Construction of competency evaluation system for infection control personnel in traditional Chinese medicine hospitals

Background:This study uses a literature review and the Delphi expert consultation method to construct a competency evaluation model for infection control personnel in traditional Chinese medicine(TCM)hospitals.The aim is to strengthen infection control management in TCM hospitals,assess the competency of infection control personnel in their positions,and assist them in identifying the competencies that need improvement.Methods:Based on the literature research method and the Delphi expert consultation method,a competency model for the position was constructed through two rounds of expert consultations,analyzing the relationships between various factors and establishing a hierarchical structure model.Pairwise comparisons were made among the elements at the same level to construct a judgment matrix.Through the analytic hierarchy process,the weight coefficients of the indicators at each level in the competency model were obtained.Results:This study conducted a comprehensive assessment of various capabilities and practices related to hospital infection control.The survey results indicate that participants excelled in multiple areas,with a high overall satisfaction rate.95.28%of participants were able to develop hospital infection monitoring plans based on national infection control policies,demonstrating a good understanding and execution of these policies.94.09%of participants were familiar with high-risk populations and key departments in the hospital.91.73%of participants were able to establish monitoring scopes based on the trends of multidrug-resistant bacteria and conduct information monitoring,reflecting strong response capabilities.92.91%of participants were able to collaborate with relevant departments to conduct bacterial resistance monitoring,showing a good team spirit.94.49%of participants were able to perform targeted monitoring,including surgical site infections,indicating that they have effective monitoring strategies.91.34%of participants were able to collect and organize monitoring data and establish a systematic database,demonstrating good data management skills.90.16%of participants were able to interpret laws and regulations related to hospital infection management,indicating a high level of legal knowledge.89.37%of participants generally possessed good communication skills.92.52%of participants were able to guide medical staff on occupational safety and protective knowledge,showing an emphasis on occupational health.Participants demonstrated a strong desire to learn and innovate,with 87.01%actively participating in continuing education and research activities,reflecting a pursuit of professional development.Conclusion:Based on the results of the two rounds of expert consultations,a competency evaluation model for infection control personnel in TCM hospitals was formed.Through the analytic hierarchy process,the weight coefficients of various indicators at different levels in the model were obtained,and the research results have good scientific validity and reliability.

A holistic strategy for quality and safety control of traditional Chinese medicines by the “iVarious” standard system

An effective quality control system is the key to ensuring the quality, safety and efficacy of traditional Chinese medicines(TCMs). However, the current quality standard research lacks top-level design and systematic design,mostly based on specific technologies or evaluation methods. To resolve the challenges and questions of quality control of TCMs, a brand-new quality standard system, named "iVarious", was proposed. The system comprises eight elements in a modular format. Meaning of every element was specifically illustrated via corresponding research instances. Furthermore, frankincense study was taken as an example for demonstrating standards and research process, based on the "i Various" system. This system highlighted a holistic strategy for effectiveness,security, integrity and systematization of quality and safety control standards of TCMs. The establishment of"i Various" integrates multi-disciplinary technologies and progressive methods, basis elements and key points of standard construction. The system provides a novel idea and technological demonstration for regulation establishment of TCMs quality standards.

Quality of life and survival analyses of breast cancer cases treated with integrated traditional Chinese and Western medicine

BACKGROUND Breast cancer(BC)is the second leading cause of tumor-related mortality after lung cancer.Chemotherapy resistance remains a major challenge to progress in BC treatment,warranting further exploration of feasible and effective alternative therapies.AIM To analyzed the quality of life(QoL)and survival of patients with BC treated with integrated traditional Chinese and Western medicine(TCM-WM).METHODS This study included 226 patients with BC admitted to the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine between February 2018 and February 2023,including 100 who received conventional Western medicine treatment(control group)and 126 who received TCM-WM treatment(research group).The total effective rate,side effects(alopecia,nausea and vomiting,hepatorenal toxicity,and myelosuppression),QoL assessed using the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire(EORTC QLQ-C30),1-year overall survival(OS),recurrence and metastasis rates,and serum inflammatory factors[interleukin(IL)-6,IL-10,and tumor necrosis factor alpha]were comparatively analyzed.RESULTS The research group showed statistically better overall efficacy,EORTC QoL-C30 scores,and 1-year OS than the control group,with markedly lower side effects and 1-year recurrence and metastasis rates.Moreover,the posttreatment levels of serum inflammatory in the research group were significantly lower than the baseline and those in the control group.CONCLUSION Overall,TCM-WM demonstrated significantly improved therapeutic efficacy while ensuring drug safety in BC,which not only improved patients’QoL and prolonged survival,but also significantly inhibited the inflammatory response.

A Comparative Analysis of the Control Effect of Medical Expenses between General Hospitals and Traditional Chinese Medicine Hospitals from 2012 to 2021

Objective To analyze the changing trend of average medical expenses and structure in general hospitals and traditional Chinese medicine(TCM)hospitals and the effects and differences achieved by the two kinds of hospitals through controlling unreasonable growth of medical expenses,so as to provide reference for controlling the rapid rise of medical cost in public hospitals and optimizing the cost structure.Methods Based on the changes of related indicators of medical expense control from 2012 to 2021,the overall characteristics,changes of cost structure and trends of medical expenses in general hospitals and TCM hospitals were investigated.Results and Conclusion From 2012 to 2021,the increase of medical expenses in general hospitals and traditional Chinese medicine hospitals had slowed down,the proportion of drug revenue to medical income began to decline,and the medical service income increased.However,the proportion of inspection,test and sanitary materials income has increased instead of decreasing,but the management cost has decreased.The two kinds of hospitals have achieved certain cost control results,the structure of medical cost has changed greatly,and the technical service and labor value of medical personnel have been reflected to a certain extent.However,it is still necessary to explore a more scientific and reasonable cost control mechanism to promote the further optimization of medical cost structure.

Development of chromatographic technologies for the quality control of Traditional Chinese Medicine in the Chinese Pharmacopoeia

As an important branch of medicine, Traditional Chinese Medicine(TCM) has been applied for the treatment of diseases for thousands of years in China and other countries in East Asia. The Chinese Pharmacopoeia(ChP) is a drug code formulated by the Chinese government, and it includes a special volume for the monographs of TCM, which plays an important role in ensuring the quality of drugs. The use of quality control technology has always been a complex and important factor in TCM. Owing to the chemical diversity of TCM, chromatography technology has been proven to be a comprehensive strategy for the assessment of the overall quality of TCM and has become the main analytical method in the ChP.This article provides an overview of the classical and modern chromatographic technologies applied in the ChP, and summarizes the advantages and disadvantages of each technique in the TCM monographs.In 2020, the new edition of the Ch P(the 2020 edition) has been implemented at the end of 2020. This paper also contains a brief introduction about the application of chromatographic technologies in the new edition of the ChP.

Pharmacological intervention of traditional Chinese medicine for the quality of life in patients with colorectal cancer： a systematic review and meta-analysis

Objective： The objective of this study is to evaluate the impact of various traditional Chinese medicine （TCM）approaches on the quality of life in patients with colorectal cancer. Methods： In this study, we systematically performedthe screening of randomized controlled trials from Cochrane Library, Pubmed, Embase, Medline, and Web of Science.The data were extracted by two reviewers independently, and then risk assessment was performed. All the analyses wereconducted using Review Manager 5.3. Results： A total of 18 eligible studies containing 1312 patients were included.Experimental group were treated with TCM combined with Western medicine or TCM alone （N = 688） and controlgroup were treated with Western medicine treatment alone （N = 624）. The results showed that the recent clinicalefficiency between the two groups was not statistically significant （P = 0.06）. KPS scores of the experimental group werehigher than those in the control group [P 〈 0.001, WMD = 9.60, 95%CI = （5.62, 13.57）]. The toxicity comparisonshowed that the occurrence of toxicities, such as leucopenia, thrombocytopenia, nausea and vomiting, diarrhea, andneurotoxicity in the experimental group was lower than that in the control group [P 〈 0.001, OR = 0.31, 95%CI = （0.19,0.50）], [P = 0.003, OR = 0.49, 95%CI = （0.31, 0.78）], [P 〈 0.001, OR = 0.30, 95%CI = （0.16, 0.54）], [P 〈 0.001, OR =0.40, 95%CI = （0.27, 0.58）], and [P 〈 0.001, OR = 0.43, 95%CI = （0.30, 0.61）]. The immunological test comparisondemonstrated that the immunological parameters （CD3, CD4, and CD4/CD8） showed higher values in the experimentalgroup than those in the control group [P 〈 0.001, MD = 5.55, 95%CI = （4.83, 6.28）], [P 〈 0.0001, MD = 6.75, 95%CI =（5.25, 8.26）], and [P = 0.001, MD = 0.26, 95%CI = （0.10, 0.41）]. Conclusions： TCM did not show significant recentclinical efficiency. However, treatment with TCM showed increase in KPS scores in patients with colorectal cancer,alleviation of toxicity associated with chemotherapy, regulation of autoimmunity, and improvement in the quality of lifeof patients.

Traditional Chinese medicine for acute mountain sickness prevention: A systematic review and meta-analysis of randomized controlled trials

Objective: To evaluate the efficacy of traditional Chinese medicine(TCM) for preventing acute mountain sickness(AMS).Methods: We included randomized controlled trials(RCTs) which evalueded the effect of TCM for preventing AMS, compared with a placebo, no treatment or acetazolamide. The literature was searched in 6major databases. RevMan 5.4 software was used for the meta-analysis. The relative risk for discrete variables and the mean difference for continuous variables with 95% confidence intervals(CIs) were applied to express the effect size. The risk of bias in the included studies was evaluated using the Cochrane risk assessment tool 2.0(RoB 2.0), and the evidence certainty was assessed using the Grading of Recommendations Assessment and the Development and Evaluation(GRADE) approach.Results: Twenty RCTs involving 3015 participants and 16 TCM patent drugs were included. The overall risk of bias in the majority of studies(15/20) was of some concerns. In terms of the AMS incidence,Rhodiola rosea(R. rosea, Hong Jing Tian) and Ginkgo biloba(G. biloba, Yin Xing Ye) were equivalent to the placebo/no treatment [RR(95% CI): 0.66(0.43-1.01), 0.82(0.63-1.06), respectively]. The AMS incidence in the G. biloba group was higher than that in the acetazolamide group [RR(95% CI): 2.92(1.69-5.06)]. In terms of improving the AMS symptom score on days 1 and 3 in the plateau, R. rosea and G. biloba were superior to the placebo or no treatment [MD(95% CI):-0.98(-1.71,-0.25),-2.05(-3.14,-0.95), respectively]. The other 14 Chinese patent medicines were evaluated in a single trial, and the majority of the results were negative. The subgroup analysis showed that the effect of R. rosea was related to the intervention time, way of ascending, and altitude.Conclusion: R. rosea and G. biloba were effective in improving AMS symptoms but had no effect in reducing the AMS incidence. There was insufficient evidence to support the use of other TCM patent drugs to prevent AMS. More randomized double-blind placebo-controlled trials are warranted to evaluate and screen effective Chinese patent medicines for AMS prevention.

Current status of outcome reporting in randomized controlled trials of traditional Chinese medicine for mammary gland hyperplasia: A systematic review

Objective:To assess outcome indicators in clinical trials and provide a reference for establishing a core outcome set to treat hyperplasia of mammary gland(HMG)with traditional Chinese medicine(TCM).Methods:Eight online databases were searched from their inception to December 31,2022,to assess outcomes reported in randomized controlled trials(RCTs)of HMG treated with TCM.The quality of the included studies was assessed according to the Cochrane Risk of Bias Assessment Tool.All outcomes were extracted,classified,and described.Results:A total of 8249 articles were initially retrieved.Of these,70 articles were eligible and involved 10618 participants with HMG.A total of 17 outcome indicators with a frequency of 271 times were involved and were collected according to six outcome domains.Conclusions:The core outcomes of RCTs of HMG treated with TCM are large and divergent.There are problems in evaluation standards,primary and secondary outcomes,TCM characteristic indicators,long-term prognosis,and standardization of reporting.It is recommended to strengthen the trial design and actively construct the core outcome sets with TCM characteristics for HMG.

Metabonomics/metabolomics analysis technology and its application in quality control of traditional Chinese medicines

Chinese medicines are an important part of traditional Chinese medicines,but their'safe,effective,stable and controllable'issue still remains to be solved.The rise of metabonomics in 20th century,consistent with the overall adjustment concept of multi-component,multi-level,multi-target,multi-metabolic pathways of traditional Chinese medicines,is conducive to solve basic problems in their quality control.This paper systematically describes recent application and development of 1H-NMR metabonomics techniques,LC-MS metabonomics techniques and GC-MS metabonomics techniques in the quality control of traditional Chinese medicines.It provides a new reference for Chinese medicines and the identification and quality assessment of their products.

Quality Markers of Traditional Chinese Medicine:Concept,Progress,and Perspective

As the most important complementary medication against a variety of diseases,traditional Chinese medicines(TCMs)have been extensively applied over thousands of years.Current quality control of herbal medicines,however,is in great dispute.Unlike chemical drugs,which have clear and validated quality standards,the content of only one(or a few)compounds of many herbs and preparations is currently assessed as an indicator of quality,even though the assessed compound(s)is neither closely associated with the efficacy nor representative of the medicine as a whole.Based on the clinical use,compatibility of multiple component prescriptions,and manufacturing process of TCM,the new concept of a TCM quality marker that was proposed in previous work is discussed further here.In addition,practical technological approaches are described for the qualitative analysis and quantification of TCMs including herbs,processed products,and preparations,which lead to the discovery and identification of specific chemicals as quality markers and new quality control patterns.The progress that has been made in TCM quality control is also addressed.This work provides useful information for the quality control of herbal medicines in the future.

Epigastric pain syndrome: What can traditional Chinese medicine do? A randomized controlled trial of Biling Weitong Granules

BACKGROUND Recent research suggests that although prokinetic agents,acid suppressors,and radical treatment for Helicobacter pylori infection may be effective in patients with functional dyspepsia(FD),a large proportion of patients still fail to respond to these treatments or may suffer from severe adverse reactions.Many traditional Chinese medicinal herbs can regulate the status of the entire body and have special advantages in the treatment of functional diseases.The present study was designed to verify the efficacy of Biling Weitong Granules(BLWTG),a traditional Chinese medicinal herbal compound formula,in alleviating epigastric pain syndrome(EPS)in FD patients,in an attempt to provide an effective prescription for the clinical treatment of this disease.AIM To evaluate the clinical efficacy and safety of BLWTG in treating EPS in patients with FD.METHODS In this multicenter,stratified,randomized,double-blind,placebo-controlled,parallel group clinical trial,eligible patients were randomized into the BLWTG and placebo groups who were treated for 6 wk.Efficacy indicators including the severity and frequency of EPS and the time to pain resolution and safety indicators including adverse events were observed and compared.RESULTS The baseline demographic data and clinical characteristics,such as epigastric pain symptoms,pain intensity,and frequency of attacks,were matched between the two groups before randomization.After 6 wk of treatment and after the center effect was eliminated,the epigastric pain was significantly improved in 28.33%and 85.59%of the patients in the placebo and BLWTG groups,respectively(P<0.05).At 6 wk,the resolution rate of epigastric pain was 15%and 69.49%in the placebo and BLWTG groups,respectively(P<0.05).The differences of total FD clinical score between these two groups were significant(P<0.05)at 2,4,and 6 wk(P<0.05).The scores of each item and the total score in the Functional Digestive Disorders Quality of Life Questionnaire showed significant differences between the two groups at 6 wk after both the center and interaction effects were eliminated(P<0.05).There was no significant difference in the incidence of adverse events between the two groups,and no serious adverse event was noted during the observation.CONCLUSION Compared with placebo,BLWTG markedly improved EPS in FD patients without causing serious adverse reactions.

An ultra-robust fingerprinting method for quality assessment of traditional Chinese medicine using multiple reaction monitoring mass spectrometry

Chromatographic fingerprinting has been perceived as an essential tool for assessing quality and chemical equivalence of traditional Chinese medicine.However,this pattern-oriented approach still has some weak points in terms of chemical coverage and robustness.In this work,we proposed a multiple reaction monitoring(MRM)-based fingerprinting method in which approximately 100 constituents were simultaneously detected for quality assessment.The derivative MRM approach was employed to rapidly design MRM transitions independent of chemical standards,based on which the large-scale fingerprinting method was efficiently established.This approach was exemplified on QiShenYiQi Pill(QSYQ),a traditional Chinese medicine-derived drug product,and its robustness was systematically evaluated by four indices:clustering analysis by principal component analysis,similarity analysis by the congruence coefficient,the number of separated peaks,and the peak area proportion of separated peaks.Compared with conventional ultraviolet-based fingerprints,the MRM fingerprints provided not only better discriminatory capacity for the tested normal/abnormal QSYQ samples,but also higher robustness under different chromatographic conditions(i.e.,flow rate,apparent pH,column temperature,and column).The result also showed for such large-scale fingerprints including a large number of peaks,the angle cosine measure after min-max normalization was more suitable for setting a decision criterion than the unnormalized algorithm.This proof-of-concept application gives evidence that combining MRM technique with proper similarity analysis metrices can provide a highly sensitive,robust and comprehensive analytical approach for quality assessment of traditional Chinese medicine.

Multimodal integrated strategy for the discovery and identification of quality markers in traditional Chinese medicine

With the modernization and internationalization of traditional Chinese medicine(TCM),the requirement for quality control has increased.The quality marker(Q-marker)is an important standard in this field and has been implemented with remarkable success in recent years.However,the establishment of Qmarkers remains fragmented and the process lacks systematicity,resulting in inconsistent quality control and insufficient correlation with clinical efficacy and safety of TCM.This review introduces four multimodal integrated approaches that contribute to the discovery of more comprehensive and accurate Qmarkers,thus aiding in the establishment of new quality control patterns based on the characteristics and principles of TCM.These include the whole-process quality control strategy,chemical-activity-based screening method,efficacy,safety,and consistent combination strategy,and TCM theory-guided approach.Furthermore,methodologies and representative examples of these strategies are described,and important future directions and questions in this field are also proposed.

Protection and Quality Control of Wild Chinese Herbal Medicine Resources in Nature Reserves by Taking Longyuwan Scenic Spot Within Funiu Mountain Nature Reserve as an Example

This paper discussed how to protect and control the quality of wild Chinese herbal medicine resources in nature reserves by taking Longyuwan National Forest Park within Funiu Mountain Nature Reserve as an example. Through the combination of three methods including literature review, visiting and investigational studies, and field surveys, the data of investigation, collection and collation were analyzed. According to data of surveys, collection and collation, problems related to the protection of wild Chinese herbal medicine resources faced by Longyuwan Scenic Spot within Funiu Mountain Nature Reserve were also analyzed and protection strategies and quality control of wild Chinese herbal medicine resources in this nature reserve were discussed. It was expected that the results would provide important scientific references for the sustainable development, protection and quality control of wild Chinese herbal medicine resources within nature reserves.

Study on the Quality of Traditional Chinese Veterinary Medicine and Discussion on the Problems

In this paper,the study on the quality of traditional Chinese veterinary medicine and its existing problems are discussed,which mainly include the research techniques and research thoughts of traditional Chinese veterinary medicine,and the problems in its research progress,at the same time,the causes for the quality problems of traditional Chinese veterinary medicine are analyzed,and the solutions for the problems are put forward. The quality research of traditional Chinese veterinary medicine should refer to traditional Chinese medicine,then inherit,carry forward and innovate it based on the modern research. Solving the problems in the development of traditional Chinese veterinary medicine and putting forward the thinkings conforming to the development of traditional Chinese veterinary medicine using advanced instruments and devices as well as science and technology are urgent affairs.

Effects of Traditional Chinese Medicine Five-element Music Combined with Acupoint Application on Perioperative Sleep Quality in Patients Undergoing Joint Replacement Surgery

OBJECTIVE: To explore the effects of traditional Chinese medicine(TCM) five-element music combined with acupoint application on perioperative sleep quality in patients undergoing joint replacement surgery. METHODS: In this study, a total of 122 patients with joint replacement surgery in Beijing Jishuitan Hospital were targeted from 2015 to 2018. All patients were grouped by random number table method. Among them, 61 patients with routine nursing were included in the control group. On this basis, the other 61 patients with acupoint application and TCM five-element music therapy were included as the observation group. 2 weeks later, the Pittsburgh Sleep Quality Index(PSQI) was used to evaluate sleep quality in all patients. The sleep improvement of the 2 groups was evaluated, and the patient was assessed for anxiety and depression, and the curative efficacy was evaluated. RESULTS: After 2 weeks of nursing, the PSQI of the patients improved significantly. The PSQI of the observation group was only 6.6 ± 2.4, and the control group decreased to 9.9 ± 2.7. The observation group was better than the control group, and the difference was statistically significant(P < 0.05). Comparing the 2 groups, the anxiety score of the observation group decreased to 4.8 ± 1.6, which was significantly lower than that of 6.9 ± 2.2 in the control group. The depression score of the observation group decreased to 4.6 ± 1.3, which was significantly lower than that of 6.8 ± 2.3 in the control group. In the control group, the negative emotion scores after nursing were better than those before nursing, and the difference was statistically significant(P < 0.05). Comparing the 2 groups, the effective rate of sleep improvement in the observation group was 96.6%, and the cure rate was as high as 49.1%. The control group was 82.0%, and the cure rate was 18.0%. The observation group was better than the control group, and the difference was statistically significant(P < 0.05). CONCLUSION: The combination of TCM five-element music with acupoint application can improve the perioperative sleep quality of patients undergoing joint replacement surgery, and it can help patients to relieve negative emotions. It is worth promoting.

A clinical protocol: A double-blinded, randomized controlled trial on the effect of traditional Chinese medicine formula Shoutai Pill in the treatment of threatened abortion

for about 20%of all clinically confirmed pregnancy.It is the main cause of early abortion.Vaginal bleeding is the main clinical manifestation,which seriously affects the mental health and quality of life of pregnant women.Currently,there is effective treatment for this condition.A recent meta-analysis showed that Shoutai Pill(ST Pill),a traditional Chinese medicine(TCM)formula,can effectively decrease the rate of threatened abortion.However,high heterogeneity was found among the studies included in the meta-analysis,this conclusion on the efficacy of TCM is not definitive.Although several have been conducted,some of them do not describe randomization and blinding methods.To address these problems,this article proposes an improved clinical treatment scheme based on ST Pill,which is to be tested through a well-designed randomized controlled trial,for the treatment of threatened abortion.Methods:This is a double-blinded,randomized,placebo-controlled trial to be conducted in a public Three-A hospital in China's Mainland.A total of 200 people will be enrolled.Using computer-generated random numbers,the participants will be randomly divided into two groups at a ratio of 1:1(treatment group(treated with ST Pill group)and placebo group).Both groups will receive medication to the end of the 20th gestational week or 1 week after vaginal bleeding stops,depending on which is longer.Participants in the treatment group will be treated with ST Pill(20 pills/time,once a day),and those in the placebo group will receive a placebo drug which is similar in appearance and smell with ST Pill.The main observation index is the live birth rate.Discussion:Although the efficacy of ST Pill in threatened abortion is well-known,no study has tested its efficacy through a double-blinded,randomized trials.Therefore,there is an urgent need for a standardized randomized double-blinded controlled trial to evaluate the clinical efficacy of ST Pill.ST Pill is likely to be a convenient and effective TCM pill for the prevention of threatened abortion.

Discussion on the Quality Evaluation Method of Traditional Chinese Medicine Compound Preparations

As an important representative of the modernization of the Chinese medicine industry,traditional Chinese medicine(TCM)compound preparations are an indispensable part of the development of TCM.The complex ingredients and unclear action mechanism of TCM compound preparations restrict the development of TCM.In line with this problem,the modern TCM research has made extensive remarkable achievements.From the single indicator in the past to multiple indicator,the research on the combination of TCM fingerprints and pharmacodynamics also has made great progress.The introduction of quality evaluation methods such as the"quantitative analysis of multi-components by a single marker","dose-effect"indicator,"Bioactive Equivalent Combinatorial Components"(BECCs)and TCM quality markers have brought new ideas for quality control of TCM compound preparations.

Effect of traditional Chinese medicine on rheumatoid arthritis bone destruction:A systematic review and meta-analysis

Objective:To systematically evaluate the efficacy of Traditional Chinese medicine for improving bone damage in rheumatoid arthritis(RA),and provide guidance for clinical treatment.Methods:computer retrieval China hownet database(CNKI),Chinese biomedical literature retrieval(SinoMed),ten thousand Data knowledge service system(WanFang Data),VIP full-text database(VIP),PubMed,MedLine and the cochrane library,collect relevant Chinese medicine for the treatment of rheumatoid arthritis,bone destruction randomized controlled trial(RCT),screening from built by researchers at the two libraries to literature in February 2020,to extract the required indicators,and incorporated into RevMan 5.2 analysis.Results:a total of 1291 patients were included in 14 RCTS.The results of meta-analysis showed that compared with the control group,The traditional Chinese medicine treatment group could improve the 25-hydroxyvitamin D of patients with RA bone damage,which was better than the western medicine control group,and the difference was statistically significant.TCM treatment group can improve the balance between osteoblasts and osteoclasts(nuclear factor B receptor activating factor;Bone mineral density;Bone alkaline phosphatase;Bone protectin;(osteocalcin),and was superior to the western medicine control group,the difference was statistically significant;(3)traditional Chinese medicine treatment group can improve RA patients with bone destruction of the balance of osteoblast and osteoclast(Ⅰtype collagen amino terminal propeptide before;Carboxy-terminal peptide of collagen;The effect of nuclear factor B receptor activator factor and bone protectin was similar to that of the western medicine control group,and the difference was not statistically significant.Conclusion:At present,the existing evidence can prove that Traditional Chinese Medicine in the treatment of rheumatoid arthritis bone damage has an exact effect,regulate the function of osteoblasts and osteoclasts,improve the level of bone metabolism of patients,prevent the progress of bone damage.

Meta-analysis of randomized controlled trials of traditional Chinese medicine in the treatment of obstructive sleep apnea syndrome

Objective:Though Chinese medicine(CM)has showed its clinical efficacy for the treatment of obstructive sleep apnea(OSA)in China,no systematic reviews or meta-analyses provide evidences for its therapeutic effects on OSA and the long-term safety.The aim of the present study is to evaluate the effectiveness and safety of CM on OSA using meta-analysis.Methods:We used search items of"Chinese Medicine"AND"obstructive sleep apnea"to retrieve the randomized control trials(RCTs)of CM treatments for OSA in PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),VIP database,and Wanfang database from their respective inception dates to December 2019.Only RCTs of CM therapy versus no treatment which could be quantitatively synthesized were included.Finally,20 studies representing 1,297 participants were included after extraction.Two investigators independently extracted and analyzed the data using RevMan5.3 software.Results:The treatment group using CM decoctions or CM granules presented significantly ameliorative effects on apnoea-hypopnoea index(AHI)compared with the control group(MD:-2.58,95%CI:-3.59 to-1.56,P<0.00001 and MD:-5.47,95%CI:-6.75 to-4.19,P<0.00001,respectively)in the sensitivity analysis.However,there were non significant differences in the duration of treatment between subgroups,indicating that the duration of treatment has no impacts on the therapeutic effects on AHI.CM granules also showed significantly ameliorative effects on the lowest nocturnal oxygen saturation(LSaO2)(MD:2.76,95%CI:1.85 to 3.68,P<0.00001).CM decoctions exhibited significantly improved Epworth Sleepiness Scale(ESS)scores compared with the control group in a sensitivity analysis(MD:-1.50,95%CI:-2.13 to-0.88,P<0.00001).CM granules showed a better improvement of ESS than the control group(MD:-1.35,95%CI:-1.92 to-0.78,P<0.00001).Mild adverse reactions occurred only in five patients and disappeared without special treatment.Conclusion:This study showed favorable therapeutic efficacy of CM on OSA.However,in consideration of the low methodological quality of the included RCTs,more rigorous designed,large sample size RCTs are recommended for providing more high-quality evidences.