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This study aims to evaluate the methodological and reporting quality of diagnosis and treatment guidelines for hyperuricemia as well as the expert consensuses and promote the understanding and application of the diagnosis and treatment guidelines for hyperuricemia. With "hyperuricemia" "guidelines" "consensus" "recommendations" as the key words in titles, the authors searched for the published clinical guidelines on hyperuricemia in Chinese against CNKI, Wanfang, VIP, Medlive and the official website of the industry association. The retrieval time limit was until May 31, 2021. The appraisal of guidelines for research and evaluation Ⅱ(AGREEⅡ) and the reporting items for practice guidelines in health care(RIGHT) were employed to evaluate the methodological quality and reporting quality of 14 guidelines/consensuses included. The average scores of the guidelines/consensuses were 80.85%(48.61%-98.61%) for the domain of scope and purpose, 34.52%(0-69.44%) for the domain of stakeholder involvement, 35.53%(6.25%-92.19%) for the domain of rigor of development, 55.85%(23.61%-86.11%) for the domain of clarity of presentation, 26.19%(0-76.04%) for the domain of applicability, and 21.42%(0-50.00%) for the domain of editorial independence. Nine guidelines/consensuses were of medium overall quality with grade B recommendation, and five guidelines/consensuses were of poor quality with grade C recommendation. The RIGHT classified the fourteen guidelines/consensuses into one of high reporting quality, three of medium reporting quality, and ten of low reporting quality. The results of this study indicate that the standardization and rigor of the methodological quality and the reporting quality of the clinical guidelines/consensuses for hyperuricemia in China remain to be strengthened.
Subject(s)
Humans , China , Consensus , Hyperuricemia/drug therapy , Publications , Reference StandardsABSTRACT
<p><b>BACKGROUND</b>Functional magnetic resonance imaging (fMRI) is a novel method for studying the changes of brain networks due to acupuncture treatment. In recent years, more and more studies have focused on the brain functional connectivity network of acupuncture stimulation.</p><p><b>OBJECTIVE</b>To offer an overview of the different influences of acupuncture on the brain functional connectivity network from studies using resting-state fMRI.</p><p><b>SEARCH STRATEGY</b>The authors performed a systematic search according to PRISMA guidelines. The database PubMed was searched from January 1, 2006 to December 31, 2016 with restriction to human studies in English language.</p><p><b>INCLUSION CRITERIA</b>Electronic searches were conducted in PubMed using the keywords "acupuncture" and "neuroimaging" or "resting-state fMRI" or "functional connectivity".</p><p><b>DATA EXTRACTION AND ANALYSIS</b>Selection of included articles, data extraction and methodological quality assessments were respectively conducted by two review authors.</p><p><b>RESULTS</b>Forty-four resting-state fMRI studies were included in this systematic review according to inclusion criteria. Thirteen studies applied manual acupuncture vs. sham, four studies applied electro-acupuncture vs. sham, two studies also compared transcutaneous electrical acupoint stimulation vs. sham, and nine applied sham acupoint as control. Nineteen studies with a total number of 574 healthy subjects selected to perform fMRI only considered healthy adult volunteers. The brain functional connectivity of the patients had varying degrees of change. Compared with sham acupuncture, verum acupuncture could increase default mode network and sensorimotor network connectivity with pain-, affective- and memory-related brain areas. It has significantly greater connectivity of genuine acupuncture between the periaqueductal gray, anterior cingulate cortex, left posterior cingulate cortex, right anterior insula, limbic/paralimbic and precuneus compared with sham acupuncture. Some research had also shown that acupuncture could adjust the limbic-paralimbic-neocortical network, brainstem, cerebellum, subcortical and hippocampus brain areas.</p><p><b>CONCLUSION</b>It can be presumed that the functional connectivity network is closely related to the mechanism of acupuncture, and central integration plays a critical role in the acupuncture mechanism.</p>
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Objective To evaluate the anti-depression effect of astilbin on mice with depressive disorder and to explore its mechanism of action.Methods Seventy-two male mice (C57BL/6J type) were randomly divided into control group,model group,low,middle,high dose of astilbin group and imipramine(IMI) group,with 12 mice in each group.The mice in the control group were adopted in a normal way.The rats in the model group,low,middle,high dose of astilbin group and IMI group were adopted in chronic unexpected mild stress (CUMS) to establish depression model,and the stress was continuously kept for three weeks and daily medicine with physiological saline,10,20,40 mg · kg-1 astilbin and 10 astilbin imipramine were provided in the way of intraperitoneal injection.Examination for behavioural changes of animals was implemented via tail suspension test,forced swimming test,sucrose preference test,open field test.High performance liquid chromatography (HPLC) was adopted to examine the level of dopamine (DA) and 5-hydroxytryptamine(5-HT)in prefrontal cortex.Results There was no significant difference in the number of horizontal movement and vertical movement among the control group,model group,IMI group and low,middle,high dose of astilbin group(P ＞ 0.05).Compared with the control group,the dead time of tail suspension test and forced swimming test in the model group was longer (P ＜ 0.05),and sugar preference,DA and 5-HT in prefrontal cortex decreased dramatically (P ＜ 0.05).Compared with the model group,the dead time of tail suspension test and forced swimming test in the low,middle,high dose of astilbin group was shorter (P ＜ 0.05),and sugar preference and DA level in prefrontal cortex increased dramatically (P ＜ 0.05).The 5-HT level in prefrontal cortex in the middle,high dose of astilbin group and IMI group was higher than that in the model group (P ＜ 0.05),but there was no significant difference in the 5-HT level in prefrontal cortex between low dose of astilbin group and model group (P ＞ 0.05).There was no significant difference in the dead time of tail suspension test and forced swimming test and sugar preference among the control group,IMI group and low,middle,high dose of astilbin group (P ＞ 0.05).Conclusion Astilbin works excellently in anti-depression,and the major mechanism may involve in up-regulating the level of DA and 5-HT in prefrontal cortex.
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Proteolysis-targeting chimeras (PROTACs) are small-molecule protein degraders based on the ubiquitin-proteasome system. Recently, the development of specific small-molecule ligands for several E3 ligases (CRL4CRBN, CRL2VHL and cIAP) have significantly advanced the PROTACs technology. Several PROTACs against various oncogenic proteins including bromodomain-containing protein 4 (BRD4), estrogen receptor (ER) and androgen receptor (AR) have been developed and considered a novel approach for therapy of cancers. There are advantages of the new technology over the traditional small-molecule strategies. This review article provides a summary on the recent progress in the small-molecule-based PROTACs as antitumor drugs, and the challenges of this technology.