Can Tibetan medicine Honghua Ruyi pills relieve endometriosisassociated dysmenorrhea?Protocol for a randomized placebocontrolled trial

Objective:To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi(HHRY)pills for endometriosis-associated dysmenorrhea.Methods:This study constitutes a multicenter,randomized,double-blind,placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period.A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio.The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale(VAS)scores and quality of life,whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain,duration of pain episodes(in days),frequency and quantity of the consumption of ibuprofen sustained-release capsules(or other non-steroidal anti-inflammatory drugs),and days off work/study for staff/student due to dysmenorrhea,ovarian cyst,and/or pelvic nodule size.The safety was monitored throughout the treatment period.All the analyses were based on the intention-to-treat principle.For continuous outcomes,simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups,with categorical data expressed as the number and percentage of occurrences.Differences were compared using the chi-square test or Fisher's exact test.The predefined analysis was adjusted for concomitant treatment,a variable considered to be associated with outcomes but unaffected by treatment allocation.Estimates of treatment effects were reported with 95%confidence intervals.Two-tailed P values≤.05 were considered statistically significant.Conclusion:Positive results from this trial,upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.

藏药白脉软膏治疗腰椎间盘突出症的疗效与安全性:一项多中心、随机、双盲、安慰剂对照试验方案

目的:评价白脉软膏在腰椎间盘突出症(lumbar disc herniation)患者中的疗效与安全性。方法:本研究设计了一项前瞻、随机、双盲、安慰剂对照的多中心临床试验方案。计划招募194例患者,按1:1的比例平均分配至试验组和对照组。患者将接受为期14天的白脉软膏或安慰剂的干预,随后进行为期1周的随访。通过视觉模拟评分法(visual analogue scale score)评估疼痛程度,日本骨科协会评估治疗分数(Japanese Orthopedic Association score)评估功能状态,Likert量表将用于评估麻木程度,此外还将记录应急处理的使用和对健康教育的依从情况。安全性评估将包括实验室检查和不良事件记录。讨论:这项试验将首次对白脉软膏在腰椎间盘突出症患者中进行临床疗效和安全性评价。使用安慰剂的优势在于排除因盲法不充分而导致的偏倚。为了避免由研究对象和研究者的主观因素引起的任何偏倚,对于结局评价者、数据管理人员、统计分析人员以及所有相关研究人员都将实施盲法。本试验结果将为腰椎间盘突出症的治疗以及白脉软膏的未来研究方向提供重要依据。

宫瘤宁辅助治疗子宫肌瘤随机对照试验的系统评价

目的:系统评价宫瘤宁作为辅助疗法治疗子宫肌瘤的有效性和安全性。方法:检索数据库中国知网、万方、维普、PubMed、Cochrane Library、Embase、Web of Science以及中国临床试验注册系统、美国临床试验注册系统中有关宫瘤宁辅助治疗子宫肌瘤的临床随机对照试验。检索时限为各数据库建库至2023年3月20日。对符合纳入排除标准的研究采用“偏倚风险评估工具”进行文献质量评价,采用GRADE工具进行证据质量评价,应用RevMan5.3进行数据分析。结果:最终纳入20项研究,共1907例患者。15项研究的meta分析结果显示,宫瘤宁联合米非司酮在提高有效率方面优于单独使用米非司酮[RR=1.22,95%CI=(1.11,1.33),P<0.001]。因异质性较大,采用随机效应模型对纳入的研究进行合并。在缩小子宫肌瘤体积[MD=−4.09 cm^(3),95%CI(−5.16,−3.02),P<0.001],缩小子宫体积[MD=−23.22 cm^(3),95%C(I−29.10,−17.33),P<0.001],以及降低女性激素水平如孕激素水平、雌激素水平、促卵泡生成激素和促黄体生成激素等方面优于对照组(均P<0.001)。10项研究报告了不良事件。纳入研究的方法质量不高,存在中等偏倚风险。结论:与仅使用西医常规疗法相比,联合使用宫瘤宁在提高有效率方面有一定优势,在缩小子宫肌瘤体积、缩小子宫体积和降低女性激素水平等方面体现出一定优势趋势,但仍需更多质量高且设计严谨的研究进行验证。

Comparison of Chinese medicine higher education programs in China and five Western countries

Object:Traditional Chinese medicine(TCM)has been taught widely in the both Eastern and Western world countries.This study compared the origin,student source,duration,and curriculum design of TCM higher education programs in China and five Western countries.Method:We searched the Internet and the China National Knowledge Infrastructure(CNKI)database to gather relevant information.Result:All the six countries offer acupuncture and/or Chinese herbal medicine programs at universities and/or private schools.However,there are great large differences among them in the education of curriculum and TCM students enrollment and curriculum policies of TCM courses.Conclusions:There are large differences among their curriculum and enrollment policies.This comparison should provide information about the further development of international standards in TCM education.

Acupoint injection for asthma:Systematic review of randomized controlled trials

Objective:To assess the effectiveness and safety of acupoint injection for the treatment of asthma.Methods:Six electronic databases were searched for randomized controlled trials(RCTs)of acupoint injection for asthma.Two authors extracted data and assessed methodological quality independently using the Cochrane Collaboration Risk of Bias tool.Data were evaluated using RevMan v5.2.Results:Eighteen RCTs involving 1913 participants with asthma were identified.Overall methodological quality of the RCTs was classified as unclear risk of bias.Western medicine(12 RCTs)was injected most frequently into acupoints,followed by Chinese herbal medicine(four RCTs),vitamins(one RCT),and Chinese herbal medicine combined with Western medicine(one RCT).Four RCTs used only one acupoint[ST36(two RCTs),BL13,CV22],whereas the other RCTs selected multiple acupoints(among which BL13 was used most frequently).One RCT reported mortality,no RCT reported quality of life,15 RCTs reported the symptom improvement rate,one RCT reported asthma control test(ACT)data,one RCT reported the duration of asthma,three RCTs reported the mean time that asthma was controlled(MTAC),and 13 RCTs reported lung-function tests(LFTs).Some RCTs showed acupoint injection may improve the attack time of asthma,MTAC,and LFTs.Five RCTs reported the outcome of adverse events and showed no significant differences between the acupoint injection group and control group.Conclusions:The findings suggest that acupoint injection may be effective for improving ACT data,duration of asthma,MTAC and LFTs.However,the evidence is insufficient owing to the poor methodological quality of the RCTs.

Effectiveness of traditional Chinese exercises on stroke risk factors in individuals with pre-hypertension or mild-to-moderate essential hypertension: A systematic review and meta-analysis

Objective:The aim of this study was to evaluate the effects of traditional Chinese exercises (TCEs) on stroke risk factors in patients with pre-hypertension or mild-to-moderate essential hypertension.Methods:We performed searches of seven electronic databases for studies published from their inception until July 2017.We included randomized controlled trials (RCTs) of the effects of TCEs with or without health education on stroke risk factors in patients with prehypertension or mild-to-moderate essential hypertension.Outcomes were independently extracted from each study by two authors and were pooled to determine risk ratios and standardized mean differences.materials-methodsResults:We included 15 RCTs,involving 1272 hypertensive participants.Compared with no intervention,TCEs were associated with a clinically meaningful amelioration of stroke risk factors,including reductions in systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting blood glucose,blood lipids,and waist-to-hip ratio,and improved quality of life.Compared with health education,TCEs reduced SBP but had no effect on DBP.Compared with health education alone,TCEs plus health education resulted in an amelioration of stroke risk factors.No serious adverse events were reported.resultsConclusion:TCEs may be effective alongside health education in ameliorating stroke risk factors in individuals with pre-hypertension or mild-to-moderate essential hypertension.However,the current evidence is insufficient due to poor methodology and lack of adequate safety data.Further rigorously-designed RCTs are warranted.conclusion.

Estimating antiwear properties of esters as potential lubricantbased oils using QSTR models with CoMFA and CoMSIA

Comparative molecular field analysis and comparative molecular similarity indices analysis were employed to analyze the antiwear properties of a series of 57 esters as potential lubricant-based oils. Predictive 3D-quantitative structure tribo-ability relationship models were established using the SYBYL multifit molecular alignment rule with a training set and a test set. The optimum models were all shown to be statistically significant with cross-validated coefficients q^2 > 0.5 and conventional coefficients r^2 > 0.9, indicating that the models are sufficiently reliable for activity prediction, and may be useful in the design of novel ester-based oils.