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1.
Article in Chinese | WPRIM | ID: wpr-920365

ABSTRACT

Objective Health education resource allocation is one of the basic indicators for evaluating health equity. At present, the research on the equity of health education resource allocation in China is mostly limited to a single year or regional data. This study was aimed to understand the equity of health education resources in the whole China from 2015-2019, and to provide a corresponding basis for further rational allocation of health education resources. Methods The data was obtained based on the number of health education training work, health education publicity work, distribution of health education publicity materials and the annual use of funds carried out mainly by the CDC or health education centers in each province according to the 2016-2020 China Health Statistics Yearbook. The inequality coefficient (Gini coefficient) and Lorenz curve were applied to study the selected data. Results The total number of health education resources in China from 2015-2019 was 1 789 735 and 1 933 336, respectively. The Gini coefficients of health education resource allocation by population distribution were all below the warning line of 0.4, which were in an equitable state. Conclusion The equity of health education resources in China is good according to demographic indicators, and there is no significant inequity. Especially, the aspects of health education services, such as technical consultation and media cooperation, are relatively good, but there is still much room for improvement in the construction of websites.

2.
Article in Chinese | WPRIM | ID: wpr-888190

ABSTRACT

As one of the most commonly diagnosed cancers in the world, female breast cancer is induced by the high level of estrogen. Saussureae Involucratae Herba(SIH), a gynecological medicinal, regulates estrogen-induced diseases. However, the therapeutic effect of SIH on breast cancer has not been reported. Therefore, this study aims to explore the potential efficacy of SIH on breast cancer based on in vitro experiment and network pharmacology. The inhibitory effect of SIH water extract on proliferation and migration of breast cancer MDA-MB-231 cells was examined. The result demonstrated SIH water extract significantly suppressed the proliferation of breast cancer cells(IC_(50)=6.47 mg·mL~(-1)) and also restricted the migration. A total of 39 components of SIH were retrieved from traditional Chinese medicine database(TCMD) and 160 targets of SIH were screened by target fishing with the PharmaDB database. The Online Mendelian Inheritance in Man(OMIM) was used to establish a 1 001-targets data set of breast cancer. Based on the overlaps(45) of targets between SIH and breast cancer, a protein-protein interaction(PPI) network was built to analyze the interactions among these targets with STRING platform and Cytoscape. Finally, through topology and GO and KEGG analysis, 8 targets, 101 pathways and 85 biological processes were found to involve the treatment of breast cancer by SIH. SIH may exert the anti-breast cancer effect by regulating cell cycle, inhibiting proliferation, migration and adhesion of cancer cells, and modulating estrogen receptor. This study clarified the mechanism of SIH in treating breast cancer, which lays a foundation for the further development of SIH.


Subject(s)
Breast Neoplasms/genetics , Databases, Genetic , Drugs, Chinese Herbal , Female , Humans , Medicine, Chinese Traditional
3.
Article in Chinese | WPRIM | ID: wpr-888168

ABSTRACT

To systematically review the efficacy and safety of acupuncture combined with minimally invasive surgery or basic the-rapy in treating hypertensive intracerebral hemorrhage(HICH) patients compared with minimally invasive surgery or basic treatment. In this study, the four Chinese databases, the four English databases, Chinese Clinical Trial Registry and ClinicalTrail.gov, all above were systematically and comprehensively retrieved from the time of database establishment to September 10, 2020. Rando-mized controlled trials(RCTs) were screened out according to inclusion criteria and exclusion criteria established in advanced. The methodological quality of included studies was evaluated by the tool named "Cochrane bias risk assessment 6.1". Meta-analysis of the included studies was performed using RevMan 5.4, and the quality of outcome indicators was evaluated by the GRADE system. Finally, 17 studies were included, involving 1 852 patients with HICH, and the overall quality of the included studies was not high. According to Meta-analysis,(1)CSS score of the group of acupuncture combined with minimally invasive surgery or basic therapy was superior to the group of minimally invasive surgery or basic therapy(MD=-3.50,95%CI[-4.39,-2.61],P<0.000 01);(2)NIHSS score of the group of acupuncture combined with minimally invasive surgery or basic therapy was superior to the group of minimally invasive surgery or basic therapy(MD=-4.78,95%CI[-5.55,-4.00],P<0.000 01);(3)the cerebral hematoma volume of the group of acupuncture combined with minimally invasive surgery or basic therapy was superior to the group of minimally invasive surgery or basic therapy(MD=-4.44,95%CI[-5.83,-3.04],P<0.000 01);(4)ADL score of the group of acupuncture combined with minimally invasive surgery or basic therapy was superior to the group of minimally invasive surgery or basic therapy(MD=20.81,95%CI[17.25,24.37],P<0.000 01);(5)the GCS score of the group of acupuncture combined with minimally invasive surgery or basic therapy was superior to the group of minimally invasive surgery or basic therapy(MD=2.41,95%CI[1.90,2.91],P<0.000 01). The GRADE system showed an extremely low level of evidence for the above outcome indicators. Adverse reactions were mentioned only in two literatures, with no adverse reactions reported. The available evidence showed that acupuncture combined with minimally invasive surgery or basic therapy had a certain efficacy in patients of HICH compared with minimally invasive surgery or basic therapy. However, due to the high risk of bias in the included studies, its true efficacy needs to be verified by more high-quality studies in the future.


Subject(s)
Acupuncture Therapy , Humans , Intracranial Hemorrhage, Hypertensive/therapy , Treatment Outcome
4.
Article in Chinese | WPRIM | ID: wpr-888167

ABSTRACT

To overview of systematic reviews/Meta-analysis of Xingnaojing Injection(XNJ) in the treatment of intracerebral hemorrhage(ICH). The systematic reviews concerning XNJ in the treatment of ICH were retrieved from four Chinese databases, four English databases, Chinese Clinical Trial Registry and ClinicalTrail.gov, with the retrieval time set from their inception to September 2020. Following the independent screening and data extraction by two researchers, a measurement tool to assess systematic evaluation 2(AMSTAR 2) and grades of recommendation, assessment, development and evaluation(GRADE) system were used to evaluate the metho-dological, reporting and evidence qualities of the 10 included systematic reviews. The results showed that XNJ was superior to the wes-tern medicine or conventional treatment in improving the effective rate and National Institutes of Health stroke scale(NIHSS) score, Barthel index(BI), and Glasgow coma scale(GCS) score and Chinese stroke scale(CSS) score, and reducing the mortality and cerebral hematoma volume, without inducing obvious adverse reactions. In general, the methodological, reporting and evidence qualities of the 10 included systematic reviews were poor. The AMSTAR 2 scores showed that key items No. 2 and No. 16 failed to meet the stan-dard, resulting in poor methodological quality. There was only one outcome indicator graded by GRADE as intermediate quality, 43% indicators as low quality, 42% indicators as extremely low quality, and none as high quality. These available evidences have suggested that the methodological, reporting and evidence qualities of the systematic evaluation concerning XNJ for the treatment of ICH need to be improved. Most evidences support that XNJ was better than the western medicine or conventional treatment in the treatment of ICH, but the methodological quality and the reliability of outcome indicators in relevant systematic review were low. More high-quality studies are still required for further verification.


Subject(s)
Cerebral Hemorrhage/drug therapy , Drugs, Chinese Herbal , Humans , Meta-Analysis as Topic , Reproducibility of Results , Systematic Reviews as Topic , United States
5.
Article in Chinese | WPRIM | ID: wpr-888166

ABSTRACT

This study aims to systematically evaluate the clinical efficacy and safety of Toutongning Capsules in the treatment of tension-type headache(TTH), so as to provide a corresponding basis for clinical treatment. Eight commonly used medical research databases and two clinical trial registration systems were retrieved with the time interval from the establishment of the database or system to November 2020. The randomized controlled trials of Toutongning Capsules in the treatment of TTH were screened out according to the pre-set criteria. The quality of the included papers was evaluated by the bias risk assessment tool in Cochrane Reviewers Handbook 6.1 and the data were statistically analyzed by RevMan v5.4 provided by Cochrane collaboration. A total of 13 studies were included and the quality of methodology was generally low. Meta-analysis showed that Toutongning Capsules assisted with western medicine therapy can effectively reduce the pain intensity(MD_(VAS)=-1.94,95%CI[-2.50,-1.38],P<0.000 01;MD_(NRS)=-0.83,95%CI[-0.86,-0.80],P<0.000 01), headache duration(SMD=-0.98,95%CI[-1.17,-0.79],P<0.000 01), headache frequency(MD=-1.01,95%CI[-1.16,-0.85],P<0.000 01), headache index(MD=-11.13,95%CI[-12.10,-10.16],P<0.000 01), anxiety and depression scale score(MD_(HAMA)=-4.02,95%CI[-6.58,-1.46],P=0.002;MD_(HAMD)=-2.67,95%CI[-4.04,-1.29],P=0.000 1), while Toutongning Capsules as monotherapy only reduced the headache score(MD=-2.24,95%CI[-2.97,-1.51],P<0.000 01). The available clinical studies demonstrate that Toutongning Capsules combined with western medicine in the treatment of TTH can improve the related outcome indicators, but the clinical safety and efficacy of Toutongning Capsules alone remain unclear. Due to the small number and low quality of the included studies, large-sample, multi-center, high-quality and strictly designed randomized controlled trials are still needed to verify the clinical efficacy in the future.


Subject(s)
Capsules , Databases, Factual , Drugs, Chinese Herbal , Humans , Tension-Type Headache/drug therapy , Treatment Outcome
6.
Article in Chinese | WPRIM | ID: wpr-888165

ABSTRACT

The efficacy of gastrodin as a Chinese herbal medicine extract in the treatment of tension-type headache has been confirmed. This paper systematically reviewed the efficacy and safety of gastrodin in the treatment of tension-type headache, aiming to provide a new choice for the treatment of this disease. In this study, four Chinese databases, four English databases and two trial registries were searched from the date of establishment to September 2020. The related randomized controlled trials(RCTs) were screened out according to the predetermined criteria. The bias risk assessment tool developed by Cochrane collaboration was used to evaluate the quality of the reports. RevMan 5.4.1 was used for Meta-analysis, and GRADE system for the evidence-based evaluation on the quality of outcome indicators. A total of 177 articles were retrieved and 8 articles were finally included for analysis, with a total sample size of 1 091 cases, which included 565 cases in the treatment group and 526 cases in the control group. The overall quality of included stu-dies was not high. The results of Meta-analysis are as follows:(1)In terms of headache frequency, gastrodin group was better than wes-tern medicine group(MD=-2.90, 95%CI[-3.76,-2.03], P<0.000 01).(2)In terms of number of abnormal blood vessels in TCD, gastrodin group was better than western medicine group(MD=-88.96, 95%CI[-102.36,-75.55], P<0.000 01).(3)In terms of effective rate, gastrodin group was better than western medicine group(RR=1.47, 95%CI[1.29, 1.68], P<0.000 01). The results of subgroup analysis are as follows:(1)Effective rate based on age, for the patients upper age limit 40-46 years old, gastro-din group was better than western medicine group(RR=1.69, 95%CI[1.50, 1.90], P<0.000 01); for the patients upper age limit 55-60 years old, gastrodin group was better than western medicine group(RR=1.27, 95%CI[1.16, 1.38], P<0.000 01).(2)Effective rate based on dosage form, both the gastrodin capsules and injection groups were better than western medicine group(RR_(capsules)=1.42, 95%CI[1.08, 1.88], P=0.01; RR_(injection)=1.50, 95%CI[1.26, 1.77], P<0.000 01). GRADE evaluation showed that the above outcomes had low quality of evidence. Only one article detailed the occurrence of adverse reactions and thus the present study cannot make a positive conclusion on the safety of gastrodin in the treatment of tension-type headache. The small number and low quality of the included reports affected the reliability of the results. In the future, more high-quality randomized controlled trails are needed to improve the evaluation on the efficacy and safety of gastrodin in the treatment of tension-type headache.


Subject(s)
Adult , Benzyl Alcohols/therapeutic use , Drugs, Chinese Herbal/adverse effects , Glucosides , Humans , Middle Aged , Reproducibility of Results , Tension-Type Headache
7.
Article in Chinese | WPRIM | ID: wpr-888164

ABSTRACT

The study aims to analyze the outcome indicators of randomized controlled trial(RCT) of traditional Chinese medicine(TCM) in the treatment of hypertensive intracerebral hemorrhage(HICH) in recent three years, and thus provide suggestions for the future studies in this field. Four English databases, four Chinese databases and two online registration websites of clinical trials were searched. The RCTs published between January 2018 and September 2020 were screened. The risk of bias was assessed and outcome measures were classified. A total of 151 839 articles were retrieved, of which 44 RCTs were included for analysis after screening. The outcome measures of the included RCTs were classified into 7 categories, among which the symptoms/signs category showed the highest reporting rate. National Institute of Health stroke scale(72.73%) was the most frequently reported outcome indicator, while the vo-lume of intracerebral hemorrhage determined by computerized tomography(36.36%) was the most frequently reported lab test outcome. Most studies collect the outcomes at the end of treatment, while 9 studies reported long-term outcomes 3 months or more after onset. Compared with those of international clinical trials, the application of some of the outcomes was reasonable, focusing on patients' symptoms, quality of life and objective outcomes. However, there were still several problems: unclear primary and secondary outcome measures, insufficient attention to long-term prognosis, insufficient attention to social function, few TCM outcomes, lack of measurement blindness and the use of unreasonable composite outcomes. It is recommended that researchers should rationally design the outcome indicators of clinical trials and develop the core outcome set.


Subject(s)
Drugs, Chinese Herbal/therapeutic use , Humans , Intracranial Hemorrhage, Hypertensive/drug therapy , Medicine, Chinese Traditional , Quality of Life , Randomized Controlled Trials as Topic
8.
Article in Chinese | WPRIM | ID: wpr-888163

ABSTRACT

To evaluate the application of outcome indicators in randomized controlled trials(RCTs) concerning the treatment of tension-type headache(TTH) with traditional Chinese medicine(TCM) in recent five years, so as to provide a basis for the study of core outcome set(COS) for TCM intervention in TTH. The RCTs on TCM treatment of TTH in recent five years were systematically retrieved from CNKI, Wanfang, VIP, CBM, EMbase, PubMed, Cochrane Library, Web of Science, ClinicalTrials.gov and China Clinical Trial Registry. After literature screening, data extraction and evaluation of the risk of bias, the outcome indicators in the included RCTs were subjected to qualitative analysis. The preliminary search yielded 19 042 articles, and 10 983 were left after the elimination of duplication. Finally, 52 RCTs(48 in Chinese and 4 in English) were included for qualitative analysis. The outcome indicators of RCTs included in this study were classified into seven domains: TCM syndrome, symptom and sign, physical and chemical detection, quality of life, long-term prognosis, economic evaluation, and safety event. The findings demonstrated that headache characteristic index in the symptom and sign domain was the index with the highest reporting frequency and reporting rate. Seventeen RCTs used TCM syndrome score as the outcome indicator. Further analysis revealed that there existed such problems in research design as non-distinction between primary and secondary outcome indicators, great difference in the adopted measurement tools for outcome indicators, and the neglect of measurement time of outcome indicators. Moreover, the syndrome indicators reflecting TCM advantages, objective evaluation indicators, safety and health-economic indicators were lacking. These limitations have affected the quality and reliability of RCTs on TTH treatment with TCM. It is suggested that the efficacy and characteristics of TCM should be combined into current clinical research, and the COS in RCTs regarding TCM treatment of TTH should be established according to internationally recognized standard procedures.


Subject(s)
Drugs, Chinese Herbal , Humans , Medicine, Chinese Traditional , Quality of Life , Randomized Controlled Trials as Topic , Reproducibility of Results , Tension-Type Headache/drug therapy
9.
Article in Chinese | WPRIM | ID: wpr-888123

ABSTRACT

The traditional Chinese medicines(TCM) for activating blood circulation and the TCM for regulating Qi are often used in combination in clinical practice. However, their mechanisms are still unclear. The activity spectrum of targets can fuse the active components, targets and intensity of action, which provides support for the discussion of efficacy targets. The chemical components of common TCM sets for activating blood circulation and regulating Qi, as well as the negative sets not for activating blood circulation and re-gulating Qi were obtained from the database of TCM. By the similarity analysis of chemical components in TCM for activating blood circulation and DrugBank database, the predicted targets of chemical components in TCM for activating blood circulation were obtained, and the similarity value of the two was taken as the activity value of the active components and predicted targets. Then, the component-target activity value was weighted. The activity values of herb acting on the same target were fused to construct activity spectra of targets of the herbs for activating blood circulation, herbs for regulating Qi and negative herbs. The targets whose activity values of activating blood circulation and regulating Qi were higher than those of negative herbs were selected as potential targets of efficacy. Protein-protein interaction networks were constructed for topological, GO and KEGG enrichment analysis to determine the key targets of efficacy of activating blood circulation and regulating Qi. The component-target activity information collected from DrugBank database contained 4 499 compounds, 627 targets and 11 295 action relationships. The activating blood function protein-protein interaction network contained 206 nodes and 1 728 edges, while the regulating Qi function protein-protein interaction network contained 230 nodes and 986 edges. The enrichment analysis of topology, GO and KEGG showed that TCM for activating blood circulation mainly exerted its anti-inflammatory, neuroprotective and angiogenic effects on signaling cascade pathway mediated by VEGF/VEGFR2, ERK signaling pathway, calcium signaling pathway and PI3 K-AKT signaling pathway, and the key targets included mitogen activated protein kinases 3(MAPK3), proto-oncogene tyrosine-protein kinase Src(SRC), mitogen activated protein kinases 1(MAPK1), epidermal growth factor receptor(EGFR), phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit alpha isoform(PIK3 CA), peroxisome proliferators-activated receptor gamma(PPARG), nitric oxide synthase 3(NOS3), prostaglandin G/H synthetase 2(PTGS2), matrix metalloproteinase-9(MMP9), and vascular endothelial growth factor A(VEGFA). TCM for regulating Qi mainly exerted anti-inflammatory and neuroprotective effects by acting on MAPK signaling pathway and PI3 K-AKT signaling pathway, and the key targets included mitogen activated protein kinases 8(MAPK8), SRC, mitogen activated protein kinases 14(MAPK14), and RAC-alpha serine/threonine-protein kinase(AKT1), mitogen activated protein kinases 3(MAPK3). Based on the activity spectrum of targets, the targets of the TCM for activating blood and the targets of the TCM for regulating Qi were analyzed to provide reference for the study of efficacy targets of TCM, and also provide some scientific basis for clinical application.


Subject(s)
Drugs, Chinese Herbal/pharmacology , Medicine, Chinese Traditional , Protein Interaction Maps , Qi , Vascular Endothelial Growth Factor A
10.
Article in Chinese | WPRIM | ID: wpr-888086

ABSTRACT

Wuwei Ganlu, a formula for medicated bath, consists of medicinal materials of Ephedra sinica, Platycladus orientalis, Myricaria squamosa, Artemisia carvifolia, and Rhododendron anthopogonoides, which is effective in inducing perspiration, resisting inflammation, relieving pain, regulating yellow water disease, and activating blood circulation. On this basis, a variety of formulas for Tibetan medicated bath have been derived for the treatment of diseases in internal organs, joints, nerves, etc. Modern studies have confirmed that Wuwei Ganlu has a good therapeutic efficacy on knee osteoarthritis(KOA). The present study explored the mechanism of Wuwei Ganlu in treating KOA based on network pharmacology and molecular docking. Firstly, the chemical components of Wuwei Ganlu were obtained through literature mining and database retrieval, and corresponding potential targets were predicted according to the BATMAN-TCM database. The protein-protein interaction(PPI) network was obtained after the potential targets were input into the STRING database. The network function modules were analyzed by the Molecular Complex Detection(MCODE) algorithm, and the functions of the modules were annotated to analyze the action mode of Wuwei Ganlu. Secondly, the related targets of KOA were collected through the DisGeNET database, and the overlapping targets were confirmed to analyze the mechanism of Wuwei Ganlu in treating KOA. Finally, the key targets were selected for molecular docking with the main components of Wuwei Ganlu to verify the component-target interaction. A total of 550 chemical components and 1 365 potential targets of Wuwei Ganlu were obtained. PPI analysis indicated that this formula could exert the effects of oxidation-reduction, inflammation resistance, bone absorption, bone mineralization, etc. Nineteen common targets were obtained from the intersection of potential targets of Wuwei Ganlu and KOA disease targets. It was found that the Wuwei Ganlu mainly acts on nuclear factor-κB(NF-κB), interleukin-1 beta(IL1β), tumor necrosis factor(TNF), IL6, IL1 receptor antagonist(IL1 RN), and prostaglandin-endoperoxide synthase-2(PTGS2) to treat KOA. Among the 550 chemical components of Wuwei Ganlu, 252 potential active components were docked with TNF and 163 with PTGS2, indicating good binding of the components with potential key targets. The study preliminarily explored the mechanism of Wuwei Ganlu in treating KOA to provide a reference for the further development and utilization of Tibetan medicated bath that has been included in the UN Intangible Cultural Heritage.


Subject(s)
Databases, Factual , Drugs, Chinese Herbal , Humans , Inflammation , Molecular Docking Simulation , Osteoarthritis, Knee
11.
Article in Chinese | WPRIM | ID: wpr-888037

ABSTRACT

The effect of oral or nasal feeding with Chinese patent medicine on hypertensive intracerebral hemorrhage was systematically evaluated by using the method of network Meta-analysis. Four Chinese databases(CNKI, VIP, Wanfang, CBM), three English databases(Medline, EMbase, Cochrane Library) and ClinicalTrials.gov were retrieved through computers. According to the inclusion criteria and exclusion criteria, randomized controlled trials(RCTs) of Chinese patent medicine combined with Western medicine in the treatment of hypertensive intracerebral hemorrhage were screened out according to the inclusion criteria and exclusion criteria. The Cochrane bias risk assessment tool was used to evaluate the quality of the included studies, and Stata 16.0 software was used to analyze the outcome indicators. A total of 3 888 literatures were retrieved, and 30 studies involving 6 kinds of Chinese patent medicines were finally included. The total sample size was 2 758 cases, including 1 401 cases in the treatment group and 1 357 cases in the control group. According to the results of network Meta-analysis,(1)in terms of improving the degree of nerve function defect, the order of Chinese patent medicines was conventional Western medicine combined with Xiaoyukang Capsules>combined with Tongxinluo Capsules>combined with Naoxuekang Oral Liquid>combined with Naoxueshu Oral Liquid>combined with Angong Niuhuang Pills>conventional Western medicine;(2)in terms of reducing the amount of residual cerebral hematoma, the order of Chinese patent medicines was conventional Western medicine combined with Naoxueshu Oral Liquid>combined Xiaoyukang Capsules>combined Naoxuekang Oral Liquid>conventional Western medicine;(3)in terms of improving ability of daily living, the order of Chinese patent medicines was conventional Western medicine combined with Shenzhi Huoxue Capsules>combined with Angong Niuhuang Pills>combined with Naoxueshu Oral Liquid>conventional Western medicine;(4)in terms of improving total effective rate, the order of Chinese patent medicines was conventional Western medicine combined with Naoxueshu Oral Liquid>combined with Xiaoyukang Capsules>combined with Angong Niuhuang Pills=combined with Naoxuekang Oral Liquid>combined Tongxinluo Capsules>conventional Western medicine treatment. The results showed that in addition to conventional Western medicine therapy, the combined use with Chinese patent medicine can improve the clinical efficacy in the treatment of hypertensive intracerebral hemorrhage. However, due to the differences in the number and quality of various Chinese patent medicines included in the studies, and the lack of direct comparison of Chinese patent medicines, the ranking results still need to be verified by multi center, large-sample-size randomized double-blind trials in the future, so as to provide more reliable evidence support for clinical drug use.


Subject(s)
China , Humans , Intracranial Hemorrhage, Hypertensive , Medicine, East Asian Traditional , Network Meta-Analysis , Nonprescription Drugs , Randomized Controlled Trials as Topic
12.
Article in Chinese | WPRIM | ID: wpr-888036

ABSTRACT

To systematically review the efficacy and safety of Naoxueshu Oral Liquid in treatment of hypertensive intracerebral hemorrhage, four Chinese databases, four English databases, clinical trials registration center(ClinicalTrials.gov) and Chinese clinical trial registry were retrieved. The retrieval time was from the establishment of each database to September 9, 2020. According to the set criteria, the randomized controlled trial(RCT) of Naoxueshu Oral Liquid combined with conventional Western medicine was selected. The "Cochrane bias risk assessment" tool was used to evaluate the quality of the included studies. RevMan 5.4.1 was used to conduct Meta-analysis of the included studies and GRADE system was used to evaluate the evidence quality of the outcome indicators. Eleven studies were finally included, with a total sample size of 1 221 cases, 612 cases in the treatment group and 609 cases in the control group. Meta-analysis showed that Naoxueshu Oral Liquid combined with conventional Western medicine had no significant difference compare with conventional Western medicine in reducing National Institute of health stroke scale(NIHSS) after 2 weeks of treatment for hypertensive intracerebral hemorrhage(MD=-1.59,95%CI[-3.46,0.29],P=0.10), but was superior to conventional Western medicine after 30 d of treatment(MD=-1.16,95%CI [-1.39,-0.94],P<0.000 01). Naoxueshu Oral Liquid combined with conventional Western medicine was superior to conventional Western medicine in improving Glasgow coma scale(MD=1.00,95%CI[0,2.00],P=0.05) and reducing the incidence of secondary brain insults(RR=0.38,95%CI[0.24,0.59],P<0.000 1), but there was no significant difference in increasing Barthel index(MD=1.00,95%CI[-0.30,2.30],P=0.13). In terms of effective rate, studies using Guideline for clinical trials of new patent Chinese medicines, NHISS or Glasgow outcome scale(GOS) had shown that Naoxueshu Oral Liquid combined with conventional Western medicine was superior to conventional Western medicine(RR_(Guideline for clinical trials of new patent Chinese medicines)=1.27,95%CI[1.10,1.46],P=0.001;RR_(NHISS)=1.26,95%CI[1.13,1.40],P<0.000 1;RR_(GOS)=1.54,95%CI[1.22,1.93],P=0.000 2). In reduction of hematoma volume, Naoxueshu Oral Liquid combined with conventional Western medicine was superior to conventional Western medicine after 2 and 4 weeks of treatment(MD_(2 week)=-2.31,95%CI[-3.12,-1.49],P<0.000 01;MD_(4 week)=-2.04,95%CI[-2.41,-1.68],P<0.000 01). GRADE system showed that the evidence level of the above outcome indicators was low and extremely low. In terms of adverse reactions, two of the included studies reported mild adverse reactions, and the rest of studies were not mentioned, so this study was not able to make a positive evaluation of the safety of Naoxueshu Oral Liquid. This study showed that compared with conventional Western medicine, combined Naoxueshu Oral Liquid may be better for hypertensive intracerebral hemorrhage. However, due to the high bias risk in the included studies, more large-sample and high-quality RCTs are still needed in the future.


Subject(s)
Drugs, Chinese Herbal/adverse effects , Humans , Intracranial Hemorrhage, Hypertensive/drug therapy , Nonprescription Drugs , Stroke
13.
Article in Chinese | WPRIM | ID: wpr-888034

ABSTRACT

To overview the systematic reviews of Panax notoginseng saponins in the treatment of acute cerebral infarction. CNKI, CBM, Wanfang, VIP, PubMed, Cochrane Library and EMbase databases were retrieved to collect the systematic reviews of the efficacy of P. notoginseng saponins in the treatment of acute cerebral infarction. The retrieval time was from the time of database establishment to January 2021. After two researchers independently screened out the literature and extracted the data, AMSTAR-2 scale was used to evaluate the methodological quality of the included systematic reviews, GRADE system was used to grade the quality of evidences of the outcome indicators, and the efficacy evaluation was summarized. A total of 5 systematic reviews were included. AMSTAR-2 evaluation results showed that 3 items were relatively complete, while 4 items had a poor overall quality. P. notoginseng saponins combined with conventional Western medicine therapy was superior to single conventional therapy in the recovery of neurological function, enhancement of the total effective rate in clinic, and improvement of activities of daily living. GRADE evaluation results showed that the quality of evidence was from low quality to very low quality. In conclusion, in the treatment of acute cerebral infarction, P. notoginseng saponins can improve the clinical efficacy, with a good safety but a not high methodological quality and a low evidence quality. It is suggested that high-quality clinical studies shall be further carried out to provide evidence-based basis for the application of P. notoginseng saponins in the treatment of acute cerebral infarction.


Subject(s)
Activities of Daily Living , Cerebral Infarction/drug therapy , Humans , Panax notoginseng , Saponins , Systematic Reviews as Topic
14.
Article in Chinese | WPRIM | ID: wpr-888032

ABSTRACT

To systematically search and sort out the clinical randomized controlled trial(RCT) on the prevention and treatment of acute cerebral infarction with traditional Chinese medicine(TCM) by using the method of evidence map, and to understand the evidence distribution of related studies. CNKI, Wanfang, VIP, CBM, PubMed, EMbase, Cochrane Library and Web of Science were retrieved from January 2016 to September 2020, and literatures related to the prevention and treatment of acute cerebral infarction with traditional Chinese medicine were included. Text description combined with table and bubble chart were used to analyze the distribution characteristics of evidence. A total of 1 102 clinical articles in recent five years were retrieved. The annual trend of clinical study publication, study size, TCM therapy category and main scheme, and study literature quality were analyzed. We find that TCM treatment of acute cerebral infarction has become a hot topic of clinical research, the number of literature showed a trend of increased year by year, various means of intervention of TCM in the treatment of the advantages of increasingly highlight. Follow-up clinical research should highlight the characteristics of TCM: in the analysis of outcome indicators; increase the neuropsychological patients after stroke and cognitive ability, and the theory of combined treatment of TCM disease when thoughts; At the same time, the quality of clinical research needs to be improved. At present, there is still a lack of unified standards for the production of evidence map. This study is the first to explore the application of evidence map to summarize and display the clinical research status of TCM treatment of acute cerebral infarction, and combine it with the setting of priority areas of TCM clinical research, so as to provide a reference basis for determining the priority topic selection of TCM treatment optimization research.


Subject(s)
Brain Ischemia , Cerebral Infarction/drug therapy , Drugs, Chinese Herbal/therapeutic use , Humans , Medicine, Chinese Traditional , Stroke/drug therapy
15.
Article in Chinese | WPRIM | ID: wpr-911230

ABSTRACT

Objective:To evaluate the relationship between preoperative frailty and postoperative cognitive dysfunction (POCD) in elderly patients undergoing non-cardiac surgery.Methods:A total of 336 elderly patients of both sexes, aged≥65 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with body mass index of 18.6-25.1 kg/m 2, undergoing elective non-cardiac surgery under general anesthesia, were enrolled in the study.Faltering status was assessed with the Clinical Faltering Scale at 1 day before surgery.Mini-Mental State Examination score, Digital Span Test, Digit Symbol Substitution Test, Stroop Color and Word Test, Visual Word Learning Test and Trail Making Test were performed at 1 day before surgery and at 1, 7 and 30 days after surgery.The Z score was used to identify POCD.The patients was divided into non-POCD group and POCD group according to the occurrence of POCD within 30 days after surgery.Logistic regression analysis was used to identify the risk factors for POCD in elderly patients undergoing non-cardiac surgery. Results:The results of logistic regression analysis showed that preoperative frailty and diabetes mellitus were independent risk factors for POCD in elderly patients undergoing non-cardiac surgery ( P<0.05). Conclusion:Preoperative frailty is an independent risk factor for POCD in elderly patients undergoing non-cardiac surgery.

16.
Article in Chinese | WPRIM | ID: wpr-910353

ABSTRACT

Objective:To discuss the problems existing in the implementation of the Chinese health industry standard WS 523-2019 by testing SPECT device.Methods:Under the WS 523-2019 standards, a total of 10 SPECT devices were tested with regard to their SPECT reconstructed spatial resolution (SRSR), system planar sensitivity (SPS), system spatial resolution (SSR), whole body system spatial resolution (WSSR), intrinsic uniformity (IU), intrinsic count rate performance (ICR), intrinsic spatial resolution (ISR) and intrinsic spatial linearity(ISL).Result:Under the requirements of WS 523-2019 standards for qualified limits, there are 3 devices with ISL unqualified and the rest of the performances qualified. The new standards basically can meet the clinical requirements and reflected the overall performance of SPECT.Conclusions:The distance between the radiation source and the surface of the detector has great influence on the spatial resolution.In the measurement of ISL, there must be a lead grid separately in the x and y directions. The lead grids with the parallel slits shall be positioned on the detector with the center slit centered on the detector. It is suggested to add rotation center in the new standards.

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Article in Chinese | WPRIM | ID: wpr-908065

ABSTRACT

Objective:To summarize and analyze the clinical and genotype features of female-restricted X-linked syndromic mental retardation-99(MRXS99F, OMIM: 300968)caused by USP9 X gene mutation, and to improve the clinicians′ understanding of the disease. Methods:Clinical data and genotypes of 2 children with MRXS99F treated in the Children′s Hospital of Nanjing Medical University in March 2020 (case 1) and June 2020 (case 2) were analyzed, and the relevant databases at home and abroad were reviewed to summarize the clinical characteristics and gene variation characteristics of the disease.Results:The 2 cases were 6 months old (case 1) and 5 years old (case 2), both showed psychomotor retardation.Case 1 presented a short stature, pigment abnormality, characteristic facial features, hypotonia, recurrent respiratory tract infections, laryngeal cartilage hypoplasia, atrial septal defect, feeding difficulty, hearing loss and brain hypoplasia.Case 2 had abnormal electroencephalogram.As confirmed by whole-exome sequencing, two children carried c. 6972+ 1G>A, c.6437C>T of USP9 X, respectively.Neither of the 2 variations was previously reported.Twenty-two cases of MRXS99F caused by USP9 X gene mutation were reported in 4 literatures globally, and 24 cases were combined with this study.The clinical manifestations of 20/22 children had special faces.All of them accompanied mental retardation combined with motor and language retardation, and carried neonatal variation. Conclusions:This is the first case report of MRXS99F induced by USP9 X gene variation in China.MRXS99F caused by functional deletion and variation of USP9 X gene is mainly characterized by psychomotor retardation, language disorder, special face and multiple congenital malformations.For children with unexplained growth retardation, special face and multiple congenital malformations, genetic testing like high-throughput sequencing should be carried out as early as possible to determine the etiology.

18.
Article in Chinese | WPRIM | ID: wpr-906295

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Objective:To study the protective effect of essential oil from Alpiniae Zerumbet Fructus (EOAZF) against high glucose (HG)-induced injury of human umbilical vein endothelial cells (HUVECs) <italic>in vitro</italic>, so as to provide experimental evidence for the treatment of diabetes-induced cardiovascular diseases with EOAZF. Method:The cells were divided into the normal group, model group (25 mmol·L<sup>-1</sup> glucose), positive control group (100 mg·L<sup>-1</sup> vitamin C), and the low- (0.25 μg·L<sup>-1</sup>), medium- (1 μg·L<sup>-1</sup>), and high-dose (4 μg·L<sup>-1</sup>) EOAZF groups. The HUVECs were damaged by HG. The secretion amounts of malondialdehyde (MDA), nitric oxide (NO), and endothelin-1 (ET-1) in HUVECs of different groups were measured to assess the protective effect of EOAZF against HG-induced injury. The effects of EOAZF on the apoptosis and reactive oxygen species (ROS) generation of HUVECs damaged by HG were detected by Annexin V-fluorescein isothiocyanate/propidium iodide (Annexin V-FITC/PI) staining and dichloro-dihydro-fluorescein diacetate (DCFH-DA) assay. The protein and mRNA expression levels of thioredoxin interacting protein (TXNIP) and thioredoxin 1 (Trx-1) were determined by Western blot and Real-time polymerase chain reaction (Real-time PCR), followed by the measurement of total intracellular Trx-1 activity with insulin disulfide reduction method. Result:The comparison with the control group revealed that the proliferation of HUVECs in the model group was significantly inhibited and their shape was damaged. Compared with the model group, EOAZF protected HUVECs against HG-induced injury in a concentration-dependent manner. The secretion amounts of MDA and ET-1 (<italic>P</italic><0.05) in the model group were increased in contrast to those in the control group, while the NO level was decreased (<italic>P</italic><0.01). Compared with the model group, EOAZF at all the three concentrations, especially at 4 μg·L<sup>-1</sup>, obviously reduced the secretion of MDA and ET-1 (<italic>P</italic><0.05), but elevated NO after HG induction (<italic>P</italic><0.05). The cell apoptosis assay and ROS detection results demonstrated that the apoptosis and ROS level in the model group were higher than those in the control group (<italic>P</italic><0.01). Compared with the model group, EOAZF at 4 μg·L<sup>-1 </sup>significantly lowered the ROS level and apoptosis (<italic>P</italic><0.05) of HUVECs damaged by HG. The Western blot assay and Trx-1 activity detection uncovered that the protein and mRNA expression levels of TXNIP in the model group were significantly up-regulated as compared with those in the control group (<italic>P</italic><0.05), whereas the Trx-1 activity was decreased (<italic>P</italic><0.01). Compared with the model group, EOAZF at 4 μg·L<sup>-1 </sup>significantly down-regulated the mRNA and protein (<italic>P</italic><0.05) expression levels of TXNIP and enhanced the total Trx-1 activity (<italic>P</italic><0.05) in HUVECs, thus suppressing the oxidative stress. Conclusion:EOAZF exerts the protective effects against HG-induced injury in HUVECs by improving the endothelial function and reducing intracellular ROS and apoptosis. Its efficacy in anti-oxidative stress may be related to the down-regulation of mRNA and protein expression levels of TXNIP and the enhancement of Trx-1 activity.

19.
Article in Chinese | WPRIM | ID: wpr-906256

ABSTRACT

Qingjin Huatanpang, first contained in Yixue Tongzhi, was composed of eleven medicinal materials of Scutellariae Radix, Gardeniae Fructus, Fritillariae Thunbergii Bulbus, Mori Cortex, Trichosanthis Semen Tostum, Citri Exocarpium Rubrum, Platycodonis Radix, Ophiopogonis Radix (core removed), Anemarrhenae Rhizoma, Poria and Glycyrrhizae Radix et Rhizoma. It is a classic prescription created by YE Wen-ling in Ming dynasty for treating pulmonary disease with phlegm-heat obstructing lung syndrome. With the significant functions of clearing heat and moistening lung, reducing phlegm and relieving cough, it has been included in the "Classic Catalogue of Ancient Classics (First Batch)". Modern pharmacological studies have shown that Qingjin Huatantang has multiple activities such as relieving cough and eliminating phlegm, anti-inflammatory, bronchodilation, and immunoregulatory, and now it is commonly used for treating infectious lung diseases, such as acute exacerbation of chronic obstructive pulmonary disease, community acquire pneumonia, bronchiectasis, acute and chronic bronchitis in a form of its modified prescription or its combined use with western medicine, consistent with the clinical application in ancient times. According to the literatures on the study of Qingjin Huatantang published in recent years, this paper summed up the historical evolution, compatibility analysis, chemistry constituents, quality control, advances in pharmacology research, and clinical uses, which can provide theoretical and experimental data reference for further research and development, and proposed to establish a biological activity assay for quality control based on the pharmacological effect such as immunoregulatory activity, which can improve its quality control method and provide a reference for other famous classical formulas.

20.
Article in Chinese | WPRIM | ID: wpr-906233

ABSTRACT

Objective:To investigate the effect of compatibility of Anemarrhenae Rhizoma-Phellodendri Chinensis Cortex couplet medicines on glucolipid metabolism in type 2 diabetic rats before and after salt-processing. Method:The type 2 diabetic rat model was induced by high-fat and high-glucose diet combined with low dose streptozotocin (STZ), the model rats were randomly divided into six groups, including the model group, metformin group (200 mg·kg<sup>-1</sup>), and different compatibility groups of raw and salt-processed of Anemarrhenae Rhizoma and Phellodendri Chinensis Cortex (6.48 g·kg<sup>-1</sup>). In addition, The same week old rats fed with normal diet were set as the blank group. After 30 d of continuous intragastric administration, changes of fasting blood glucose (FBG), fasting serum insulin (FINS), glycosylated serum protein (GSP), hepatic glycogen, blood lipid [total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], nonesterified fatty acid (NEFA), adipocytokines [adiponectin (ADP) and leptin)], kidney function [blood urea nitrogen (BUN) and creatinine (CRE)] and other indicators of rats from different groups were detected, and the insulin sensitivity index (ISI) and insulin resistance index (HOMA-IR) were calculated, hematoxylin-eosin (HE) staining was used to observe the morphological changes of pancreas, liver and kidney of rats from different groups. Result:Compared with the model group, compatibility of Anemarrhenae Rhizoma-Phellodendri Chinensis Cortex couplet medicines before and after salt-processing all could decrease the levels of FBG, GSP, TC, TG, LDL-C, NEFA, leptin, BUN, CRE and HOMA-IR, and increase the contents of FINS, HDL-C, ADP, hepatic glycogen and ISI, among which the compatibility of salt-processed Anemarrhenae Rhizoma and salt-processed Phellodendri Chinensis Cortex had the most significant effect on regulating glucolipid metabolism in type 2 diabetic rats. The compatibility of all couplet medicines could improve the histopathological changes of pancreas, liver and kidney in type 2 diabetic rats, among which the compatibility of salt-processed Anemarrhenae Rhizoma and salt-processed Phellodendri Chinensis Cortex had the most prominent effect on repairing pathological damage. Conclusion:The compatibility of Anemarrhenae Rhizoma and Phellodendri Chinensis Cortex before and after salt-processing can improve glucolipid metabolism in type 2 diabetic rats, while the comprehensive effect of salt-processed Anemarrhenae Rhizoma and salt-processed Phellodendri Chinensis Cortex<italic> </italic>on lowering glucose and regulating lipid is the best.

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