Which of the acupuncture treatment regimen for lumbar disc herniation is more effective and safer: A protocol for systematic review and network meta-analysis

Introduction:Lumbar disc herniation (LDH) is the most common cause of low back pain and severely affects people''s quality of life and ability to work. Although many clinical trials and medical reports conducted over the years have shown that acupuncture treatments are effective for LDH, the comparative effectiveness of these different acupuncture therapies is still unclear. This protocol of a network meta-analysis was designed to compare the effects and safety of acupuncture treatment regimens on LDH using both direct and indirect evidence.Methods and analysis:This protocol is reported according to the 2015 PRISMA-P and PRISMA guidelines for acupuncture. Eight databases and two platforms will be searched for articles published from their establishment to 1 December 2020 with medical subject heading terms and keywords. Three reviewers will verify the eligible randomized controlled trials independently. NoteExpress (3.2.0) software will be utilized to manage the literature. The overall quality of evidence will be evaluated by Confidence In Network Meta-Analysis (CINeMA). Additionally, we will conduct a meta-analysis of the effectiveness, recurrence rate, and symptom score of acupuncture in treating LDH using Review Manager (RevManV.5.4.1) and R4.0.2 software (The R Foundation for Statistical Computing).Results:The results of the study will be published in journals or relevant conferences.Conclusion:This proposed systematic review will evaluate the comparative efficacy and safety of various acupuncture methods and combination protocols for LDH.     

Effectiveness of traditional Chinese medicine music therapy on anxiety and depression emotions of lung cancer patients: A protocol for systematic review and meta-analysis

Background:Lung cancer patients often accompanied with severe depression and anxiety emotions, and those negative emotions could affects the treatment and recovery of the illness, decrease the patients’ quality of life. In recent years, traditional Chinese medicine five-element music therapy (TCM-FEMT) is widely used for psychological problems of lung cancer patients for its unique advantages, TCM-FEMT applied to negative emotions management of lung cancer patients has been reported in many publications, but there is lacks evidence-based medicine, in this study, effectiveness of TCM-FEMT on anxiety and depression emotions of lung cancer patients will be systematically evaluated.Methods:PubMed, the Cochrane Library, Web of Science, Embase, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, VIP Database, WanFang Database were electronically searched to collect RCTs on the efficacy of TCM-FEMT on anxiety and depression emotions of lung cancer patients from inception to February 2021. In addition, retrospect the references of the included literature to supplement the relevant literature. Research selection, data extraction and quality evaluation of literature will be carried out by 2 researchers, respectively. RevMan 5.3 software will be used for statistical analysis.Results:This study will comprehensively summarize the current trials to determine the effectiveness of TCM-FEMT on anxiety and depression emotions of lung cancer patients.Conclusion:This study will provide comprehensive evidence for the efficacy of TCM-FEMT on anxiety and depression emotions of lung cancer patients.     

PD-L1 expression on peripheral T-cells and association with coronary heart disease patients: A protocol for systematic reviews and meta-analysis

Background:As immune checkpoint pathways, programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) can be exploited by tumor cells to evade immuno-surveillance. Inflammation and immune processes play decisive roles in the occurrence and development of coronary heart disease (CHD). The low expression level of PD-1/ PD-L1 or anti-PD-1/PD-L1 therapy can accelerate the immune processes in CHD and aggravates disease based on numerous studies. However, the expression of PD-L1 and CHD still remains controversial to date. We conducted this meta-analysis to detect the value of PD-L1 expression on peripheral T-cells in CHD.Methods:We will search PubMed, Embase, Web of Science, Google Scholar, Chinese National Knowledge Infrastructure, Chinese VIP Information, Wanfang Database, and Chinese Biomedical Literature Database for related published studies before February 2021. Two review authors will search and assess relevant studies independently. Case control studies and cohort studies will be included. The Revman 5.3 software was applied to carry out the meta-analysis for the included literature.Results:The findings of this systematic review will be disseminated in a peer-reviewed publication and/or presented at relevant conferences.Conclusion:This study will provide a new theoretical basis for the immunological prevention and treatment of CHD.Trial registration number:DOI 10.17605/OSF.IO/X3R52.Ethics and dissemination:Formal ethical approval is not required, as the data are not individualized.     

Integrated Chinese and western medicine for SLE: A protocol for systematic review and meta-analysis

Background:The efficacy and safety of integrated Chinese and western medicine in the treatment of Systemic Lupus Erythematosus (SLE) have not been systematically evaluated.Methods:This systematic review and meta-analysis will be performed and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We will search PubMed, Embase, Cochrane Library, Chinese Biomedical Database WangFang, VIP, and China National Knowledge Infrastructure (CNKI) for potentially eligible studies from their inception to Dec. 2020, and we will select all the eligible randomized controlled trials (RCTs) of the integrated Chinese and western medicine for Systemic Lupus Erythematosus. All the studies will be screened according to the inclusion and exclusion criteria and meta-analysis will be conducted using Review Manager V.5.3. and Stata V.12.0. The primary endpoint was the clinical efficacy rate, the secondary outcomes were SLEDAI score, adverse reaction rate, and laboratory test parameters (white blood cells, complement C3).Results:The results of this study will systematically evaluate the effectiveness and safety of the integrated Chinese and western medicine in the treatment of primary dysmenorrhea.Conclusion:The efficacy and safety of integrated Chinese and western medicine will be systematically evaluated in this paper, thus providing evidence for the clinical application of this therapy.Ethics and dissemination:This study is a systematic review, which is based on the published studies, so examination and agreement by the ethics committee are not required in this study. We intend to publish the study results in a journal or conference presentations.Open Science Framework (OSF)registration number:https://osf.io/mabxh.     

Acupuncture for treating tic disorders in children: A protocol for systematic review and meta-analysis

Background:Tic disorders (TDs) are a group of neurodevelopmental disorders in children, while pharmacotherapy is often associated with various side effects and has limited clinical effects for some patients, thus significantly affecting patients’ quality of life. Studies have found acupuncture shows certain advantages in the treatment of TDs. However, there is no high level of evidence evaluating the effectiveness and safety of acupuncture for children with TDs.Methods:Each data of acupuncture for treating TDs will be searched. We will search for related English and Chinese databases. The time is limited from inception until November 2020. The primary outcome is the reduction rate (amount) of tic severity using related scales or methods, and the secondary outcomes include recurrence rate and adverse events. The risk of bias will be assessed, and the RevMan5.3 and Stata14.0 will be performed for meta-analysis. Finally, we will assess the level of the resulting evidence.Results:The results of the study will synthesize the current evidence and be published in peer-reviewed journals.Conclusions:This research aims to provide convincing evidence of the effectiveness and safety of acupuncture for treating TDs in children.INPLASY registration number:INPLASY2020110050.     

Diagnostic performance of magnetic resonance imaging and ultrasonography on the detection of cesarean scar pregnancy: A meta-analysis

Background: There is still a debate on which imaging method is the best to diagnose cesarean scar pregnancy (CSP). Accordingly, this study aimed to analyze the diagnostic performance of magnetic resonance imaging (MRI) and ultrasonography (US) on the detection of CSP based on current evidence in the literature.Methods:PubMed, Embase, Cochrane, Chinese Biomedical Documentation Service System, WanFang, and China National Knowledge Infrastructure databases were searched up to June 2020. The included studies were all comparisons of MRI and US in the diagnosis of CSP that adopted postoperative histological examination as the reference standard. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the summary receiver operating characteristic curve (AUC) were calculated for MRI and US.Results:Thirteen studies were included, with a total sample size of 948 patients. The pooled sensitivity, specificity, PLR, NLR, and AUC of MRI in diagnosing CSP were 0.93 (95% CI, 0.91-0.95), 0.83 (95% CI, 0.75-0.89), 5.46 (95% CI, 3.70-8.05), 0.08 (95% CI, 0.06-0.11), and 0.96 (95% CI, 0.93-0.97), respectively; for US they were 0.84 (95% CI, 0.79-0.88), 0.73 (95% CI, 0.62-0.81), 3.06 (95% CI, 2.22-4.21), 0.23 (95% CI, 0.18-0.28), and 0.86 (95% CI, 0.83-0.89), respectively.Conclusion:We found that both MRI and US effectively diagnosed CSP; however, MRI had a higher diagnostic performance in detecting CSP than US.     

基于网络药理学和铁死亡探讨牡荆苷改善心肌缺血再灌注损伤的潜在作用机制

目的 基于生物信息数据库平台,采用网络药理学方法及分子对接技术研究牡荆苷通过铁死亡途径改善心肌缺血再灌注损伤的分子机制。方法 利用多个数据库对牡荆苷的潜在靶点和心肌缺血再灌注损伤的相关靶点进行筛选,取交集后构建蛋白质相互作用(PPI)网络并筛选核心靶点,对交集靶点进行基因本体(GO)功能、京都基因与基因组百科全书(KEGG)通路富集分析,构建“牡荆苷–靶点–通路”网络并筛选关键核心靶点和通路。进一步对牡荆苷潜在靶点、铁死亡相关靶点、心肌缺血再灌注损伤相关靶点取交集,并筛选牡荆苷–铁死亡–心肌缺血再灌注损伤相关的关键核心靶点。利用分子对接研究牡荆苷与各关键核心靶点间的结合机制。结果 牡荆苷与心肌缺血再灌注损伤的交集靶点共74个,筛选出肿瘤坏死因子(TNF)、淋巴细胞瘤-2(Bcl-2)、雌激素受体1(ESR1)等22个核心靶点,主要参与白细胞介素(IL)-17通路、脂质和动脉硬化通路等信号通路。分子对接结果表明牡荆苷与各关键核心靶点主要以氢键、范德华力、π-π堆积等作用力产生稳定结合。结论 牡荆苷通过抑制炎症反应、细胞凋亡及调控铁稳态平衡和氧化应激限制铁死亡等多种生理过程的协同作用来达到...     

基于网络药理学和分子对接探讨心可舒片治疗高血压的作用机制

目的 基于网络药理学方法和分子对接技术探究心可舒片治疗高血压的作用机制。方法 利用TCMSP、HERB、ETCM数据库和Swiss Target Prediction平台检索心可舒片的活性成分及作用靶点;通过OMIM、Gene Cards、TTD和DrugBank数据库获取高血压的相关靶点。筛选出药物与疾病的交集靶点,通过Cytoscape 3.7.2软件和STRING数据库分别构建“中药–活性成分–靶点–疾病”及蛋白相互作用(PPI)网络并筛选出关键活性成分和核心靶点。运用DAVID数据库进行基因本体(GO)及京都基因与基因组百科全书(KEGG)通路富集分析,利用AutoDockTools软件进行分子对接验证。结果 共获得心可舒片活性成分147个,药物与疾病的交集靶点262个。心可舒片治疗高血压的关键活性成分为丹参醇A、香紫苏醇、三裂鼠尾草素等;核心靶点为原癌基因酪氨酸蛋白激酶Src(SRC)、肿瘤坏死因子(TNF)、信号转导和转录激活因子3(STAT3)等。GO富集分析涉及238个生物学过程,41个细胞组分,81个分子功能。KEGG富集分析涉及131条信号通路,包括钙信号通路、神经...     

基于网络药理学及分子对接探讨当归补血汤治疗动脉粥样硬化的机制

目的]利用网络药理学及分子对接技术探讨当归补血汤治疗动脉粥样硬化(As)的作用机制。 [方法]借助TCMSP数据库获得当归补血汤的活性成分,使用Swiss Target Prediction平台预测其潜在作用靶点。应用GeneCards及DisGeNET数据库筛选As靶点,并将活性成分预测靶点与疾病靶点取交集获得关键交集靶点。采用STRING平台构建交集靶点PPI互作网络,Cytoscape软件网络拓扑分析筛选潜在关键靶点。再次使用Cytoscape软件构建药物-成分-靶点,并找到核心活性成分。通过Metascape数据库进行GO功能富集分析和KEGG通路富集分析,最后通过分子对接,进一步明确其发挥治疗效用的成分与靶点作用机制。 [结果]筛选当归补血汤活性成分共19个,预测靶点204个,疾病靶点5 213个,筛选得到治疗As的交集靶点176个,排名前5位的核心靶点为Akt1、JUN、TP53、TNF、IL-6。GO和KEGG富集分析主要指向氧化应激反应、转录调节复合物等功能,参与的信号转导主要包括FoxO信号通路、JAK-STAT信号通路、IL-17信号通路等。分子对接结果显示5个活性成分及5个重要核心靶点对接结合能均小于－5 kJ/mol,提示其受体蛋白与配体小分子之间结合稳定,数值越低,结合稳定性越高,且结合能排名前5位的包含β谷固醇与槲皮素两种活性成分,其中活性成分β谷固醇与TNF结合能最低,为－10.52 kJ/mol,说明β谷固醇与槲皮素两种中药有效成分可能在治疗动脉粥样硬化性疾病中起重要作用。 [结论]当归补血汤中槲皮素、β谷固醇等核心活性成分可能通过作用于Akt1、JUN、TP53、TNF、IL-6等核心靶点,调节炎症反应、脂质代谢和其他相关通路,从而发挥治疗As的作用。     

下肢动脉硬化闭塞症膝下病变潜在机制的加权基因共表达网络和免疫浸润分析

目的]探讨下肢动脉硬化闭塞症膝下病变的潜在机制和免疫相关性。 [方法]从高通量基因表达数据库下载GSE100927数据集,利用R语言软件Limma数据包和加权基因共表达网络分析筛选与下肢动脉硬化闭塞症膝下病变相关的基因并进行信号通路富集分析;构建蛋白-蛋白相互作用网络并筛选下肢动脉硬化闭塞症膝下病变相关的核心基因,分析核心基因在下肢动脉硬化闭塞症膝下病变样本与对照样本间的差异,利用受试者工作特征曲线下面积评价核心基因的诊断效能。采用反卷积算法(CIBERSORT)评估各样本中免疫细胞分布并计算不同免疫细胞在下肢动脉硬化闭塞症膝下病变样本与对照样本间的差异。 [结果]筛选获得下肢动脉硬化闭塞症膝下病变差异表达上调基因153个,差异表达下调基因63个,加权基因共表达网络分析结果表明下肢动脉硬化闭塞症膝下病变基因差异表达以上调为主,涉及胆固醇代谢、血小板活化等信号通路;蛋白酪氨酸磷酸酶受体C型(PTPRC)、Spi-1原癌基因(SPI1)、集落刺激因子1受体(CSF1R)和Fcγ受体Ⅲa(FCGR3A)可能是下肢动脉硬化闭塞症膝下病变的核心基因,且诊断效能较好。下肢动脉硬化闭塞症膝下病变与单核细胞的浸润程度呈正相关(r＝0.419,P＝0.037),与M2型巨噬细胞的浸润程度呈负相关(r＝－0.491,P＝0.013)。 [结论]下肢动脉硬化闭塞症膝下病变涉及胆固醇代谢、血小板活化等多种信号通路;与单核细胞、巨噬细胞介导的免疫反应密切相关;PTPRC、SPI1、CSF1R和FCGR3A可能是下肢动脉硬化闭塞症膝下病变的核心基因。