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.

Histopathology and the predominantly progressive,indeterminate and predominately regressive score in hepatitis C virus patients after direct-acting antivirals therapy

BACKGROUND Histological changes after direct-acting antivirals(DAAs)therapy in hepatitis C virus(HCV)patients has not been elucidated.Whether the predominantly progressive,indeterminate and predominately regressive(P-I-R)score,evaluating fibrosis activity in hepatitis B virus patients has predictive value in HCV patients has not been investigated.AIM To identify histological changes after DAAs therapy and to evaluate the predictive value of the P-I-R score in HCV patients.METHODS Chronic HCV patients with paired liver biopsy specimens before and after DAAs treatment were included.Sustained virologic response(SVR)was defined as an undetectable serum HCV RNA level at 24 wk after treatment cessation.The Ishak system and P-I-R score were assessed.Inflammation improvement and fibrosis regression were defined as a≥2-points decrease in the histology activity index(HAI)score and a≥1-point decrease in the Ishak fibrosis score,respectively.Fibrosis progression was defined as a≥1-point increase in the Ishak fibrosis score.Histologic improvement was defined as a≥2-points decrease in the HAI score without worsening of the Ishak fibrosis score after DAAs therapy.The P-I-R score was also assessed.“absolutely reversing or advancing”was defined as the same directionality implied by both change in the Ishak score and posttreatment P-I-R score;and“probably reversing or advancing”was defined as only one parameter showing directionality.RESULTS Thirty-eight chronic HCV patients with paired liver biopsy specimens before and after DAAs treatment were included.The mean age of these patients was 40.9±14.6 years and there were 53%(20/38)males.Thirty-four percent(13/38)of patients were cirrhotic.Eighty-two percent(31/38)of patients achieved inflammation improvement.The median HAI score decreased significantly after SVR(pretreatment 7.0 vs posttreatment 2.0,Z=-5.146,P=0.000).Thirty-seven percent(14/38)of patients achieved fibrosis improvement.The median Ishak score decreased significantly after SVR(pretreatment 4.0 vs posttreatment 3.0,Z=-2.354,P=0.019).Eighty-two percent(31/38)of patients showed histological improvement.The P-I-R score was evaluated in 61%(23/38)of patients.The progressive group showed lower platelet(P=0.024)and higher HAI scores(P=0.070)before treatment.In patients with stable Ishak stage after treatment:Progressive injury was seen in 22%(4/18)of patients,33%(6/18)were classified as indeterminate and regressive changes were seen in 44%(8/18)of patients who were judged as probably reversing by the Ishak and P-I-R systems.CONCLUSION Significant improvement of necroinflammation and partial remission of fibrosis in HCV patients occurred shortly after DAAs therapy.The P-I-R score has potential in predicting fibrosis in HCV patients.

Analysis on Predominant Periods Distribution by Microtremor Observations for Seismic Disaster Prevention in Yokohama, Japan Using GIS

In recent years, predictions of damage from earthquakes have been made on a prefectural scale, and expectations exist that more detailed damage forecasts should be made even on a city/town/village scale. It is important to know detailed ground characteristics to do damage prediction on a fine scale. Using GIS is the best way to communicate this planar disaster prevention information to the general public. Yokohama City is the second largest city in Japan and developed as part of the capital region of Metropolitan Tokyo. Recently, the population of this city has reached about 3,000,000, and economic and cultural facilities, social infrastructure, and residential complexes are concentrated in this city. The capital region, including Yokohama City, was attacked by the 1923 Great Kanto Earthquake (M7.9) and Yokohama City was devastated by this earthquake. From the research so far, it is known that the H/V spectrum obtained from microtremor observation has a good correlation with the ground characteristics. The authors have been conducting high-density tremor observations that have been ongoing since the 1990s, mainly in Kanagawa Prefecture, Japan. Here, we have organized the predominant periods obtained from the observation results for Yokohama City. The entirety of Yokohama City was divided into 250 m × 250 m meshes and their centers were used as microtremor observation sites. Excluding sites that could not be used due to geographical conditions, observations were made at approximately 5700 sites. So, we compared the data obtained separately, such as the period, terrain classification, and amplification characteristics. The distribution maps of predominant periods in Yokohama City show that the city contains a lot of artificially transformed land, and consequently, the distribution of predominant periods is not uniform. However, it can be seen that the periods become gradually longer, moving from the higher elevation eastern part toward the lower elevation western part. Investigation of the site amplification factors and detailed topographical classifications indicates a clear correlation with the predominant period distribution.

Screen and Capacity of Predominant Strain for Toluene Biodegradation in Groundwater

The soil nearby a gas station was collected, from which we isolated a series of strains by means of enrichment and screening technigues. The most effective strain for the degradation of toluene, i.e., JYZ0315 was screened by the further mutation of the above strains. The degradation capacity experiment was carried out in simulated groundwater. Under the optimal conditions, the degradation rate could reach 93.5%. During the extend application experiments with a percolation tank, the degradation of toluene reached 87.3% in 11 d and 95.2% in 15 d, which was close to that of the microenvironment, and this proves that JYZ0315 is one of the predominant strains to degrade toluene in groundwater.

Diagnostics of Sensory Ataxia in Patients with Sensory Predominant Chronic Inflammatory Demyelinating Polyneuropathy from Republic of Sakha (Yakutia) and Krasnoyarsk Region

Materials and Methods: A group of healthy volunteers (24 people) and patients with SP-CIDP from Republic of Sakha (Yakutia) (42 people) and Krasnoyarsk region (87 people). Diagnostics Methods: Clinical neurologic, neurophysiological. Results: The results of stabilometry research of patients with SP-CIDP have revealed area expansion of pressure centre in phase EO and EC with deflection PC forward by anteropulsion type among patients with SP-CIDP from Republic of Sakha (Yakutia). Also in the Yakut group has been noted to have severer clinical course in comparison with inhabitants of Krasnoyarsk region. Conclusion: The method of computer stabilometry allows estimating objectively presence and degree of manifestation of sensitive ataxia in patients with SP-CIDP.

Shuchang decoction for treatment of diarrhea predominant irritable bowel syndrome with Gan depression and Pi deficiency:a multicenter,randomized,double-blind,placebo controlled trial

Objective To observe the clinical efficacy and safety of Shuchang Decoction (SCD) in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D)with Gan depression and Pi deficiency syndrome.Methods A total of 179 patients with IBS-D were recruited from 12 hospitals of Shanghai TCM Gastroenterology Federation.

Single-station microtremor surveys for site characterization:A case study in Erzurum city,eastern Turkey

The single-station microtremor method is one of the fastest,most reliable,and cheapest methods used to identify dynamic soil properties.This study utilizes 49 single-station microtremor measurements to identify the dynamic soil properties of the Hilalkent quarter of the Yakutiye district in Erzurum.Soil dominant frequency and the amplification factor were calculated by using the Nakamura horizontal/vertical spectral ratio(H/V)method.While the soil dominant frequency values varied between 0.4 Hz and 10 Hz,the soil amplification factor changed between 1 and 10.Higher H/V values were acquired with lower frequency values.The vulnerability index(K_(g))and shear strain parameters that are utilized to estimate the damage that may be caused by an earthquake were mapped.Especially in the west side of the study area,higher K_(g) values were observed.The shear strain map was created with 0.25 g,0.50 g and 0.75 g bedrock accelerations,and soil types that lost elasticity during an earthquake were identified.The average shear wave velocity for the first 30 m(V_(s30))was calculated.Finally,it was observed that the western part of the study area,which resulted in a higher period and higher H/V,higher K_(g) and lower V_(s30) values,presents a higher risk of damage during an earthquake.

Novel emphasis on somatostatinergic system in retinal ganglion cell neuroresilience

The neuromodulatory peptide somatostatin(somatotropin release inhibiting factor,SRIF)-14 acts at multiple levels through five SRIF receptor subtypes(sst1 to sst5).SRIF-28 is also derived from a common propeptide translated from a single SRIF gene,although SRIF-14 is the predominant form in the mammalian nervous system.Due to its short half-life,synthetic SRIF analogs have been developed over the years and are available for therapeutic approaches.

Does astrocytic L-lactate enhance cognition through myelination?

Introduction:Astrocytes,the predominant glial cell in the brain,play a vital role in a plethora of central nervous system functions.They are the major storage site of glycogen in the central nervous system.They produce L-lactate by glycogenolysis and glycolysis which is then transported to neurons(Magistretti and Allaman,2018).Multiple evidence using diverse behavioral paradigms,such as fear conditioning,conditioned place avoidance,rat gambling task(RGT),and flavor-place paired associate(PA)learning suggest that L-lactate has a beneficial effect on various aspects of cognition(Wang et al.,2017;Akter et al.,2023b).While the molecular mechanisms underlying the cognitive benefits of L-lactate are still emerging,it is well-established that astrocytic L-lactate can be used as an energy substrate by neurons and can induce N-methyl-D-aspartate receptor-dependent plasticity-driven gene expression during cognition(Magistretti and Allaman,2018).Additionally,recent evidence has revealed more roles of L-lactate which include myelination,neuronal mitochondrial biogenesis,and antioxidant defense(Sanchez-Abarca et al.,2001;Ichihara et al.,2017;Akter et al.,2023a,b).Myelin in the central nervous system is a specialized lipid-rich membrane formed by oligodendrocytes.

Hodgkin's lymphoma:2023 update on treatment

Hodgkin's lymphoma(HL)is a common,malignant hematological tumor of the lymph nodes and lymphatic system,accounting for 10%of all lymphomas.HL comprises 2 main subtypes:classical HL(cHL)and nodular lymphocyte predominant HL.

Sex differences in Alzheimer's disease:an urgent research venue to follow

Due to increasing life expectancy,the amount of people with dementia worldwide is expected to experience a substantial rise,with estimates indicating a growth from 55 million in 2019 to a staggering 139 million by the year 2050.Among the various forms of dementia.Alzheimer's disease(AD)stands out as the predominant and most prevalent.

Post-marketing Re-evaluation of Tongxiening Granules (痛泻宁颗粒) in Treatment of Diarrhea-Predominant Irritable Bowel Syndrome:A Multi-center,Randomized,Double-Blind,Double-Dummy and Positive Control Trial

Objective: To evaluate the efficacy and safety of Tongxiening Granules(痛泻宁颗粒, TXNG) in the treatment of irritable bowel syndrome with predominant diarrhea(IBS-D). Methods: A randomized, double-blind, double-dummy, and positive paral el control ed clinical trial was conducted from October 2014 to March 2016. Total y 342 patients from 13 clinical centers were enrolled and randomly assigned(at the ratio of 1:1) to a treatment group(171 cases) and a control group(171 cases) by a random coding table. The patients in the treatment group were administered oral y with TXNG(5 g per time) combined with pinaverium bromide Tablet simulator(50 mg per time), 3 times per day. The patients in the control group were given TXNG simulator(5 g per time) combined with pinaverium bromide Tablets(50 mg per time), 3 times per day. The treatment course lasted for 6 weeks. The improvement of Irritable Bowel Syndrome Symptom Severity Score(IBS-SSS) was used to evaluate the primary outcome. Secondary outcomes included adequate relief(AR) rate, Irritable Bowel Syndrome-Quality of Life Questionnaire(IBS-QOL), Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD), and the recurrence rate at fol ow-ups. Safety indices including the adverse events(AEs) and related laboratory tests were evaluated. Results: Primary outcome: IBS-SSS at baseline, weeks 2, 4, 6 showed no statistical significance in both full analysis set(FAS) and per protocol set(PPS, P>0.05). After 6 weeks of treatment, the total effective rate of IBS-SSS scores in the treatment group(147/171, 86.0%) was higher than the control group(143/171, 83.6%) by FAS(P>0.05). In regard to secondary outcomes, after 6-week treatment, there was no significant difference in AR rate, total score of IBS-QOL, improvement of HAMD and HAMA total scores between the two groups(P>0.05). The recurrence rate at 8-week fol ow-up was 12.35%(10/18) in treatment group and 15.79%(12/76) in control group, respectivery(P>0.05). A total of 21 AEs occurred in 15 cases, of which 11 occurred in 8 cases in the treatment group and 10 AEs in 7 cases in the control group. The incidence of AEs had no statistical significance between the two goups(P>0.05). Conclusion: Tongxiening Granules could relieve the symptoms of patients with IBS-D and the treatment effect was comparable to pinaverium bromide.(No. ChiCTR-IPR-15006415)

Tonic Electromyogram Density in Multiple System Atrophy with Predominant Parkinsonism and Parkinson＇s Disease

Background： Both Parkinson＇s disease （PD） and multiple system atrophy （MSA） have associated sleep disorders related to the underlying neurodegenerative pathology. Clinically, MSA with predominant parkinsonism （MSA-P） resembles PD in the manifestation of prominent parkinsonism, Whether the amount of rapid eye movement （REM） sleep without atonia could be a potential marker for differentiating MSA-P from PD has not been thoroughly investigated. This study aimed to examine whether sleep parameters could provide a method for differentiating MSA-P from PD. Methods： This study comprised 24 MSA-P patients and 30 PD patients, and they were of similar age, gender, and REM sleep behavior disorder （RBD） prevalence. All patients underwent clinical evaluation and one night of video-polysomnography recording. The tonic and phasic chin electromyogram （EMG） activity was manually quantified during REM sleep of each patient. We divided both groups in terms of whether they had RBD to make subgroup analysis. Results： No significant difference between MSA-P group and PD group had been tbund in clinical characteristics and sleep architecture. However, MSA-P patients had higher apnea-hypopnea index （AHI; 1.15 [0.00, 8.73]/h vs. 0.00 [0.00, 0.55]/h, P = 0.024） and higher tonic chin EMG density （34.02 [ 18.48, 57.18]% vs. 8.40 [3.11, 13.061%, P 〈 0.001 ） as compared to PD patients. Subgroup analysis found that tonic EMG density in MSA ＋ RBD subgroup was higher than that in PD ＋ RBD subgroup （55.04 [26.81,69.62]% vs. 11.40 [8.51,20.411%, P 〈 0.001 ）. Furthermore, no evidence of any difference in tonic EMG density emerged between PD ＋ RBD and MSA - RBD subgroups （P 〉 0.05）. Both disease duration （P = 0.056） and AHI （P = 0.051） showed no significant differences during subgroup analysis although there was a trend toward longer disease duration in PD ＋ RBD subgroup and higher AHI in MSA - RBD subgroup. Stepwise multiple linear regression analysis identified the presence of MSA-P （[3 0.552, P 〈 0.001 ） and RBD （[3 = 0.433, P 〈 0.001 ） as predictors of higher tonic EMG density. Conclusion： Tonic chin EMG density could be a potential marker for differentiating MSA-P from PD.

HCV 6a was expanding and became the predominant subtype among blood donors between 2004 and 2019 in Guangdong, China

Dear Editor,There were an estimated 9.4 million patients with chronic hepatitis C virus(HCV)in China,putting a considerable burden on public health(Polaris Observatory HCV Collaborators,2022).What is more,the incidence of HCV infection increased 14.5%every year based on data from China's National Notifiable Diseases Reporting System(Zhang et al.,2019).Approximately 75%of individuals infected with HCV develops chronic hepatitis,while long-term chronic HCV infection is the most important cause of liver fibrosis,cirrhosis,and hepatocellular carcinoma.

Clinical observation on acupuncture for diarrhea-predominant irritable bowel syndrome patients in syndrome of liver-stagnation and spleen-deficiency and its impact on Th1 /Th2

Objective To observe clinical therapeutic effects of acupuncture for pattern of liver-stagnation and spleen-deficiency in diarrhea-predominant irritable bowel syndrome(D-IBS)and its impact on cell factors.Methods Forty cases were selected and divided into an acupuncture group(21 cases)in which acupuncture was applied and a medicine group(19 cases)in which oral administration of dicetel and bifidobacterium lactobacillus triple viable capsulas were applied.The symptom scores,level of

Correlation between food intolerance and colon mucosal mast cells and substance P in 27 patients with diarrhea predominant irritable bowel syndrome

Objective To investigate the significance and possible mechanism of food intolerance in diarrhea-predominant irritable bowel syndrome(IBS-D).Methods Twenty-seven IBS-D patients matched the RomeⅢcriteria were selected as IBS-D group.Twenty-seven healthy individuals without gastrointestinal symptoms were

Randomized,parallel-control and multi-centered research on venlafaxine sustained release tablet and pinaverium bromide in treating patients with diarrhea-predominant irritable bowel syndrome

Objective To observe the efficacy,adverse effects and the influence on the depression and anxiety scoringof combined venlafaxine sustained release tablet with pinaverium for treating patients with dominant-diarrhea irritable bowel syndrome (IBS-D) .Methods With randomized,parallel control,multi-center and opening

Pulse-like ground motion observed during the 6 February 2023 M_(W)7.8 Pazarcık Earthquake(Kahramanmaraş,SE Türkiye)

In this study,we analyzed 100 three-component strong ground motion records observed within 200 km of the causative fault of the 6 February 2023 M_(W)7.8 Pazarcık(Kahramanmaraş)Earthquake in SE Türkiye.The wavelet method was utilized to identify and analyze the characteristics of pulse-like ground motions in the near-fault region,while considering the uncertainty of the pulse orientation during the analysis.Our investigation focused on the effects of the focal mechanism and rupture process on the spatial distribution,pulse orientation,and maximum pulse direction of the observed pulse-like ground motion.We also analyzed the amplitude and period of the observed ground pulses and the effect of long-period amplification on the ground motion response spectra.Our results indicated the following:(1)A total of 21 typical ground velocity pulses were observed during this earthquake,exhibiting complex characteristics due to the influence of the strike-slip mechanism and rupture directivity.Most ground pulses(17 out of 21)were recorded within 20 km of the fault,in a wide range of orientations,including normal and parallel to the fault direction.The waveforms exhibited unidirectional features,indicating the effects of left-lateral fault slip.Distinct pulses observed more than 20 km from the fault were mainly oriented normal to the fault.The waveforms were bidirectional with double-or multi-round trips as a result of rupture directivity.(2)The amplitudes of the observed pulses ranged from 30.5 to 220.0 cm/s,with the largest peak velocity of 220.0 cm/s observed at Station 3138.The pulse periods ranged from 2.3 to 14.5 s,with the longest pulse period of 14.5 s observed at Station 3116.The amplitude and period of the pulses observed during this earthquake were comparable to those of similar-magnitude global earthquakes.The amplitude of the pulses decreased significantly with increasing fault distance,whereas the pulse period was not significantly affected by the fault distance.(3)Compared with non-pulse records,the velocity pulse records had a pronounced amplification effect on the acceleration response spectra near the pulse period,with factors ranging from 2.1 to 5.8.The larger velocity pulses also significantly amplified the velocity response spectra,particularly over the long periods.This significant amplification effect of the pulses on the response spectra leads to empirical models underestimating the long-period earthquake ground motion.

Traditional Chinese medicine:Eastern natural remedy for management of lipid metabolic disorders

Lipids is one of the predominant agents for energy storage in mammals,and lipid metabolism is one of the predominant ways to supply energy for human physiological activities.Dysfunctional lipid metabolism can result in a series of serious chronic diseases,such as obesity,non-alcoholic fatty liver diseases,cardiovascular diseases,and type 2 diabetes mellitus,etc.Owing to the improvement of living standards,changes in dietary structure,and insufficient exercise,these aforementioned diseases show an increasing tendency towards becoming a global epidemic and spreading.

Integrative lipidomics profile uncovers the mechanisms underlying high-level α-linolenic acid accumulation in Paeonia rockii seeds

Tree peony(Paeonia rockii)is an excellent woody oilseed crop,known for its highα-linolenic acid(ALA,∼45%)content,which is of great value for human health.However,the mechanisms underlying this high-level ALA accumulation in tree peony seeds are poorly understood.In this study,we evaluated the dynamic changes in the lipidomic profile of P.rockii seeds during development.A total of 760 lipid molecules were identified in P.rockii seeds;triacylglycerol(TAG)lipid molecules showed the highest abundance and diversity,both increasing during seed development.Particularly,ALA was the predominant fatty acid at the TAG sn-3 position.We further characterized two diacylglycerol acyltransferase(DGAT)genes and three phospholipid:diacylglycerol acyltransferase(PDAT)genes involved in the transfer of fatty acids to the TAG sn-3 position.Gene expression and subcellular localization analyses suggested that PrDGATs and PrPDATs may function as endoplasmic reticulum-localized proteins in seed TAG biosynthesis.In vitro functional complementation analysis showed different substrate specificities,with PrPDAT2 having a specific preference for ALA.Multiple biological assays demonstrated that PrDGAT1,PrDGAT2,PrPDAT1-2,and PrPDAT2 promote oil synthesis.Specifically,PrPDAT2 leads to preferential ALA in the oil.Our findings provide novel functional evidence of the roles of PrDGAT1 and PrPDAT2,which are potential targets for increasing the ALA yield in tree peony and other oilseed crops.