Meta-analysis of clinical efficacy and safety of kidney Tonifying therapy in the treatment of interstitial lung disease

Objective:To evaluate the efficacy and safety of kidney tonifying therapy in the treatment of Interstitial Lung Disease(ILD).Methods:We searched Wanfang Data,CNKI,CBM,VIP,Pub Med,EMBASE,Web of science and Cochrane Library for Randomized Controlled Trials(RCTs)of kidney tonifying therapy in the treatment of ILD.The retrieval time was from the establishment of the database to December 15,2020.Rev man 5.3 software was used to analyze and summarize the collected literature,and the methodological quality of the included studies was evaluated by the bias risk assessment scale of Cochrane Collaboration Network.Results:A total of 15 articles with 1045 patients were included.The results of meta-analysis showed that compared with the control group treated with conventional western medicine alone,kidney tonifying therapy or combined with conventional western medicine was beneficial to improve the clinical total effective rate[RR=1.33(95%CI 1.24-1.43),P<0.00001].At the same time,compared with the control group treated with routine western medicine,kidney tonifying therapy or combined with routine western medicine can improve cough and wheezing symptoms of patients[MD=-0.62(95%CI-0.78~-0.46),P<0.00001]and MD=-0.79(95%CI-0.18~-0.49),P<0.00001].However,there was no significant improvement in 6-minute walk test and lung function(DLCO%)(P>0.05);only one study reported 7 patients with adverse reactions,but after corresponding treatment,the symptoms were significantly relieved.The analysis of the characteristics of intervention measures in the treatment group showed that there were a total of 80 traditional Chinese medicines involved,of which Shu Dihuang appeared the most frequently,and the tonic drugs were used the most.The two meridians of the lung and kidney appear most frequently.Among the four qi and five flavors,warm and sweet medicines have the highest frequency.Conclusion:Adopting kidney-tonifying method or combined with conventional Western medicine treatment can improve the total clinical effectiveness of patients.Adopting kidney-tonifying method or combined with conventional Western medicine treatment to improve symptoms such as coughing and wheezing.No serious adverse reactions have been reported,and the safety is reliable.Due to the low quality of the included literature,the results of this study need to be verified by high-quality,large sample randomized controlled trials.

Clinical evidence of three traditional Chinese medicine drugs and three herbal formulas for COVID-19:A systematic review and meta-analysis of the Chinese population

Background The coronavirus disease 2019(COVID-19)continues to spread worldwide.Integrated Chinese and Western medicine have had some successes in treating COVID-19.Objective This study aims to evaluate the efficacy and safety of three traditional Chinese medicine drugs and three herbal formulas(3-drugs-3-formulas)in patients with COVID-19.Search strategy Relevant studies were identified from 12 electronic databases searched from their establishment to April 7,2022.Inclusion criteria Randomized controlled trials(RCTs),non-RCTs and cohort studies that evaluated the effects of 3-drugs-3-formulas for COVID-19.The treatment group was treated with one of the 3-drugs-3-formulas plus conventional treatment.The control group was treated with conventional treatment.Data extraction and analysis Two evaluators screened and selected literature independently,then extracted basic information and assessed risk of bias.The treatment outcome measures were duration of main symptoms,hospitalization time,aggravation rate and mortality.RevMan 5.4 was used to analyze the pooled results reported as mean difference(MD)with 95%confidence interval(CI)for continuous data and risk ratio(RR)with 95%CI for dichotomous data.Results Forty-one studies with a total of 13,260 participants were identified.Our analysis suggests that compared with conventional treatment,the combination of 3-drugs-3-formulas might shorten duration of fever(MD=–1.39;95%CI:–2.19 to–0.59;P<0.05),cough(MD=–1.57;95%CI:–2.16 to–0.98;P<0.05)and fatigue(MD=–1.36;95%CI:–2.21 to–0.51;P<0.05),decrease length of hospital stay(MD=–2.62;95%CI–3.52 to–1.72;P<0.05),the time for nucleic acid conversion(MD=–2.92;95%CI:–4.26 to–1.59;P<0.05),aggravation rate(RR=0.49;95%CI:0.38 to 0.64;P<0.05)and mortality(RR=0.34;95%CI:0.19 to 0.62;P<0.05),and increase the recovery rate of chest computerized tomography manifestations(RR=1.22;95%CI:1.14 to 1.3;P<0.05)and total effectiveness(RR=1.24;95%CI:1.09 to 1.42;P<0.05).Conclusion The 3-drugs-3-formulas can play an active role in treating all stages of COVID-19.No severe adverse events related to 3-drugs-3-formulas were observed.Hence,3-drugs-3-formulas combined with conventional therapies have effective therapeutic value for COVID-19 patients.Further long-term high-quality studies are essential to demonstrate the clinical benefits of each formula.

Optimal scheme of Shengmai Injection in the treatment of angina pectoris of coronary heart disease based on Louvain algorithm: A real world study

Objective:To explore the optimal scheme of Shengmai Injection combined with other drugs for clinical doctors.Methods:Based on the large-scale data warehouse established by the institute of Clinical Basic Medicine,Chinese Academy of Traditional Chinese Medicine,the hospital information system of 22 large-scale tertiary hospitals in China was collected and 1751 patients with angina pectoris who were treated with Shengmai Injection were selected.Louvain algorithm and complex network analysis are used to build the model to summarize the rule of Shengmai Injection in the treatment of angina pectoris of coronary heart disease.Results:On the basis of Shengmai Injection,according to the symptom treatment of angina pectoris of coronary heart disease,nitrates or Suxiao Jiuxin Pill was used to dilate coronary artery;for the treatment of risk factors of angina pectoris,a combination of"insulin+acarbose+bisoprolol+nifedipine+captopril+estazolam"was used to control blood glucose and blood pressure;"Ganmao Qingre Granule+levofloxacin"to treat upper respiratory tract infection and other medication regimens were used as well.For the complications of angina pectoris of coronary heart disease,"furosemide+spironolactone+potassium chloride+magnesium sulfate"was used to reduce edema and“isosorbide nitrate+metoprolol+Shenmai injection+Wenxin Granule"was used to improve symptom of heart failure of qi and yin deficiency type.Conclusion:The therapeutic regimen of Shengmai Injection combined with traditional chinese medicine and western medicine is basically consistent with the current guidelines,but more clinical studies are still needed to explore more effective combination therapy.

Random Forest Analysis the Influencing Factors on Adverse Drug Reactions of Qingkailing Injection

Objective:To investigate the influencing factors of adverse drug reaction(ADR)in Qingkailing injection.Methods:Based on the hospitals centralized monitoring data of multicenter and prospective,the patients who used Qingkailing injection from January 2013 to March 2016 were monitored in 48 medical institutions in China.The nesting case-control study was used and the random forest was used for analysis.The main contents of the analysis are as follows:past history,past allergy history and ADR history,clinical diagnosis,dosage,interval drug,solvent type,combined drug use,etc.Results:A total of 30842 cases with Qingkailing injection were included,with 92 cases of adverse reactions and the incidence of adverse reactions was 3‰.According to the nested case-control study design,the influencing factors of 92 patients with ADR and 276 non-drug-related adverse reactions were displayed on the basis of statistical description(significance level P≤0.2 and clinical information)using Random forest analysis shows that the factors affecting the ADR of the Qingkailing injection according to the MeandecaseGini are from high to low in the first 15 positions:Vitamin supplements,tumors,gastrointestinal diseases,traditional Chinese medicine,previous allergic history,cerebral insufficiency,rash,urinary tract infection,vascular and lymphovascular diseases,pioglitazone,metabolic and endocrine system drugs,past ADR history,respiratory and mediastinal diseases,dioxpromazide,pneumonia.Conclusion:The incidence of adverse reactions in Qingkailing injection hospital is 3%.The factors closely related to the occurrence of ADR are previous tumors,gastrointestinal diseases,history of adverse reactions of rash,urinary tract infection,insufficient cerebral blood supply,respiratory system and other diseases,pioglitazone and other combined drugs.

Evidence and thinking on risk factors of hypertensive intracerebral hemorrhage: a meta-analysis

Background:To explore the related risk factors of hypertensive intracerebral hemorrhage(ICH)through meta-analysis,and to provide evidence-based medical basis for preventing ICH in hypertensive patients.Methods:The databases of CNKI,Wanfang,VIP,CBM,PubMed,Web of Science and Cochrane Library were searched by computer.Case control study on risk factors for hypertensive intracerebral hemorrhage were collected from the database establishment to October 2021.Two reviewers independently screened the literature,extracted the data,and evaluated the bias risk of the included studies.Meta-analysis was conducted on the results of the included studies using RevMan5.3 software.Results:A total of 7 studies were included,including 1512 patients.Meta-analysis results showed that:Smoking history(OR=6.23,95%CI(4.32,8.99),P<0.00001),drinking history(OR=7.24,95%CI(1.96,26.72),P=0.003),diabetes mellitus(OR=47.52,95%CI(10.31,219.31),P<0.00001),coronary heart disease(OR=9.90,95%CI(2.96,33.13),P=0.0002),daily salt intake(OR=10.21,95%CI(2.69,38.79),P=0.0006),failure to take medication regularly on time(OR=10.62,95%CI(5.40,20.91),P<0.00001),total cholesterol(OR=6.58,95%CI(2.45,17.65),P=0.0002),triglyceride(OR=8.63,95%CI(6.70,11.12),P<0.00001),body mass index(OR=6.63,95%CI(4.56,9.64),P<0.00001)and experiencing severe economic difficulties(OR=23.97,95%CI(14.82,38.77),P<0.00001)were risk factors for hypertensive intracerebral hemorrhage.Conclusion:Controlling smoking,drinking,reducing daily salt intake,controlling body weight,preventing diabetes and coronary heart disease,low-fat diet,controlling total cholesterol and triglyceride,taking antihypertensive drugs regularly and improving economic status can prevent hypertensive cerebral hemorrhage.

Research status of persistent vegetative state in recent 20 years:A bibliometric analysis

We searched PVS-related literature in the Web of Science Core Collection database,extracted and analyzed the data using the Science Citation Index Extended Edition,and included two types of literature:review and monograph.The search terms were subject=persistent vegetative state and publication year(2001-2021)and language=English.Statistical analysis of literature overview,countries and regions,institutions,authors,literature source publications,literature research direction,citation frequency,impact factor,H-index and keywords,etc.are carried out.Use VOS viewer 1.6.17 software to visually cluster the keywords in the titles and abstracts of the included literature and analyze the research direction and development trend.A total of 772 PVS-related documents published in the core collection database of Web of Science from 2001 to 2021 were included.The country with the largest number of publications was the United States(261 papers,33.80%),and the institution with the largest number of publications was the University of Liège,Belgium(40 papers,5.18%).The author with the largest number of published papers is Laureys S of the University of Liège,Belgium(39 papers,5.05%).The research directions of PVS are mainly neuroscience(350 articles,45.33%),rehabilitation(98 articles,12.69%),and internal medicine(9 articles,11.79%).The literature is mainly from Brain Injury.The annual average impact factor of the top 10 journals in 2020 was 4.55,and their publication volume accounted for 17.35%(134/772)of the total literature.The 772 articles were cited 23,503 times(21,400 self-citations were excluded),with an average of 30.44 citations per article.The H-index of the United States,the United Kingdom and Belgium are 48,27 and 27,which are significantly higher than other countries,and the citation frequencies are 8609,3451 and 3270,accounting for 36.60%,14.68%and 13.90%of the total citations,respectively.China's publication volume is in the middle,but only 8th in citation frequency and H-index(818 citations,H-index 16).We used the VOS viewer software to analyze and found that the keywords were mainly concentrated in four groups:"diagnosis-related","treatment-related","prognosis-related"and"disease-related".From 2001 to 2021,the United States,Italy and the United Kingdom have the largest number of PVS related literature publications.There is still a certain gap between China and western countries in terms of the number and quality of literature publications.

Pancreas-sparing duodenectomy with regional lymph node dissection for early-stage ampullary carcinoma: A case control study using propensity scoring methods

AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.

Effects of Mahuang(Herba Ephedra Sinica) and Wuweizi(Fructus Schisandrae Chinensis) medicated serum on chemotactic migration of alveolar macrophages and inters regions macrophages in rats

OBJECTIVE: To observe the effects of serum containing Mahuang(Herba Ephedra Sinica) or Wuweizi(Fructus Schisandrae Chinensis) on the migration of alveolar macrophages(AM) and interstitial macrophages(IM) from normal rats, and to analyze and compare the mechanisms leading to cell migration differences.METHODS: Rats were randomly divided into three groups: Mahuang(Herba Ephedra Sinica), Wuweizi(Fructus Schisandrae Chinensis), and blank serum. After treatment with the herbs, serum was extracted from the rats. AM and IM were isolated from normal rats and cultured. The effects of Mahuang(Herba Ephedra Sinica) and Wuweizi(Fructus Schisandrae Chinensis) medicated serum on normal rat AM and IM chemotactic migration were determined by transwell assays. The CC chemokine receptor(CCR) 2, CCR5, voltage-gated Kvl. 3 K^+channel(Kv1. 3), and voltage-gated Kvl. 5 K^+channel(Kv1. 5) protein levels were analyzed by western blotting.RESULTS: The migration quantities of AM and IM in the Mahuang(Herba Ephedra Sinica) and Wuweizi(Fructus Schisandrae Chinensis) medicated serum groups were significantly higher than those in the blank serum group(P < 0.01). Compared with the Wuweizi(Fructus Schisandrae Chinensis) medicated serum group, the migration quantity of cultured rat AM in the Mahuang(Herba Ephedra Sinica) medicated serum group was significantly increased(P <0.01). Meanwhile, compared with the Mahuang(Herba Ephedra Sinica) medicated serum group, the migration quantity of cultured rat IM in the Wuweizi(Fructus Schisandrae Chinensis) medicated serum group was significantly increased(P < 0.01).CCR2, CCR5, Kv1. 3, and Kv1. 5 proteins were expressed on the AM cell surface, and showed significantly higher expression in the Mahuang(Herba Ephedra Sinica) medicated serum group compared with the Wuweizi(Fructus Schisandrae Chinensis)medicated serum group. In contrast, CCR5, Kv1.3,and Kv1.5 proteins were expressed on the IM cell surface, and showed significantly higher expression in the Wuweizi(Fructus Schisandrae Chinensis)medicated serum group compared with the Mahuang(Herba Ephedra Sinica) medicated serum group.CONCLUSION: Mahuang(Herba Ephedra Sinica)and Wuweizi(Fructus Schisandrae Chinensis) can promote AM and IM migration ability, with Mahuang(Herba Ephedra Sinica) targeting AM more apparently and Wuweizi(Fructus Schisandrae Chinensis) targeting IM more apparently. The mechanism may be that, by stimulating cells, Mahuang(Herba Ephedra Sinica) and Wuweizi(Fructus Schisandrae Chinensis) promote expression of CCR2 and CCR5 receptors on the AM and IM cell surface,which pass signals to Kvl.3 and Kvl.5 ion channels,leading to changes in the cytoskeleton, and ultimately promoting chemotactic cell migration.

Effect of GAPT Extract on Expression of Tau Protein and Its Phosphorylation Related Enzymes in Hippocampal Neurons of APPV717I Transgenic Mice

Objective：To investigate the effect of GAPT,an extract mixture from Radix Ginseng,Rhizoma Acor tatarinowii,Radix Polygalae and Radix Curcuma（containing ingredient of turmeric）,etc.on expression of tau protein and its phosphorylation related enzyme in hippocampal neurons of APPV717I transgenic mice.Methods：Sixty three-month-old APPV717I transgenic mice were randomly divided into model group,donepezil group[0.92 mg/（kg·d）],the low,medium and high dosage of GAPT groups[0.075,0.15,0.30 g/（kg·d）,12 in each group],and 12 three-month-old C57BL/6J mice were set as a normal control group,treatments were administered orally once a day respectively,and both the normal group and model group were given 0.5%sodium carboxymethyl cellulose solution.Immunohistochemistry（IHC）and Western blot analysis were used to detect the expression of total tau protein（Tau-5）,cyclin-dependent kinase 5（CDK5）and protein phosphatase 2A（PP2A）in hippocampal neurons of experimental mice after 8-month drug administration（11 months old）.Results：In the model group,the expression of Tau-5 and CDK5 were increased,whereas the expression of PP2A was decreased in hippocampal neurons,which were significantly different compared with that in the normal group（all P〈0.01）.IHC test indicated the number and area of either Tau-5 or CDK5 positive cells were decreased with a dose-depended way in GAPT groups,and an increase of PP2A.Compared with the model group,the changes were significant in GAPT groups（P〈0.05 or P〈0.01）.Similar results were shown by Western blot.Conclusion：GAPT could attenuate abnormal hyperphosphorylation of tau protein in hippocampal neurons of APPV717I transgenic mice via inhibiting the expression of CDK5 and activating the expression of PP2A.