Efficacy and safety of Xileisan combined with mesalazine for ulcerative colitis:A meta-analysis and trial sequential analysis

BACKGROUND The benefits and risks of Xileisan(XLS)in the treatment of ulcerative colitis(UC)remain unclear.AIM The present study aimed to evaluate the efficacy and safety of the combination of XLS and mesalazine when treating UC.METHODS We searched eight databases for clinical trials evaluating the combination of XLS and mesalazine in the treatment of UC,up to January 2024.Meta-analysis and trial sequential analysis(TSA)were performed using Revman 5.3 and TSA 0.9.5.10 beta,respectively.RESULTS The present study included 13 clinical studies involving 990 patients,of which 501 patients received XLS combined with mesalazine while 489 patients received mesalazine alone.The meta-analysis showed that,in terms of efficacy,the combination of XLS and mesalazine significantly improved the clinical efficacy rate by 22%[risk ratio(RR)=1.22;95%CI:1.15–1.28;P<0.00001]and mucosal improvement rate by 25%(RR=1.25;95%CI:1.12–1.39;P=0.0001),while significantly reducing the duration of abdominal pain by 2.25 days[mean difference(MD)=-2.25;95%CI:-3.35 to-1.14;P<0.0001],diarrhea by 2.06 days(MD=-2.06;95%CI:-3.92 to-0.20;P=0.03),hematochezia by 2.32 days(MD=-2.32;95%CI:-4.02 to-0.62;P=0.008),tumor necrosis factor alpha by 16.25 ng/mL(MD=-16.25;95%CI:-20.48 to-12.01;P<0.00001),and interleukin-6 by 14.14 ng/mL(MD=-14.14;95%CI:-24.89 to-3.39;P=0.01).The TSA indicated conclusiveness in the meta-analysis of the efficacy endpoints.In terms of safety,the meta-analysis revealed that the combination of XLS and mesalazine did not increase the occurrence of total and gastrointestinal adverse events,abdominal distension,and erythema(P>0.05).The TSA showed non conclusive findings in the meta-analysis of the safety endpoints.Harbord’s test showed no publication bias(P=0.734).CONCLUSION Treatment with XLS alleviated the clinical symptoms,intestinal mucosal injury,and inflammatory response in patients with UC,while demonstrating good safety.

Sequential analysis of dimethyl sulfur compounds in seawater

A sequential method for the determination of dimethyl sulfur compounds, including dimethylsulfide （DMS）, dimethylsulfonio- propionate （DMSP） and dimethylsulfoxide （DMSO）, in seawater samples has been developed. Detection limit of 2.5 pmol of DMS in 25 mL sample, corresponding to 0.10 nmol/L, was achieved. Recoveries for dimethyl sulfur compounds were in the range of 68.6- 78.3%. The relative standard deviations （R.S.D.s） for DMS, DMSP and DMSO determination were 3.0, 5.4 and 7.4%, respectively.

Sequential Analysis for Comparing the Effect of Keyin Decoction (克银方)with Retinoic Acid in Treating Psoriasis

Objective: To compare the effect of Keyin Decoction(克银方)with retinoic acid in treating psoriasis. Methods: One hundred and six patients were randomly divided by paired grouping into the KYD group and the all-trans retinoic acid (RA) group, 53 in each group with 19 cases belonging to Wind-Heat Syndrome type and 34 to Wind-Dryness type. The Wind-Heat Syndrome type in the KYD group was treated with KYD I (with the action of clearing Heat, removing Dampness, cooling blood and dispelling Wind), and the Wind-Dryness type with KYD II (with the action of nourishing blood, moistening skin and dredging Qi-blood circulation,). The RA group was treated with RA. Sequential analysis was adopted to observe the effect. At the same time, the adverse reaction was observed Results:When the test got to the 44th pair of patients, the scription of result reached the UA line of sequential chart, suggesting that the efficacy of KYD was superior to that of RA. Skin lesion subsidence rate in the KYD group and the RA group was 39. 6% and 20. 8% respectively with significant difference (P<0. 05). And for the patients of progressive phase in the two groups, skin lesion subsidence rate was 57.8% and 21.1% respectively (P< 0.05). No obvious adverse reaction was found in the KYD group. Conclusion:Keyin Decoction had good effect in treating psoriasis.

Jinhuang powder for the treatment of diabetic foot ulcers:an updated metaanalysis with power analysis and trial sequential analysis

Background:Traditional Chinese Medicines(TCM)had been indicated to benefit for the chronic non-infectious diseases,such as cancers,hypertension,primary dysmenorrheal,etc.Although randomized controlled trials(RCTs)had been conducted,there was still the controversy on the efficacy of Jinhuang powder for diabetic foot ulcers(DFUs).Objective:This systematic review aimed to objectively evaluate the potential of Jinhuang powder for DFUs.Methods:Seven databases(CNKI,Chongqing VIP,Wanfang database,CBM,the Cochrane Library,PubMed and Web of Science)were searched to retrieve RCTs up to December,2016;and the relevant references of the eligible studies were screened.According to the eligible criteria,the literature was screened;data were extracted;and then the methodological quality was assessed.The meta-analysis,power analysis and trial sequential analysis(TSA)were performed by using Meta analyst software(version beta 3.13),Stata 12.0,Power and Precision statistical software package(Biostat)and TSA software(version0.9),respectively.Results:Finally,three RCTs with 198 participants were included.The results of meta-analysis showed that there were statistically significant differences between groups in(1)the cure rate(RR,1.25;95%CI.1.10to1.41;P=0.00)and(2)the wound healing time(SMD,-3.404;95%CI,-5.821 to -0.987;P=0.00).Three trials presented more than 80% power with 0.05α-errors in both outcomes and the power of two meta-analyses to pool different outcomes presented more than 95%.The TSA showed that the summary results were certain.Conclusion:The external application with Jinhuang powder was an effective and cost-effective therapy for DFUs.The power analysis and TSA showed that the efficacy of Jinhuang powder dressing for the treatment of DFUs is conclusive.

Moxibustion treatment for knee osteoarthritis： cumulative meta-analysis and trial sequential analysis

Objective： To evaluate the effect of moxibustion on knee osteoarthritis patients with cumulative meta-analysis, and trial sequential analysis was applied to test the authenticity of results. Methods： We searched PubMed, EMbase, The Cochrane Library, CNKI and CBM to collect RCTs about moxibustion on knee osteoarthritis patients. The selection of literature, data extraction and evaluation of eligible literature were carried out independently by two reviewers. Then Stata11.0 software was used for data analysis. Result： Totally 11 RCTs involved 1005 patients were recruited. The results of meta-analysis showed that no significant differences were found between the two groups in VAS, moxibustion is better than drug therapy in effective rate [OR = 0.40, 95%CI （0.27, 0.60）] and knee score [SMD = -0.70, 95%CI （-1.22, -0.19）]. The result of trial sequential analysis indicated that the sample size didn＇t reach the TSA Boundary on VAS, the sample size of effectiveness achieved Require Information Size. In the indicator of knee score has obtained certain re- sult before reaching the Require Information Size. Conclusion： moxibustion is superior to drug therapy on treatment knee osteoarthritis. However, large sample size and high-quality studies are still needed.

Rupi Sanjie capsule plus surgical operation for the treatment of hyperplasia nodule of mammary gland:A meta-analysis and trial sequential analysis

Objective:To evaluate the efficacy and safety of Rupi Sanjie(RPSJ)capsule plus the conventional surgical operation for treatment of hyperplasia nodule of mammary gland.Methods:A meta-analysis was conducted on randomized controlled trials(RCT)related to RPSJ capsule plus surgical operation in the treatment of hyperplasia nodule of mammary gland.The methodological quality of eligible RCTs was assessed according to the criteria from the Cochrane Handbook for Systematic Reviews of Interventions.RevMan5.3 and Stata14.0 were used for data analyses.Trial sequential analysis was performed to estimate the sample size of systematic review base on TSA software v0.9.Results:Twenty-two RCTs were totally included in this study,involving 2135 patients.The result showed the clinical recurrence rate of RPSJ capsule plus surgical treatment group was significantly lower than surgical treatment alone group(RR:0.25,95%CI[0.17,0.37],P<0.01).The clinical cure rate and total effective rate were higher in RPSJ capsule plus surgical treatment group than the conventional surgical treatment group(RR:1.63,95%CI[1.46,1.82],P<0.01);(RR:1.29,95%CI[1.22,1.37],P<0.01).Application of RPSJ capsule decreased the occurrence of adverse events including nausea,vomiting,irregular menstruation,constipation,dizziness,and headache etc.(RR:0.90,95%CI[0.54,1.49],P=0.68).The results of trial sequential analysis demonstrated that the current available data did not reach the expected value.Conclusion:RPSJ capsule plus the conventional surgical treatment was more effective in reducing the clinical recurrence rate,and improving the total clinical effective rate and clinical cure rate,with a decrease in the occurrence of adverse events.

Bushen Huoxue method combined with ACEI/ARB in treating diabetic kidney disease (stage Ⅲ):A meta-analysis and trial sequential analysis

Objective:To evaluate the efficiency of Bushen Huoxue method with ACEI/ARB in treating diabetic kidney disease(stageⅢ).Methods:A total of 8 major electronic databases(CNKI,WanFang,VIP,Sinomed,Pubmed,Embase,Cochrane Liberary,Web of Science)were retrieved since the establishment of the database to October 9,2019.Two reviewers extracted data,and assessed the methodological quality of the included studies.The analysis was made by Stata 15.0 and TSA 0.9 softwares.Results:A total of 10 RCT studies were obtained,including 711 patients with diabetic kidney disease of stageⅢ.Meta-analysis showed that the method of Bushen Huoxue with ACEI/ARB could reduce UAER[WMD=-31.24,95%CI(-42.98,-19.51)],β2-GM[WMD=-92.95,95%CI(-166.05,-19.85)],LDL-C[WMD=-0.19,95%CI(0.19,-0.30)].However,there were no significant effect for HbAlc[WMD=-0.08,95%CI(-0.17,-0.00)],Scr[WMD=-12.96,95%CI(-39.82,13.90)],BUN[WMD=-0.14,95%CI(-0.44,0.17)].The result of TSA indicated that the method of Bushen Huoxue with ACEI/ARB was effective in the treatment of diabetic kidney disease of stageⅢ.Conclusion:The study show that the method of Bushen Huoxue with ACEI/ARB can reduce urinary protein,renal tubular injury and LDL-C in patients with diabetic kidney disease of stageⅢ,and had no effect on HbAlc and renal function.But the conclusion of this study needs further research of high quality.

Meta-analysis and Trial Sequential Analysis of Compound Qingdai Capsule in the Treatment of Psoriasis

[Objectives]To analyze the efficacy of Compound Qingdai Capsule in the treatment of psoriasis and conduct a systematic evaluation.[Methods]The clinical total effective rate,PASI index score,IL-17 level,IL-23 level,TNF-level,and adverse reactions were analyzed.TSA 0.9 software was used to conduct sequential analysis of the total effective rate,and subgroup analysis was performed according to the average age of the experimental group.[Results]Single application of Compound Qingdai Capsule or in combination with other methods in the treatment of psoriasis was superior to non-Compound Qingdai Capsule group,and the side effects were less than non-Compound Qingdai Capsule group;the n≥40 year-old group had certain heterogeneity,suggesting that the difference was statistically significant,and the effective rate was higher than that of the control group.The funnel plot showed that the graph was asymmetrical,and there may be publication bias or the possibility of low-quality literature.The TSA results indicated that the actual sample size was far lower than the expected sample size,and the cumulative Z value did not reach the TSA cut-off value and more trials need to be included to confirm the efficacy.[Conclusions]Compound Qingdai Capsule has a clear curative effect on psoriasis,and its safety is high.This study can provide relevant evidence for the effectiveness of Chinese patent drugs(CPD)in treating psoriasis.

Efficacy and Safety of Traditional Chinese Patent Medicine Qizhi Weitong Granules(气滞胃痛颗粒)in Irritable Bowel Syndrome with Predominant Constipation:A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials

Objective:To systematically review the efficacy and clinical safety of Qizhi Weitong Granules(气滞胃痛颗粒)(QZWT)in the treatment of irritable bowel syndrome with predominant constipation(IBS-C).Methods:Randomized controlled trials(RCTs)of QZWT in patients with IBS-C were retrieved from Pub Med,EMBASE,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang,Chinese Scientific Journals Database(VIP),and Chinese Biological Medical Database(CBM)from inception to December 3,2022.Conventional meta-analysis with random-effects model or fixed-effects model and trial sequential analysis(TSA)were performed by Review Manager 5.4,Stata and TSA software.Results:A total of 4 RCTs and 368 patients with IBS-C were included in this study.The findings of the meta-analysis indicated that the cure and efficacy rate of the experimental group was significantly higher than that of the control group[RR=2.19;(95%CI,1.35–3.55),P<0.01;RR=1.14;(95%CI,1.03–1.27),P<0.05],while the result of Bristol Score was negative.The funnel plot was probably symmetry,and the P value was>0.05 in the Egger test,which confirmed the nonexistence of significant publication bias in this outcome.TSA showed the cumulative z-value crossed the traditional threshold and TSA threshold,while it didn't get to the required information size.Finally,2 studies reported adverse events after QZWT treatment,including 3 cases of diarrhea.No serious adverse events were reported.Conclusion:QZWT was an effective and safe complementary therapy in the treatment of IBS-C with no obvious adverse reactions.TSA analysis confirmed our meta-analysis results.Therefore,QZWT may be a potential candidate for the treatment of IBS-C.However,due to the limited quality of current studies,more long-term,randomized,double-blinded clinical trials are needed in future studies.

Meta-analysis and trial sequential analysis on blood uric acid and joint function in gouty arthritis treated with fire needling therapy in comparison with western medication

Objective:To conduct the meta-analysis and trial sequential analysis(TSA) on clinical trials of fire needling therapy in treatment of gouty arthritis and review systematically the clinical therapeutic effect of fire needling therapy on gouty arthritis so as to provide the medical evidences of the extensive application of this therapy in treatment of gouty arthritis.Methods:The relevant clinical trials of fire needling therapy for treatment of gouty arthritis were searched from China National knowledge Infrastructure,Wanfang Data Knowledge Service Platform,Chinese Science and Technology Journal Database,American Medical Online,Dutch Medical Literature Database and International Evidence-Based Medical library.Using Review Manager 5.3 software,the quality of the included trials was assessed and meta-analysis was performed.With TSA v0.9 software,the trial sequential analysis was conduced on the appropriate outcomes.Results:A total of 10 trials were included with 775 patients involved.The analysis results showed that compared with the western medication,the total effective rate(RR=1.14’95%CI [1.09,1.20]),the curative rate(RR=1.59’95%CI [1.33,1.89]),the reduced VAS score(MD=-1.44’ 95%CI [-1.93,-0.951]) and the reduced incidence of adverse reaction(RR=0.27’ 95% CI [0.09,0.76]) of the fire needling therapy were different significantly(all P <0.05).Regarding the reduction of blood uric acid(MD=-40.47’ 95%CI [-80.21,-0.72]) and the score of symptoms and physical signs(MD=-1.38’95% CI [-3.71,0.95]),the effect of fire needling therapy was similar to that of western medication group(both P≥0.05).The trial sequential analysis suggested that the result was reliable,in which,the total effective rate of fire needling therapy was much higher than the western medication.But,it was potentially a false-positive finding,in which,fire needling therapy was much more advantageous at reducing blood uric acid as compared with the western medication.Conclusion:Based on the analytic results,it can be determined that fire needling therapy,as an effective approach to the treatment of gouty arthritis,has a certain advantage as compared with western medication.Given the low overall quality of trials,it still needs high-quality clinical trial to verify the findings of this study results.

Effects of anesthetic depth on postoperative pain and delirium:a meta-analysis of randomized controlled trials with trial sequential analysis

Background:Whether anesthetic depth affects postoperative outcomes remains controversial.This meta-analysis aimed to evaluate the effects of deepvs.light anesthesia on postoperative pain,cognitive function,recovery from anesthesia,complications,and mortality.Methods:PubMed,EMBASE,and Cochrane CENTRAL databases were searched until January 2022 for randomized controlled trials comparing deep and light anesthesia in adult surgical patients.The co-primary outcomes were postoperative pain and delirium(assessed using the confusion assessment method).We conducted a meta-analysis using a random-effects model.We assessed publication bias using the Begg’s rank correlation test and Egger’s linear regression.We evaluated the evidence using the trial sequential analysis and Grading of Recommendations Assessment,Development and Evaluation(GRADE)methodology.We conducted subgroup analyses for pain scores at different postoperative time points and delirium according to cardiac or non-cardiac surgery.Results:A total of 26 trials with 10,743 patients were included.Deep anesthesia compared with light anesthesia(a mean difference in bispectral index of-12 to-11)was associated with lower pain scores at rest at 0 to 1 h postoperatively(weighted mean difference=-0.72,95%confidence interval[CI]=-1.25 to-0.18,P=0.009;moderate-quality evidence)and an increased incidence of postoperative delirium(24.95%vs.15.92%;risk ratio=1.57,95%CI=1.28-1.91,P<0.0001;high-quality evidence).No publication bias was detected.For the exploratory secondary outcomes,deep anesthesia was associated with prolonged postoperative recovery,without affecting neurocognitive outcomes,major complications,or mortality.In the subgroup analyses,the deep anesthesia group had lower pain scores at rest and on movement during 24 h postoperatively,without statistically significant subgroup differences,and deep anesthesia was associated with an increased incidence of delirium after non-cardiac and cardiac surgeries,without statistically significant subgroup differences.Conclusions:Deep anesthesia reduced early postoperative pain but increased postoperative delirium.The current evidence does not support the use of deep anesthesia in clinical practice.

A Look at Sequential Normal Scores and How They Apply to Financial Data Analysis

Statistical methods for analyzing economic data need to be timely, accurate and easy to compute. To accomplish this, parametric models are often assumed, but they are at best approximate, and often lack a good fit in the tails of the distribution where much of the interesting data are concentrated. Therefore, nonparametric methods have been extensively examined as alternatives to the constrictive assumptions of parametric models. This paper examines the use of Sequential Normal Scores (SNS) for transforming time series data with unknown distributions into time series data that are approximately standard-normally distributed. Particular attention is directed toward detecting outliers (out-of-control values), and applying subsequent analytic methods such as CUSUMs and Exponentially Weighted Moving Average (EWMA) schemes. Two examples of stock market data are presented for illustration.

Efficacy and safety of the heated gel mattress for prevention of hypothermia in preterm infants during intra-hospital transport： a meta-analysis

Objective： To evaluate the efficacy and safety of the heated gel mattress for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods： Systematic searches on PubMed, EM- BASE, Cochrane Library, Web of Science, CBM, CNKI, Wanfang and VIP were performed for randomized controlled trials （RCTs） or quasi-RCTs which explored the effects of heated gel mattress on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria, extracted data and assessed quality. Then, meta-analysis and trial sequential analysis were performed by RevMan 5.3 and TSA vO.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results： This systematic review included 10 studies which comprised 7 RCTs and 3 quasi-RCTs, encompassing 773 patients. The results of meta-analysis showed that in heated gel mattress group admission temperature on neonatal intensive care unit （SMD, 0.63; 95% CI, 0.40 to 0.87; P = 0.00）, incidence of hypothermia （RR, 0.73; 95% CI, 0.57 to 0.93; P = 0.01） and hyperthermia （RR, 1.82; 95% CI, 1.31 to 2.541 P = 0.00） compared with the control group had significantly statistical difference; however, there was no significant difference in admission temperature on exothermic mattresses or TransWarmer mattress group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage Ⅲ/Ⅳ between two groups, trial sequential analysis confirmed that the pooled results of admission temperature on neonatal intensive care unit and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusion： Heated gel mattress is a safe and effective re- warming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia and does not increase the incidence of morbidity and complications. However, it is recommended that clinical monitoring of body temperature should be performed dynamically to decrease the potential risk of high fever. In addition, due to the limitation of quantity and quality of included studies, its cost-effectiveness and far-reaching influence on long-term follow-up outcomes need further evaluation through clinical multicenter, large sample, and high-quality research.

Determination of Competitive Adsorption and Desorption of Heavy Metals by Isotherm and Sequential Extraction Methods in Different Soil Orders in Erzurum Plain

The objective of this study was to DTPA （complexion agent） and a sequential extraction procedure, and adsorption-desorption isotherm （competitive） evaluate the mobility and distribution of Fe, Zn, Mn, Cu, Cd, Ni, and Pb using the in surface samples of five soil great groups differing in their physicochemical properties. For determining heavy metal adsorption and desorption capacities of soil samples, six different concentrations （0, 2.5, 5, 10, 15 and 20 mg Lt） were used in a laboratory experiment with tree replications. An analytical procedure involving sequential chemical extractions has been used for partitioning of heavy metals into five fractions. Sorption isotherms were characterized using linear, Frendlich and Langmuir equations. The results indicated that the selective sequences of the metal adsorption based on the distribution coefficient was Pb〉Cu〉Ni〉Cd〉Zn〉Mn〉Fe and Pb, Cu, and Ni are the most strongly sorbed metals by these soils, whereas Cd, Zn and Mn are the least sorbed ones. The total adsorbed amount of these metals on the studied soils was well described by Langmuir equation. Calciorthid had the highset Pb, Cu, Ni, Cd, Zn, Mn, and Fe adsorption, and the sequences followed order Fluvaquent〉Argiustoll〉Pellustert〉Haplustept of the studied soil.

SEQUENTIAL ALGORITHM FOR MULTISENSOR PROBABILISTIC DATA ASSOCIATION

Based upon a multisensor sequential processing filter, the target states in a3D Cartesian system are projected into the measurement space of each sensor to extend thejoint probabilistic data association (JPDA) algorithm into the multisensor tracking systemsconsisting of heterogeneous sensors for the data association.

Interest Points Analysis for Internet Forum Based on Long-Short Windows Similarity

For Internet forum Points of Interest(PoI),existing analysis methods are usually lack of usability analysis under different conditions and ignore the long-term variation,which lead to blindness in method selection.To address this problem,this paper proposed a PoI variation prediction framework based on similarity analysis between long and short windows.Based on the framework,this paper presented 5 PoI analysis algorithms which can be categorized into 2 types,i.e.,the traditional sequence analysis methods such as autoregressive integrated moving average model(ARIMA),support vector regressor(SVR),and the deep learning methods such as convolutional neural network(CNN),long-short term memory network(LSTM),Transformer(TRM).Specifically,this paper firstly divides observed data into long and short windows,and extracts key words as PoI of each window.Then,the PoI similarities between long and short windows are calculated for training and prediction.Finally,series of experiments is conducted based on real Internet forum datasets.The results show that,all the 5 algorithms could predict PoI variations well,which indicate effectiveness of the proposed framework.When the length of long window is small,traditional methods perform better,and SVR is the best.On the contrary,the deep learning methods show superiority,and LSTM performs best.The results could provide beneficial references for PoI variation analysis and prediction algorithms selection under different parameter configurations.

Incorporating Uncertain Costs within a Series of Sequential Probability Ratio Tests

We consider an extension to Sequential Probability Ratio Tests for when we have uncertain costs, but also opportunity to learn about these in an adaptive manner. In doing so we demonstrate the effects that allowing uncertainty has on observation cost, and the costs associated with Type I and Type II error. The value of information relating to modelled uncertainties is derived and the case of statistical dependence between the parameter affecting decision outcome and the parameter affecting unknown cost is also examined. Numerical examples of the derived theory are provided, along with a simulation comparing this adaptive learning framework to the classical one.

Systematic review of Shufeng Jiedu capsules for acute attack of chronic bronchitis

Objective:To systematically evaluate the efficacy and safety of Shufeng Jiedu Capsules in the treatment of acute attacks of chronic bronchitis.Methods:CNKI,VIP,CBM,WanFang,PubMed,EMbase,Cochrane Library and ChiCTR were searched by computer,and randomized controlled trials of Shufeng Jiedu capsules in the treatment of AECB were integrated.The retrieval time was from the date of establishing the database to December 31,2020.Meta-analysis of outcome indicators[including effective rate,C-reactive protein(CRP),lung function[FEV1%and/or FEV1/FVC],interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)]were carried out by RevMan 5.3 software,and the effective rate was tested by sequential analysis(TSA),and the quality of evidence was evaluated according to GRADE standards.Results:A total of 680 cases in 8 articles were included.Shufeng Jiedu Capsules improved the effective rate of clinicaltreatment[RR=1.20,95%CI(1.13,1.28)],improved lung function[FEV1:MD=0.33,95%CI(0.22,0.45),FEV1/FVC:MD=10.17,95%CI(8.15,12.19)],reduced CRP[MD=-7.32,95%CI(-8.42,-6.22)],IL-8[MD=-63.39,95%CI(-73.49,-53.29)],TNF-α[MD=-7.44,95%CI(-8.35,-6.53)]levels.The above differences were statistically significant(P<0.05),and no serious adverse reactions were reported in all studies.The results of TSA analysis showed that the experimental group had definite evidence for improving the efficiency.According to the GRADE evaluation system,the efficiency,TNF-αwere medium-quality evidences,FEV1 was low-quality evidence,and FEV1/FVC,CRP,and IL-8 were extremely low-quality evidence.Conclusions:The curative effect of Shufeng Jiedu capsule combined with western medicine in the treatment of AECB was better than that of single western medicine.Nevertheless,considering the limited sample size and the quality of included articles,higher quality RCTs are still needed to further confirm its effectiveness and safety.

Behavioral Differentiation between Anas poecilorhyncha and Domestic Duck

Anas poecilorhyncha is one of improved variety of mallards, which was the protected bird species listed by International Union for Conservation of Nature （1UCN）. Little is known until now about behavioral characteristics of the mallard. The objective of this study was to compare the behavioral differentials between A. poecilorhyncha and domestic duck in order to make a strategy to manage A. poecilorhyncha under the condition of animal welfare. A total of 180 birds were distributed into six groups with 30 birds for each group. They were placed in a room of 3 m ~ 4 m and fed for one year old. Sansui ducks, a kind of native domestic duck （Sansui laying duck） were used for behavioral comparison. Two different rooms in the same building were applied, one room for A. poecilorhyncha and another one for Sansui ducks. All behaviors for A. poecilorhyncha and Sansui ducks were coded using the program The Observer XT 11.5 （Noldus Information Technology, Beijing）. The duration of observation was from 8：00 am to 18：00 pm daily and lasted 5 d. The results showed that there were similar behavioral percentages between A. poecilorhyncha and domestic duck. Percentages of standing activity spent for A. poecilorhyncha and Sansui duck were 34.59% and 30.25%, respectively. Accordingly, the activities, such as wing plugging, preening and head stretching, were more than 5.51%. The other activities, including walking, drinking and tail wagging, occupied less proportions （〈 3%）. While the specific behaviors, like aggression, alerting, wing dithering, clawing, nodding, pendulum clawing and crawling, took less than 1% of percentage. There were large differences between A. poecilorhyncha and domestic duck when comparing eight behavioral peaks. Lag sequential analysis was used to calculate frequency of transition between a pair of activities. Some parameters were very significant, like the frequency value from foraging converted to drinking in Sansui duck was 369-515, but 37-65 in A. poecilorhyncha. The best explaining could be given that Sansui duck was better domesticated than spot-billed duck. This study provides the basic data to study and develop spot-billed duck.

Systematic review of the therapeutic effect of fire acupuncture on psoriasis vulgaris based on"releasing stagnated fire"theory

Background:To systematically evaluate the clinical efficacy of fire acupuncture(or needle)in the treatment of psoriasis vulgaris.Methods:The following electronic databases were retrieved by calculator:PubMed,Embase,Cochrane Library,CNKI,Wanfang Academic Journal Database,VIP Chinese Journal Database,etc.All the randomized controlled trials using fire needles in the treatment of psoriasis vulgaris from the self-established database to August 2021 were included,and the qualified literatures were included.Review manager 5.3 software was used for the combined analysis of the included literatures,TSA v0.9 Beta for sequential analysis,and GRADE pro V3.6 for evidence quality evaluation.Results:A total of 14 studies with 1,440 patients were included in this study.Meta analysis results showed:effective rate[RR=1.15,95%CI(1.10,1.19),P<0.00001,very low quality evidence];Psoriasis Area and Severity Index[PASI score,WMD=-2.15,95%CI(-2.40,-1.90),P<0.00001,evidence of low quality],Dermatology Life Quality Index scale[DLQI score,WMD=-3.56,95%CI(-4.86,-2.26),P<0.00001,very low quality evidence],the experimental group was better than the control group(P<0.05).Sequential analysis further showed that the use of fire needle as the primary treatment could significantly reduce PASI score.The adverse reactions rate of the experimental group was 6%,and that of the control group was 11%,P<0.05.Conclusion:Fire acupuncture as the main treatment can reduce PASI and QLDI scores of patients with psoriasis vulgaris,improve the treatment efficiency,and fewer adverse reactions.