Comparative efficacy of traditional Chinese herbal injection for chronic renal failure: A systematic review and network meta-analysis of randomized controlled trialsOA

Objective: To conduct a systematic review and network meta-analysis(NMA) for the comparison of the efficacy and safety of Chinese herbal injection(CHI) combined with Western medicine(WM) and WM monotherapy for chronic renal failure(CRF).Methods: Eight databases were searched from inception to August 30, 2022. Randomized controlled trials(RCTs) regarding the comparison of CHI-WM combination therapy and WM monotherapy were included. Literature search, risk-of-bias assessment, and data extraction w...     

A Rapid and Effective HPLC Method for Identification of Bovis Calculus in Chinese Patent Medicines

Objective Due to the limited resource and the large demand,many kinds of Bovis Calculus(BC)including artificial Bovis Calculus(ABC),in vivo cultured Bovis Calculus(in vivo CBC),and in vitro cultured Bovis Calculus(in vitro CBC)were used in Chinese patent medicines(CPMs).Previous studies have shown that the chemical constituents of ABC and their properties were different from other BC.The two types of CBC with much higher price than ABC were approximately equivalent with natural Bovis Calculus in quality and clinical effect.The aim of the study is to establish a rapid and effective method for the identification of BC in CPMs.Methods An HPLC method with the higher specificity for analyzing bilirubin was established to distinguish ABC from other three kinds of BC by comparing the change of bilirubin content with the addition of EDTA-2Na as the extraction solvent and stabilizer.Results The bilirubin content in CPMs containing ABC was basically unchanged,while that in CPMs containing other kinds of BC showed significant difference.The proposed method was employed to analyze a variety of CPMs containing Bovis Calculus(CPMBCs)and proven to be universal.Conclusion An effective analytical method is established for the quality control of CPMBCs and further ensures the safety and efficacy of these drugs in clinical practice.     

Effectiveness and safety of Pingxiao capsule(平消胶囊)as adjuvant therapy in treatment of breast cancer:a systematic review and Meta-analysis

OBJECTIVE: To systematically review the effectiveness and safety of Pingxiao capsule( 平 消 胶 囊) adjuvant chemotherapy in the treatment of breast cancer. METHODS: A total of 8 databases including the Cochrane Library, PubMed, EMBASE, Engineering Index, Chinese Biomedical Literature Database, Wanfang database, China National Knowledge Infrastructure Database, and China Science and Technology Journal Database were searched for the Randomized Controlled Trials(RCTs) of Pingxiao capsule combined with ...     

Evidence base of randomized controlled trials and guideline recommendations of patent Traditional Chinese Medicines for uncomplicated acute lower respiratory tract infections in adults

OBJECTIVE:To compare clinical practice guideline recommendations on the use of oral patent Traditional Chinese Medicines(PTCMs) for uncomplicated acute lower respiratory tract infections(ALRTIs)in adults with the existing evidence using results of a systematic review of randomized controlled trials(RCTs).METHODS:A systematic review on RCTs and a systematic review of current guidelines on orally taken PTCMs for uncomplicated ALRTIs were performed.Pub Med,Cochrane Library,EMBASE and four Chinese databases were searched from inception to September 2016 for RCTs testing orally taken PTCMs for uncomplicated ALRTIs(excluding pneumonia).Two reviewers independently screened each study,extracted study data,and assessed risk of bias.Disagreements were resolved through discussion or by consultation with a third reviewer.Clinical practice guidelines for uncomplicated ALRTIs containing PTCM recommendations were identified and quality appraised.The quality of pooled evidence of the RCTs and the guidelines was assessed with GRADE and AGREE Ⅱ respectively.The consistency of the evidence base in RCTs and the guideline recommendations were then compared.RESULTS:For the systematic review of RCTs,4810 papers were identified,among which 29 RCTs(5093 patients) were included in the review.PTCMs compared to placebo increased the effective treatment rate of cough(3 trials,949 patients,risk ratio(RR) 2.50,1.16 to 5.43;low certainty);improved assessment of global health(3 trials,948 patients,RR1.70,1.44 to 2.01;low certainty);and increased the effective rate of specific symptom relief(1 trial,478 patients,RR 4.01,2.76 to 5.81;moderate certainty).21 trials(3432 patients) compared effects of different PTCMs.For the guideline evaluation,29 PTCMs were recommended for the use of uncomplicated ALRTIs,of which27 had no supportive evidence from RCTs.CONCLUSION:The evidence base of PTCMs for uncomplicated ALRTIs is weak and the guideline recommendations were based on almost no clinical trial evidence.Rigorous clinical research is urgently needed to inform the clinical use of these herbal medicines.Further training in evidence-based medicine methods for Traditional Chinese Medicine guideline developers is essential.     

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

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 w...     

Randomized Clinical Trials of Traditional Chinese Medicines for Treating Ulcerative Colitis: A Scoping Review

Objective: Traditional Chinese medicines (TCMs) are efficacious against ulcerative colitis (UC). In recent years, the number of randomized clinical trials (RCTs) of TCM has increased. Thus, it is very important to summarize the basic characteristics, quality, and types of TCM interventions in published RCTs. This scoping review was performed to systematically identify and describe the current situations about RCTs of TCMs for treating UC. Hope to express the focus and specifics of nowadays research in TCM interventions in RCTs and evaluate their common disadvantages exposed to help advance in TCM researching. Materials and Methods: Ascoping review was conducted according to the PRISMA extension for scoping reviews. We searched two English databases and four Chinese databases from the date of establishment of each database to January 2020. Data from RCTs focusing on any TCM treatment for patients with UC were extracted and evaluated. Selection and characterization were performed by two independent reviewers using predefined forms. All discrepancies were resolved by consensus discussion with a third reviewer. Microsoft Excel 2010 was used to extract the following data from the included studies: (1) basic information of the included studies including research ID, article title, publication language, journal, year of publication, and funding information; (2) patient information including gender, age, disease course, disease stage, severity, sample size; and (3) information on intervention measures, types of intervention measures, drug dosage forms, and treatment courses. Results: The search identified 2225 RCTs published between 1987 and 2020. These studies covered 36 provinces in China. The time frame of the RCTs was <28 days in approximately one-third of the RCTs (647, 29.08%). Only one RCT was published in English. Nearly three-quarters of RCTs (1665, 74.83%) did not report the severity of the disease. Three types of interventions were included in the RCTs: pharmacotherapy (2028, 91.15%), nonpharmacotherapy (57, 2.56%), and a combination of the two (140, 6.29%). The administration modes of the intervention groups were evaluated. Drug therapy involved 12 types of TCM dosage forms, which were decoctions, troches, powders, capsules, granules, pills, suppositories, ointments, injections, gels, oral liquids, and substitute tea according to the frequency of use. Nondrug intervention measures involved 10 treatment options, namely, acupuncture, moxibustion, hemospasia, auricular point, acupoint catgut embedding, acupoint injection, scrapping, tuina, acupoint application, and five?tone therapy according to the frequency of use. Most studies included in this review were low in quality. This underscores the need for improvement in the quality of trial methodology in TCM RCTs.     

Blinding Effect of Non-penetrating Sham Needle in the Randomized Controlled Trials of Acupuncture: A Systematic Review简

The aim of this article was to assess the clinical evidence for or against the blinding effect of non-penetrating sham needle as placebo needle. This systematic review included randomized controlled trials（RCTs） of acupuncture taking non-penetrating sham acupuncture as placebo needle. Systematic searches were conducted in 13 electronic databases up to July 2012： Medline, PubMed, the Cochrane Library, CINAHL, EMBASE, a Chinese medical database. All parallel or cross-over RCTs of acupuncture for the blinding effect of non-penetrating needle were chosen without language restrictions. Finally, totally 7 RCTs met the inclusion criteria. In conclusion, our systematic review and meta-analysis demonstrate that the non-penetrating needle is an effective instrument for placebo control in the acupuncture RCTs.     

Efficacy and safety of Buyang Huanwu decoction(补阳还五汤)for diabetic peripheral neuropathy:a systematic review and Meta-analysis

OBJECTIVE: To evaluate the efficacy and safety of Buyang Huanwu decoction(BYHWD) in treating diabetic peripheral neuropathy(DPN). METHODS: Eight electronic databases, including China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, Chinese Biomedical Literature Database, Cochrane Library, Embase, Web of Science, and PubM ed, were searched for randomized controlled trials(RCTs) of BYHWD to treat DPN. We identified all RCTs related to BYH...     

Acupuncture and moxibustion for malignant tumor patients with psychological symptoms of insomnia,anxiety and depression: a systematic review and Meta-analysis

OBJECTIVE: To evaluate the efficacy and safety of acupuncture and moxibustion therapy(AMT) for cancerrelated psychological symptoms(CRPS) of insomnia, depression and anxiety. METHODS: Seven databases were searched for randomized controlled trials(RCT) comparing AMT to routine care or conventional drug for alleviating CRPS of insomnia, depression, and anxiety before April 2020. Two independent reviewers performed the data extraction and assessed the risk of bias. RESULTS: A total of 30 RCTs invol...     

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

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 interv...     

Systematic Review and Meta-Analysis of Hugan Tablets(护肝片)in the Treatment of Drug-Induced Liver Injury

Objective:To systematically evaluate the efficacy and safety of Hugan Tablets(护肝片)in the treatment of drug-induced liver injury.Methods:Totally seven Chinese and English databases,including CNKI,Wanfang,VIP,CBM,PubMed,EMbase,Web of Science were searched for randomized controlled trials(RCTs)of Hugan Tablets(护肝片)for the treatment of drug-induced liver injury,which were published from the date of establishment to April 20,2019.The meta-analysis software RevMan 5.3 software and Excel were used to build a database into combine and analyze the studies that met the standards and to draw a forest plot.Results:Forty five RCTs were included with 7478 patients.The quality of included studies was uneven.Meta-analysis showed that the outcome index of liver injury rate was divided into seven subgroups.Hugan Tablets(护肝片)were used in the treatment of anti-tuberculosis drugs was superior to the conventional western medicine treatment group(RR=0.27,95%CI[0.22,0.33],P<0.00001).Which was also better than the without Hugan Tablets(护肝片)treatment group(RR=0.32,95%CI[0.20,0.52],P<0.00001).For the role of drug-induced liver injury in the treatment of type 2 diabetes,the Hugan Tablet+conventional treatment group is better than the conventional treatment group(RR=0.16,95%CI[0.03,0.88],P=0.03).The effect of drug-induced liver injury in the treatment of hypertension was superior to the conventional western medicine treatment group(RR=0.07,95%CI[0.03,0.14],P<0.00001).The effect of drug-induced liver injury during the treatment of hyperlipidemia was not statistically significant(RR=0.57,95%CI[0.33,1.00],P=0.05).There was no statistical difference between the two groups in the effect of drug-induced liver injury during the treatment of coronary heart disease(RR=0.09,95%CI[0.01,1.61],P=0.10).There was no significant difference between the two groups in the treatment of cerebral thrombosis for drug-induced liver injury(RR=0.11,95%CI[0.01,2.01],P=0.14).The effect of anti-hyperthyroidism on liver injury was better than that of conventional western medicine treatment group(RR=0.45,95%CI[0.25,0.82],P=0.009).Outcome index of total effective rate was divided into two subgroups.The effect of drug-induced liver injury caused by the type of drug was not mentioned was superior to the conventional western medicine treatment group(RR=0.78,95%CI[0.70,0.88],P<0.0001).There was no significant difference between the two groups in the liver injury caused by antipsychotic drugs(RR=0.97,95%CI[0.81,1.16],P=0.72).Conclusion:When used in the treatment of tuberculosis and psychiatric drug treatment,combineduse of Hugan Tablets(护肝片)can significantly reduce the incidence of drug-induced liver damage,and can significantly improve clinical symptoms caused by liver damage.In the treatment of hypertension,the addition of Hugan Tablets(护肝片)can significantly reduce the incidence of drug-induced liver injury,improving the safety of medication.In the treatment of drug-induced liver injury caused by which drug is not mentioned,Hugan Tablet has a therapeutic effect.Slight adverse reactions were reported,including rash,headache,palpitations,hypoglycemia,flushing,fatigue,nausea,bowel sounds,flatulence,diarrhea,and gastrointestinal discomfort.All studies reported minor adverse reactions that were well tolerated by patients and recovered without treatment after discontinuation.Oral administration of Hugan Tablets(护肝片)has positive effects on druginduced liver injury,but this conclusion still needs further evidences delete.It is necessary to adopt a larger sample,more design,and accord with the international standards to improve the quality of evidence.     

An Integrated Study for the Utilization of Anthraquinone Compounds Extract “Heshouwu” In vivo and their Comparative Metabolism in Liver Microsomes Using UPLC‑ESI‑Q‑TOF/MSn

Objective: Anthraquinone(AQ), a major bioactive component of the traditional Chinese medicine He ShouW u, has widespread applications in industry and medicine. The objective of the current study is to explore the differences in the bioavailability of anthraquinones in vivo and the metabolism in liver microsomes. Materials and Methods: In vivo, we used a reliable UPLC?ESI?Qq Q?MS/MS method to measure seven AQ compounds in the jugular vein plasma of rats following oral administration of He Shou Wu. Furthermore, in order to quantify the bioavailability of AQs in vivo and to further understand the metabolism of these compounds, we compared the in vitro metabolism of AQ in different species with respect to metabolic profiles, the enzymes involved, and catalytic efficiency using liver microsomes from human(HLM), mouse(MLM), rat(RLM), and beagle dog(DLM). Results: We identified two metabolic pathways, including the hydroxylation and glucuronidation of AQ, in the liver microsomes of humans and other species using UPLC?ESI?Q?TOF. We found that substitutions on the AQ ring were crucial to the activity and regioselectivity of its hydroxylation. In general, hydroxylation activity decreased greatly with β?COOH(rhein) and enhanced dramatically with β?OH(emodin). We also found that glucuronidation of the compound emodin?8?O?β?D?glucoside acts as the main isoform in AQ hydroxylation in HLM and DLM. Total microsomal intrinsic clearance values for AQ were greatest in mouse microsomes, followed by those in dog, human, and rat microsomes. Conclusion: The absorption of different anthrquinone compounds varied based on the compound structure, the metabolism types and products of anthraquinones in liver microsomes were different in different species. These findings provide vital information for a deeper unuunderstanding of the metabolism of AQs.     

Effects of Lycium barbarum polysaccharides on the proliferation and differentiation of primary Sertoli cells in young ratsOA

Objective: Sertoli cells(SCs) provide physical support and material supply for germ cells and participate in the formation of blood-testis barrier. The number of SCs is directly proportional to the number of germ cells. And mature SCs ensure the growth of germ cells and the production of sperm. In this study, we explored the effect and underlying mechanism of Lycium barbarum polysaccharides(LBP) on primary SCs in young rats.Methods: Primary SCs were isolated from the testis of 20-day old rats. T...     

Effectiveness of Huachansu injection combined with chemotherapy for treatment of gastric cancer in China: a systematic review and Meta-analysis

OBJECTIVE: to evaluate the effectiveness and safety of Huachansu(HCS) injection plus chemotherapy in the treatment of gastric cancer.METHODS: A thorough and systematic retrieval of randomized controlled trials(RCTs) concerning HCS injection for treating gastric cancer was conducted in several electronic databases from inception to May 10, 2018. The quality of the RCTs was assessed by the Cochrane risk of bias tool. And the data about objective remission rate, performance status, adverse drug rea...     

Meta Analysis of Lentinan Injection plus Cisplatin in Treatment of Malignant Pleural Effusion

Objective To evaluate the efficacy and safety of lentinan injection plus cisplatin(LIC) in the treatment of malignant pleural effusion(MPE).Methods We searched the database of Cochrane Library,PubMed,EMBASE, ISI Web of Knowledge,Chinese Biomedical Literature Database,Chinese Scientific Journals Full-text Database, Chinese Journal Full-text,and Google Scholar,etc.,up to February 28th,2011 to identify randomized controlled trials(RCTs) about lentinan injection(LI) for MPE,evaluate the quality of the included studies,and analyze the data by Cochrane Collaboration’s RevMan5.0 software.Results Twenty-nine RCTs involving 1831 patients were included.Meta analysis results suggested that there were some differences when comparing LIC with control groups suffering from MPE,for LIC could improve the near-term curative effect and the quality of life to some extent. Besides,compared with chemotherapy alone,LI plus chemotherapy had an advantage in relieving adverse reactions, such as gastrointestinal reactions,myelosuppression,chest pain,and general malaise.Conclusion The current evidence indicates that LI may have adjuvant therapeutic effects for MPE.     

Effectiveness and safety of heat-sensitive moxibustion on bronchial asthma：a Meta-analysis of randomized control trials

OBJECTIVE： To systematically evaluate the effectiveness and safety of heat-sensitive moxibustion（HSM）onasthma.METHODS： Large databases in China and overseas were searched by electronic and manual means to collect information on randomized controlled trials（RCTs）.Two evaluators independently extracted data and evaluated the quality of RCTs according to Cochrane Review Handbook v5.0. RevMan v5.0.20 was used for statisticalanalyses.RESULTS： Fourteen RCTs involving 637 patients were collected.Thirteen RCTs compared the effects of HSM and Western Medicine. After 3-month treatment and after 6-month follow-up, there was no significant difference in effective rate [relative risk（RR）=1.01, 95% CI（0.92, 1.12）, and 1.12,（0.93, 1.36）,respectively], in the asthma control test score of asthma symptoms [weighted mean difference（WMD）=﹣1.54, 95% CI（﹣3.54, 0.47）, and 1.41,（﹣0.48, 3.29）, respectively] and in the forced expiratory volumein 1 second（FEV1）and peak expiratory flow（PEF）. One RCT compared the effect of HSM with warm-suspended moxibustion. After 6-month follow-up, there was a significant difference in FEV1 and PEF [WMD=0.51, 95% CI（0.10, 0.92）, and 1.78,（1.06, 2.50）, respectively]. After 3-month treatment,there was no significant difference between the two groups. One RCT compared the effect of HSM with acupoint application. After 3-month treatment, there was no significant difference in the effectiverate[RR=0.68,95%CI（0.42,1.12）].CONCLUSION： HSM did not show superiority to conventional Western Medicine and acupoint application in terms of curative effects, and may be superior to warm-suspended moxibustion with regard to long-term curative effects. Because of low quality of the included RCTs, this conclusion must be bolstered with higher-quality RCTs.     

Pharmacodynamic advantages and characteristics of traditional Chinese medicine in prevention and treatment of ischemic strokeOA

Ischemic stroke(IS) is a severe cerebrovascular disease with a high incidence, mortality, and disability rate. The first-line treatment for IS is the use of recombinant tissue plasminogen activator(r-t PA).Regrettably, numerous patients encounter delays in treatment due to the narrow therapeutic window and the associated risk of hemorrhage. Traditional Chinese medicine(TCM) has exhibited distinct advantages in preventing and treating IS. TCM enhances cerebral microcirculation, alleviates neurolo...     

Comparative study on brain pharmacokinetics of Buyang Huanwu Decoction in normal and cerebral ischemia rats using brain microdialysis combined with LC-MS/MS

Objective: To conduct a comparative study on the brain pharmacokinetics of seven ingredients (i. e. senkyunolide A, ferulic acid, formononetin, calycosin, ononin, calycosin-O-β-D-glucopyranoside, and paeoniflorin), which were the compounds of Buyang Huanwu Decoction (BHD), in normal and cerebral ischemia rats administrated intragastrically with BHD. Methods: The samples of normal and permanent middle cerebral artery occlusion (pMCAO) rats were collected by using brain microdialysis technique. The concentrations of seven ingredients were determined by the HPLC-MS/MS method. After the BHD were administrated intragastrically to the rats for seven consecutive days, brain microdialysis probes were inserted into the hippocampus of rats, and then the brain microdialysates were collected at 20 min time intervals for 5 h. The separation of the seven ingredients and internal standard (IS) was carried out on an ACQUITY UPLC BEH C18 (2.1 mm × 100 mm, 1.7 μm) chromatographic column, using a mobile phase consisting of acetonitrile (containing 0.1% formic acid) and water (containing 0.1% formic acid) for gradient elution within 13 min. The ionization was conducted using an ESI source in positive ion mode. Multiple reaction monitoring mode was used for quantification of ingredients in BHD. Results: Linearity, accuracy, precision, matrix effect and stability of LC-MS/MS method were all satisfactory, successfully applied to compare the pharmacokinetics of the analytes between normal and model rats after intragastric administration of BHD. Compared with the normal group, the model group after the administration of the BHD showed that T1/2 of formononetin and ononin were longer, and except for calycosin-O-β-D-glucopyranoside (P < 0.01), there was no significant difference between the normal group and the model group. The Cmax of senkyunolide A and calycosin of model group were increased, while the Tmax of senkyunolide A was decreased, and except for the Tmax of PF, the differences between the two groups were statistically significant (P < 0.01). Conclusion: The LC-MS/MS method combined with microdialysis was successfully applied to the comparative study of brain pharmacokinetics of seven ingredients in BHD. After intragastric administration of BHD, there were differences in the pharmacokinetics of seven ingredients in the brain hippocampus between normal rats and model rats, probably related to the characteristics of the ingredients and the effects of cerebral ischemia on the absorption and distribution of the ingredients.     

Chinese yam yield is affected by soil nutrient levels and interactions among N,P, and K fertilizersOA

Objective: The current fertilization methods for Chinese yam are uneconomic and unfriend to environment. A rational one is very important to achieve desired balance of high yield of Chinese yam, economic and friend to environment. Here, we studied the effects of nitrogen(N), phosphorus(P), and potassium(K) fertilizers on the yield of ’Qinfeng’ Chinese yam in shallow-groove directional cultivation.Methods: The experiments were conducted in Dehua County, Fujian Province, China using a "3414" optim...