessed using the funnel plot of the Egger bias indicator test. Results Of 36 articles, including 15 tumor types and 4644 patients were included to perform meta-analysis. It was found that miR-200 family members can be used as independent protective factors in patients with various tumors but the miR-200 family has a higher heterogeneity in predicting prognosis: OS (HR = 0.82, 95% CI: 0.66–1.03, I2 = 85%, P Conclusions Our results convincingly demonstrated that the miR-200 family could serve as a prognostic biomarker for cancers mentioned above and has potential value in clinical practice. MiR-200 family as prognostic biomarkers needs to be performed according to different tumor tissues and correlation between members in miR-200 family.

Background Evaluating the clinical efficacy of acupuncture analgesia with systematic reviews (SRs) has attracted wide interest. Objective To collect a sample of published SRs on acupuncture analgesia in PubMed and examine them in terms of reporting characteristics and quality. Methods A search in PubMed was performed in January 2016. All SRs on acupuncture analgesia were included. To assess the quality of the SRs, AMSTAR and PRISMA Statements were used. Results One hundred and nine SRs were included in our analysis, the yearly number of publications ranging from 1 in 1997 to 15 in 2015. Only 17% of these publications were Cochrane Systematic Reviews, and 94% were published in Science Citation Index journals. The United Kingdom was the country with the higher number of publications. Low back pain, headache, cancer pain, and labor pain were the most reported diseases or phenotypes. Nearly 73% of these SRs conducted a meta-analysis, 58% revealed positive results, 53% used RevMan software to analyze data, and 44% used the Cochrane Risk of Bias Tool for quality assessment. Only a few SRs assessed the likelihood of publication bias, reported details about the protocol and the registration information, and performed additional analyses. Conclusions The quantity and the quality of SRs regarding acupuncture analgesia has been promoted in recent years. More effort should be expended on the assessment of publication bias, the provision of detailed information about the protocol and the registration process, and the implementation of additional analyses to improve the validity of the SRs. This article is protected by copyright. All rights reserved.

Objectives To summarize the evidence from systematic reviews (SRs) and meta-analyses that evaluated the efficacy of ginger in treating any conditions and critically assess the quality of these evidence. Methods A systematic search of the literature was conducted from inception until February 28, 2019 using the PubMed, EMBASE, Web of science, Cochrane library, and four Chinese databases. Literature selection and data extraction were conducted by two independent reviewers. The quality of SRs was evaluated using the AMSTAR-2 tool. The GRADE system was used to assess the quality of evidence. Results Twenty-seven SRs were included. The number of included studies were various, range from 3 to 27. The condition with the most included SRs was nausea and vomiting (n = 12, 44.4%). Many SRs showed a promising efficacy of ginger, including nausea and vomiting, metabolic syndrome and pain, while the effect of ginger for platelet aggregation failed to draw a certain conclusion. The quality of SRs was heterogeneous. All of included SRs well complied with the Item 1 (“research questions included the components of PICO”) and Item 3 (“explained selection of the study designs for inclusion”). Twenty review failed to provide registration information. Only one SR reported the sources of funding for studies included. Conclusions In our overview, most of SRs suggest ginger is a promising herbal medicine for health care, which is beneficial for nausea and vomiting, metabolic syndrome and pain. However, considering the limited quality of included evidence and heterogeneity of different clinical trials, more well-design studies are required to confirm the conclusion further.

Extracorporeal shock wave therapy (ESWT) as a new adjuvant therapy has shown a potential capability to promote diabetic foot ulcer (DFU) healing. The purpose of this study was to assess the efficacy and safety of ESWT on the healing of DFUs. The Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine and reference lists were searched for studies published up to December 2018. Randomized controlled trials of any design, including ESWT for patients with DFU, were included. Two reviewers extracted data, including the wound surface area (WSA), percentage of re-epithelialization, population of complete cure and unchanged and other related outcomes. Eight randomized controlled trials (N=339) were included. ESWT was found to be associated with a greater reduction of WSA by 1.54 cm2, and increase of re-epithelialization by 26.31%. A greater population with complete cure was found at the end of treatment (risk ratio [RR] = 2.22; 95% confidence interval [CI], 1.46 to 3.40); however, there was no statistically significant difference at the end of follow up (p=0.052). It can also reduce treatment inefficiency by 4.8-fold (95% CI, 0.12 to 0.37). In addition, ESWT also showed a higher superiority than hyperbaric oxygen therapy in the population for complete cure and unchanged ulcer (RR=1.83; 95% CI, 1.14 to 2.94 and RR=0.25; 95% CI, 0.13 to 0.48, respectively). ESWT is a feasible adjuvant treatment for DFUs. It can effectively improve the complete cure rate, shorten the healing period of DFUs and significantly reduce treatment ineffectiveness. This can provide new therapeutic ideas for clinical practice of intractable and recurrent DFUs.

Background Chronic renal failure (CRF) is a serious disease that has become a burden on global and local economics and public health. In addition, non-thyroidal illness syndrome (NTIS) has become increasingly more prevalent in CRF patients. Materials and methods A data search was conducted on the PubMed/Medline, Cochrane Library, Web of Science, Embase, and CBM databases to identify studies up to November 1st, 2018, that compared low T3 and normal T3 levels in patients with CRF. Data analysis was done by calculating the relative risks (RR) and 95% confidence intervals (95% CI) and continuous variables were described by weighted mean difference (WMD) and 95% CI. The efficacy outcomes included renal function and mortality. The Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality scale were used to assess the quality of the cohort and cross-sectional studies, respectively. A funnel plot was used to identify publication bias. Results Seventeen studies with a total of 4593 patients were finally included in the analysis. Among the 17 studies, 11 reported the mortality of CRF patients with low T3 and normal T3 levels. Subgroups were assigned according to different follow-up times and different methods of treatment. The mortality rate in the low T3 group was much higher than in the normal T3 group. 11 studies reported creatinine (Cr) results in patients with low T3 and normal T3 levels and our analysis found no significant differences between the two groups (95%CI: 0.46–0.25; P-heterogeneity = 0.000; P = 0.559). Five studies reported uric acid results and we found no significant differences between the two groups (95%CI: 0.08–0.22; P-heterogeneity = 0.438; P = 0.377). Five studies reported the urea levels in the two groups and our analysis found no significant differences (95%CI: 1.60–1.23; I2 = 0.0%; P-heterogeneity = 0.498;P = 0.798). Conclusion Low T3 had a greater impact on the short-term prognosis of patients with CRF than on the long-term prognosis. NTIS did not cause substantial kidney damage.

Purpose To provide an overview of existing meta-analysis (MAs) on the efficacy and safety of acupuncture for depression, and assess the methodological quality and the strength of evidence of the included MAs. Methods We searched MAs of randomized trials that have evaluated the effects of acupuncture on depression in three international and three Chinese databases from their inception until August 2019. The methodological quality of included MAs was evaluated with the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), and the strength of evidence with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). We used the intra-class correlation coefficient (ICC) to assess reviewer agreement in the pre-experiment. Results We included 31 MAs and 59 RCTs. The results of included MAs were conflicting, our meta-analyses found that acupuncture may confer small benefit in reducing the severity of depression by end of treatment than no treatment/wait list/treatment as usual(SMD -0.74, 95% CI -1.06 to -0.41, eight trials, 624 participants), control acupuncture (invasive, non-invasive sham controls) (SMD 0.27, 95% CI -0.51 to -0.04, 20 trials, 1055 participants), antidepressants(Selective serotonin reuptake inhibitors (SSRI)/ Tetracyclic antidepressants(TCAs)) (SMD -0.28, 95% CI -0.46 to -0.10, 30 trials, 3068 participants), acupuncture plus antidepressants versus antidepressants(SSRI/TCAs) (SMD -0.99, 95% CI -1.37 to -0.61, 17 trials, 1110 participants). Subgroup analyses showed that there was no difference between electro-acupuncture and invasive control (P = 0.37), electro-acupuncture and non-invasive control (P = 0.90), manual acupuncture and Tetracyclic antidepressants (P = 0.57), electro-acupuncture and Tetracyclic antidepressants (P = 0.07). Six MAs concluded that acupuncture reduced the incidence of adverse events compared with antidepressants. The evaluation with AMSTAR-2 showed that the quality of included MAs was low or critically low. The results of the GRADE evaluation showed that the strength of evidence was low to very low for most outcomes. Conclusions Although acupuncture appears to be more effective and safer than no treatment, control acupuncture and antidepressants, the quality of the available evidence was very low. Further methodologically rigorous and adequately powered primary studies are needed to confirm the effectiveness of acupuncture for depression.

Importance. Acupuncture can help reduce unpleasant side effects associated with endocrine therapy for breast cancer. Nevertheless, comprehensive evaluation of current evidence from randomized controlled trials(RCTs) is lacking. Objective. To estimate the efficacy of acupuncture for the reduction of hormone therapy-related side effects in breast cancer patients. Evidence review. RCTs of acupuncture in breast cancer patients that examined reductions in hormone therapy–related side effects were retrieved from PubMed, EMBASE, Web of Science, Ovid MEDLINE, and Cochrane Library databases through April 2016. The quality of the included studies was evaluated according to the 5.2 Cochrane Handbook standards, and CONSORT and STRICTA (Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture) statements. Intervention. Interventions included conventional acupuncture treatment compared with no treatment, placebo, or conventional pharmaceutical medication. Major outcome measures were the alleviation of frequency and symptoms and the presence of hormone therapy–related side effects. Findings/Results. A total of 17 RCTs, including a total of 810 breast cancer patients were examined. The methodological quality of the trials was relatively rigorous in terms of randomization, blinding, and sources of bias. Compared with control therapies, the pooled results suggested that acupuncture had moderate effects in improving stiffness. No significant differences were observed in hot flashes, fatigue, pain, gastrointestinal symptoms, Kupperman index, general well-being, physical well-being, tumor necrosis factor (TNF), and interleukin (IL). Conclusions. Acupuncture therapy appears to be potentially useful in relieving functional stiffness. However, further large-sample trials with evidence-based design are still needed to confirm these findings.

Background: Neoadjuvant chemotherapy (NAC) increases breast conservation rates in patients with resectable breast cancer at the associated cost of higher locoregional recurrence rates; however, the magnitude of the survival benefits of NAC for these patients remains undefined. Therefore, we aimed to clarify the survival benefit of NAC versus postoperative chemotherapy by conducting an updated meta-analysis of randomized clinical trials (RCTs). Methods: The authors searched the Cochrane Library, PubMed, Embase, Web of Science, Chinese biomedical literature database, and Chinese Scientific Journals full-text database from their inception to December 2016. The authors identified relevant RCTs that compared NAC with postoperative chemotherapy in the treatment of operable breast cancer. The main endpoints were overall survival (OS) and recurrence-free survival (RFS). Results : A total of 21 citations representing 16 unique studies were eligible. There were 787 deaths among 2794 patients assigned to NAC groups and 816 deaths among 2799 patients assigned to adjuvant chemotherapy groups. A meta-analysis of data indicated that there was no significant benefit in terms of OS ([hazard ratio [HR] = 1.03, 95% confidence interval [CI]: 0.94–1.13, P = .51) and RFS (HR = 1.01, 95% CI: 0.93–1.10, P = .80) between the NAC and postoperative chemotherapy groups. The pooled HR estimate for OS was not influenced by NAC cycles, the total number of chemotherapy cycles, administration of tamoxifen, administration of adjuvant chemotherapy, or type of NAC regimen. Subgroup analysis showed that the pooled HR estimate for RFS was influenced by anthracycline-containing regimens. Patients with a pathological complete response had superior survival outcomes compared with patients who had residual disease. Conclusion: The survival benefits for patients with operable breast cancer who received either NAC or adjuvant chemotherapy based on anthracycline regimens were comparable.

Acupuncture techniques are commonly used as initial treatments for myofascial pain syndrome.This study aimed to assess and compare the efficacy and safety of different techniques of acupuncture for myofascial pain syndrome.Network meta-analysis.All selected studies were randomized controlled trials (RCTs).The Cochrane Central Register of Controlled Trials, PubMed, Web of Science, EMBASE, and Chinese Biomedical Literature Database were searched from their inceptions to February 2016. Only full texts of RCTs comparing acupuncture therapies with any other therapies or placebo-sham acupuncture were included. Two reviewers independently assessed eligibility and extracted data. The primary outcomes included pain intensity, PPT, and adverse events. Secondary outcome was physical function.Thirty-three trials with 1,692 patients were included. Patients were allocated to 22 kinds of interventions, of which dry needling and manual acupuncture was the most frequently investigated intervention. Compared with placebo-sham acupuncture, scraping combined with warming acupuncture and moxibustion was found to be more effective for decreasing pain intensity (standardized mean difference (SMD) = -3.6, 95% confidence interval (CI) ranging from -5.2 to -2.1); miniscalpel-needle was more effective for increasing the PPT (SMD = 2.2, 95% CI ranging from 1.2 to 3.1); trigger points injection with bupivacaine was associated with the highest risk of adverse event (odds ratio = 557.2, 95% CI ranging from 3.6 to 86867.3); and only EA showed a significant difference in the ROM (SMD = -4.4, 95% CI ranging from -7.5 to -1.3).Lack of clarity concerning treatment periods, repetitive RCTs, and other valuable outcome measurements. The potential bias might affect the judgment of efficacy and safety.The existing evidence suggests that most acupuncture therapies, including acupuncture combined with other therapies, are effective in decreasing pain and in improving physical function, but additional investigation on the safety of these therapies is required.Key words: Myofascial pain syndrome, acupuncture, anesthesia, efficacy, safety, network meta-analysis, systematic review, randomized controlled trials.

Background The PRISMA statement was rarely used in the field of acupuncture, possibly because of knowledge gaps and the lack of items tailored for characteristics of acupuncture. And with an increasing number of systematic reviews in acupuncture, it is necessary to develop an extension of PRISMA for acupuncture. And this study was the first step of our project, of which the aim was to investigate the need for information of clinical evidence on acupuncture from the perspectives of evidence users. Methods We designed a questionnaire based on a pilot survey and a literature review of acupuncture systematic review or meta-analysis(SR/MA). Participants from five cities (Lanzhou, Chengdu, Shanghai, Nanjing and Beijing) representing the different regions of China, including clinicians, researchers and postgraduates in their second year of Master studies or higher level, were surveyed. Results A total of 269 questionnaires were collected in 18 hospitals, medical universities and research agencies, and 251 (93 %) with complete data were used for analysis. The average age of respondents was 33 years (SD 8.959, range 25–58) with male 43 % and female 57 %. Most respondents had less than 5 years of working experience on acupuncture, and read only one to five articles per month. Electronic databases, search engines and academic conferences were the most common sources for obtaining information. Fifty-six percent of the respondents expressed low satisfaction of the completeness of information from the literature. The eight items proposed for acupuncture SR/MAs received all high scores, and five of the items scored higher than eight on a scale zero to ten. The differences for the scores of most items between postgraduates and non-postgraduates were not statistically significant. Conclusions The majority of the respondents were not very satisfied with the information provided in acupuncture SRs. Most of the items proposed in this questionnaire received high scores, and opinions from postgraduates and non-postgraduates tended to agree on most items. Comments from the respondents can promote future work. Electronic supplementary material The online version of this article (doi:10.1186/s12906-016-1434-0) contains supplementary material, which is available to authorized users.

Background: Gastric cancer is the third leading cause of cancer death in the world. The benefit of adjuvant chemotherapy has been demonstrated by published individual patient data meta-analysis and Cochrane systematic review. However, there is no consensus on which is the optimal adjuvant chemotherapy regimens. Present network meta-analysis aims to compare the differences of effect between all available adjuvant chemotherapy regimens in improving overall survival and disease-free survival, and to rate the certainty of evidence from present network meta-analysis. Methods: We will conduct this systematic review and network meta-analysis using Bayesian method and according to Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement. We will search PubMed, EMBASE.com, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese National Knowledge Infrastructure (CNKI), and Chinese Biological Medical Database (CBM), and ClinicalTrials.gov (http://clinicaltrials.gov/) to identify randomized controlled trials (RCTs) comparing adjuvant chemotherapy to surgery alone. We will assess the risk of bias of individual RCTs using a modified version of Cochrane tool. We will also use the advance of GRADE to rate the certainty of network meta-analysis. Data analysis will be performed with R-3.4.1 and WinBUGS software. Results: The results of this study will be published in a peer-reviewed journal. Discussion: To the best of our knowledge, this systematic review and network meta-analysis will firstly use both direct and indirect evidence to compare the differences of all available adjuvant chemotherapy regimens for resected gastric cancer patients. This is a protocol of systematic review and meta-analysis, so the ethical approval and patient consent are not required.

The copy of our questionnaire. (DOC 44Â kb)

Objective. Tai Chi Chuan (TCC) is a form of aerobic exercise that may be an effective therapy for improving psychosomatic capacity among breast cancer survivors. This meta-analysis analyzed the available randomized controlled trials (RCTs) on the effects of TCC in relieving treatment-related side effects and quality of life in women with breast cancer.Methods. RCTs were searched in PubMed, Embase, Web of Science, and Cochrane Library through April 2014. Data were analyzed on pathology (pain, interleukin-6, and insulin-like growth factor 1), physical capacity (handgrip, limb physical fitness, and BMI), and well-being (physical, social, emotional, and general quality of life).Results. Nine RCTs, including a total of 322 breast cancer patients, were examined. Compared with control therapies, the pooled results suggested that TCC showed significant effects in improving handgrip dynamometer strength, limb elbow flexion (elbow extension, abduction, and horizontal adduction). No significant differences were observed in pain, interleukin-6, insulin-like growth factor, BMI, physical well-being, social or emotional well-being, or general health-related quality of life.Conclusion. The short-term effects of TCC may have potential benefits in upper limb functional mobility in patients with breast cancer. Additional randomized controlled trials with longer follow-up are needed to provide more reliable evidence.

SummaryObjectives The aim of this study was to investigate the quality of clinical practice guidelines (CPGs) of traditional Chinese medicine (TCM) published in journals and books using AGREE II instrument for further enhancing TCM CPG development. Methods A systematic search of relevant guideline websites and literature databases (including Chinese Guideline Clearinghouse, PubMed Wanfang Data Knowledge Service Platform, VIP Online Publishing Platform, China National Knowledge Infrastructure and SinoMed) was undertaken from inception to December, 2015 to identify and select CPGs related to TCM. Four independent reviewers assessed the eligible TCM CPGs using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Their degree of agreement was evaluated by intra-class correlation coefficient (ICC). Results From 2380 citations, 115 TCM CPGs were included. The mean scores for each AGREE II domain were as follows: (i) scope and purpose (mean±SD=41.1±19.6); (ii) stakeholder involvement (mean±SD=37.6±15.1); (iii) rigour of development (mean±SD=20.1±10.9); (iv) clarity and presentation (mean±SD=33.3±15.4); (v) applicability (mean±SD=10.5±4.5) and (vi) editorial independence (mean±SD=11.4±7.6). Only 10% (n=12) TCM CPGs were rated as “recommended”. The ICC values for TCM CPGs appraisal using the AGREE II ranged from 0.76 to 0.93. Conclusions The quality of TCM CPGs has remained suboptimal according to AGREE II instrument evaluation. The use of AGREE II in the development process ensures that these considerations are incorporated, and more efforts must be made to improve the quality of TCM CPGs. Therefore, an evidence-based method should be used, and reporting the full texts according to AGREE II checklists for the further TCM CPGs development to ensure the translation of evidence into practice.