Evidence quality assessment of acupuncture intervention for stroke hemiplegia: an overview of systematic reviews and meta-analyses.

Objective: Summarize the conclusions of the systematic review/meta-analysis of the clinical efficacy of acupuncture for stroke hemiplegia, and evaluate its methodological quality and the quality of evidence. Methods: Two researchers searched and extracted 8 databases for systematic reviews (SRs)/meta-analyses (MAs), and independently assessed the methodological quality, risk of bias, reporting quality, and quality of evidence of SRs/MAs included in randomized controlled trials (RCTs). Tools used included the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The search time is from database building to July 2023. Results: A total of 11 SRs/MAs were included, including 2 English literature and 9 Chinese literature, with all study sites in China. AMSTAR-2 evaluation results showed that the methodological quality of 11 articles was rated as very low quality; Based on the ROBIS evaluation results, the SRs/MAs was assessed as a high risk of bias; According to the results of the PRISMA checklist evaluation, most of the SRs/MAs reports are relatively complete; according to GRADE system, 42 outcomes were extracted from the included SRs/MAs for evaluation, of which 1 was rated as high-quality evidence, 14 as moderate-quality evidence, 14 as low-quality evidence, and 13 as very low-quality evidence. Conclusion: The available evidence indicates that acupuncture has certain clinical efficacy in the treatment of stroke hemiplegia. However, there are still some limitations to this study, such as the lower quality of SRs/MAs methodologies and evidence included, and more high-quality studies are needed to verify them.

Exploring the causal relationship between female reproductive traits and frailty: a two-sample mendelian randomization study.

Background: The impact of female reproductive factors, including age at menarche (AAM), age at first birth (AFB), age at first sexual intercourse (AFS), age at natural menopause (ANM), and pregnancy abortion (PA), on the risk of developing frailty remains uncertain. Our objective is to examine the potential causal relationship between female reproductive traits and frailty through the utilization of two-sample univariable Mendelian Randomization (UVMR) and multivariable Mendelian Randomization (MVMR) analyses. Methods: Leveraging large-scale Genome-Wide Association Study (GWAS) data from individuals of European ancestry, we performed two-sample UVMR and MVMR analyses to examine the causal relationship between female reproductive traits and frailty. The primary analysis employed inverse-variance-weighted (IVW) estimation, and sensitivity analyses were conducted to assess the robustness of the findings. Results: The UVMR analysis revealed a significant causal relationship between female reproductive traits (AFS, AFB, AAM) and frailty [IVW: OR = 0.74, 95%CI(0.70-0.79), p = 0.000; OR = 0.93, 95%CI(0.92-0.95), p = 0.000; OR = 0.96, 95%CI(0.95-0.98), p = 0.000]. However, there was no significant effect of ANM and PA on frailty (p > 0.05). The sensitivity analysis results were robust, supporting the findings. Furthermore, this association remained significant even after adjusting for body mass index (BMI) and educational attainment (EA) in the MVMR analysis [IVW: OR = 0.94, 95%Cl (0.91-0.97), p = 0.000; OR = 0.77, 95%Cl (0.70-0.86), p = 0.000; OR = 0.95, 95%Cl (0.94-0.97), p = 0.000]. BMI and EA serve as mediators in this process. Conclusion: Our research has established a significant causal relationship between female reproductive traits (AFS, AFB, AAM) and frailty, with BMI and EA acting as mediating factors in this process. However, further research is warranted to validate our findings and elucidate the underlying biological mechanisms.

Evidence quality assessment of sodium tanshinone IIA sulfonate injection intervention coronary heart disease angina pectoris: An overview of systematic reviews and meta-analyses.

BACKGROUND: Sodium tanshinone IIA sulfonate injection (STS) is widely used in the clinical treatment of coronary heart disease angina pectoris (CHDAP). This article systematically summarizes and evaluates the available evidence for STS in the treatment of AP, and assess its quality. METHODS: Two researchers searched and extracted 8 databases for systematic reviews (SRs)/meta-analyses (MAs), and independently assessed the methodological quality, risk of bias, reporting quality, and quality of evidence of SRs/MAs included in randomized controlled trials (RCTs). Tools used included the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the risk of bias in systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. RESULTS: This overview includes 11 SRs/MAs that use quantitative calculations to comprehensively evaluate various efficacies of STS in AP intervention. The methodological quality, reporting quality, risk of bias, and quality of evidence for outcome measures of SRs/MAs were all unsatisfactory. All SRs/MAs are of low quality according to the results of the AMSTAR-2 assessment, and only a small number of SRs/MAs were assessed as low risk of bias based on the results of the ROBIS assessment, and none of the SRs/MAs has been fully reported on the checklist. According to GRADE system, 33 outcomes were extracted from the included SRs/MAs for evaluation, of which 12 were rated as moderate-quality evidence, 7 as low-quality evidence, and 14 as very low-quality evidence. Limitations included the lack of essential items such as protocol registration, screening of duplicate studies, provision of a list of excluded studies and assessment of publication bias. CONCLUSION: Tanshinone IIA Sulfonate Sodium Injection may be an effective and safe treatment method. However, further standardized, comprehensive SRs/MAs and RCTs are needed to provide evidence-based medical support.

The efficacy and safety of sodium tanshinone â ¡A sulfonate injection in the treatment of unstable angina pectoris: A systematic review and meta-analysis.

OBJECTIVE: To systematically evaluate the efficacy and safety of Sodium tanshinone ⅡA sulfonate injection (STS) in the treatment of unstable angina pectoris (UAP). METHODS: CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Web of Science, Embase were searched by computer. The research covers the clinical randomized controlled trials of STS in the treatment of unstable angina pectoris published from the establishment of the library to January 31, 2023. Two researchers independently screened the literature, extracted data and evaluated the risk of research bias, and then conducted meta-analysis with RevMan5.3 software. RESULTS: A total of 37 randomized controlled trials were included, involving 3926 patients in total. Meta analysis results showed that, compared with conventional western medicine alone, STS combined with conventional western medicine could reduce the frequency (SMD = -2.61, 95%CI[-4.27, -0.96], P = 0.002) and duration (SMD = -4.01, 95%CI[-6.18, -1.84], P = 0.0003) of angina pectoris, improve ECG efficacy (OR = 3.61, 95%CI[2.79, 4.68], P<0.00001) and clinical symptom efficacy (OR = 4.02, 95%CI[3.32, 4.87], P<0.00001), reduce TG(SMD = -0.60, 95%CI[-1.04, -0.16], P = 0.008), TC(SMD = -3.86, 95%CI[-6.37, -1.34], P = 0.003), and LDL-C(SMD = -1.54, 95%CI[-2.67, -0.42], P = 0.007), decrease plasma viscosity(SMD = -1.02, 95%CI[-1.58, -0.47], P<0.0003), whole blood low shear viscosity(SMD = -0.85, 95%CI[-1.21, -0.49], P<0.00001), whole blood high shear viscosity(SMD = -0.82, 95%CI[-1.44, -0.20], P = 0.009), and erythrocyte aggregation index(SMD = -1.00, 95%CI[-1.75, -0.25], P = 0.009), and bring down CRP(SMD = -1.39, 95%CI[-1.91, -0.86], P<0.00001). The incidence of adverse reactions in the treatment group was higher than that in the control group (OR = 2.26, 95%CI[1.06, 4.85], P = 0.04). Neither of the two groups suffered from abnormal liver and kidney function during the study process. CONCLUSION: STS combined with routine treatment has a definite clinical efficacy and certain safety in the treatment of UAP, but it needs to be further confirmed by high-quality and low-bias randomized controlled trials in the future.

Efficacy of Acupuncture in the Treatment of Essential Hypertension: An Overview of Systematic Reviews and Meta-Analyses.

Background: Acupuncture is widely used in the clinical treatment of essential hypertension (EH). This overview is aimed at summarizing current systematic reviews of acupuncture for EH and assessing the methodological bias and quality of evidence. Methods: Two researchers searched and extracted 7 databases for systematic reviews (SRs)/meta-analyses (MAs) and independently assessed the methodological quality, risk of bias, reporting quality, and quality of evidence of randomized controlled trials (RCTs) included in the SRs/MAs. Tools used included the measurement tool to assess systematic reviews 2 (AMSTAR-2), the risk of bias in systematic (ROBIS) scale, the checklist of preferred reporting items for systematic reviews and meta-analyses (PRISMA), and the grading of recommendations assessment, development, and evaluation (GRADE) system. Results: This overview included 14 SRs/MAs that use quantitative calculations to comprehensively assess the various effects of acupuncture in essential hypertension interventions. The methodological quality, reporting quality, risk of bias, and quality of evidence for outcome measures of SRs/MAs were all unsatisfactory. According to the results of the AMSTAR-2 assessment, all SRs/MAs were of low or very low quality. According to the results of the ROBIS evaluation, a few SRs/MAs were assessed as low risk of bias. According to the results of the PRISMA checklist assessment, SRs/MAs that were not fully reported on the checklist accounted for the majority. According to the GRADE system, 86 outcomes were assessed under different interventions in SRs/MAs, and 2 were rated as moderate-quality evidence, 23 as low-quality evidence, and 61 as very low-quality evidence. Limitations of the included SRs/MAs included the lack of necessary items, such as not being registered in the protocol, not providing a list of excluded studies, and not analyzing and addressing the risk of bias. Conclusion: Currently, acupuncture may be an effective and safe treatment for EH, but the quality of evidence is low, and caution should be exercised when applying this evidence in clinical practice.

Screening and Analysis of Potential Critical Gene in Acute Myocardial Infarction Based on a miRNA-mRNA Regulatory Network.

Background: MicroRNAs (miRNAs) have been shown to be involved in the initiation, progression, and prevention of acute myocardial infarction (AMI), but the underlying mechanism remains unclear. Objective: Through the GEO database, bioinformatics methods were used to explore the miRNA-mRNA regulatory relationship pairs associated with AMI and to elucidate the underlying mechanism. Methods: Using the R software Limma package, differential expression analysis was performed using the AMI-related miRNA chip dataset (GSE31568) and mRNA chip dataset (GSE159657) from the GEO database. The miRDB, miRWalk, miRTarBase, and TargetScan databases were used to predict potential downstream target genes regulated by differentially expressed miRNAs, and a miRNA-mRNA regulatory network was built with Cytoscape; GO function and KEGG pathway enrichment analyses of target genes were done with Funrich software, and the protein interaction network of target genes in the regulatory network was built with the STRING database. Results and Conclusions: A total of 187 differentially expressed miRNAs were experimentally screened, of which 91 were upregulated (such as hsa-miR-302b, hsa-miR-1299), and 96 were downregulated (such as hsa-miR-1201, hsa-miR-1283); 507 differentially expressed mRNAs were identified, of which 430 were upregulated (such as MRM1 and SFXN4), and 77 were downregulated (such as KCTD13 and CCDC134). And 16 miRNAs and 44 mRNAs were used for regulatory network construction. GO and KEGG enrichment analyses mainly focused on Integrins in angiogenesis, angiopoietin receptor Tie2-mediated signaling, and signaling events mediated by stem cell factor receptor (c-Kit). As hub genes in the PPI network, FGF2 and MMP2 may be key targets of AMI. The experimentally constructed miRNA-mRNA regulatory network found that hsa-miR-190b targets to inhibit FGF2, while hsa-miR-330-3p targets to regulate MMP2, which may mediate Integrins in angiogenesis, Angiopoietin receptor Tie2-mediated signaling pathway to induce AMI pathogenesis, providing strong data support and a research direction for the prevention and treatment of AMI.

Analysis of the effects of Zhenju antihypertensive tablet on efficacy, safety and vascular endothelial function in patients with essential hypertension: A protocol for systematic review and meta-analysis.

BACKGROUND: : As a compound preparation of traditional Chinese and western medicine included in Volume 20 of Chinese traditional Medicine prescription, Zhenju antihypertensive tablet has been widely used in the treatment of patients with essential hypertension (EH) for many years. This study intends to evaluate the efficacy, safety and vascular endothelial function of Zhenju antihypertensive tablet in the treatment of essential hypertension. METHODS: : The search strategies of different websites were searched on Cochrane Central controlled Trials Registry, PubMed, excerpt database, Chinese Biomedical Literature Database, China National knowledge Infrastructure, Chinese Science and Technology Journal Database, WanFang, and other websites. All qualified studies were confirmed to include randomized controlled trials. The search time range was from January 1, 1900 to August 31, 2021. At the same time, the list of references and related reviews were checked. Two evaluators were responsible for the extraction and management of the data independently. The literature quality was evaluated according to Cochrane manual 4.2.2. Heterogeneity test and Meta analysis were carried out by Review ManagerV.5.3 software. The bias risk included in the study was evaluated by Cochrane "bias risk" tool. In addition, the relevant statistical data were evaluated by GRADE3.6 evidence quality grading system. RESULTS: : This study intends evaluate the efficacy and safety of Zhenju antihypertensive tablet in the treatment of EH from 4 aspects, including changes in blood pressure (systolic blood pressure, diastolic Blood pressure), effective hypotension, changes in endothelial function (NO, the level of plasma endothelin-1 in serum), and adverse reactions. CONCLUSION: : The conclusion of this study intends to provide evidence for judging the effectiveness and safety of ZJAHC intervention on EH patients and their endothelial function.PROSPERO registration number: PROSPERO CRD42021235309.

Efficacy and safety of Xinkeshu in the treatment of angina pectoris of coronary heart disease: A protocol for systematic review and meta-analysis.

BACKGROUND: The incidence of angina pectoris (AP) of coronary heart disease (CHD) is increasing in the world, which seriously affects people's lives and brings a huge economic burden. The clinical research on Xinkeshu (XKS) in the treatment of AP of CHD has been increasing. However, there is no systematic review and meta-analysis. This study intends to provide a basis for systematically evaluating the efficacy and safety of XKS combined with conventional western medicine in the treatment of AP of CHD. METHODS: CNKI, Wanfang, VIP, Web of Science, PubMed, Cochrane Library, and EMbase databases were searched for the period from the establishment of the database to August 31, 2021. The clinical randomized controlled trials of XKS in the treatment of AP of CHD were collected. Two systematic reviewers independently selected the literature, extracted the data, and evaluated the quality according to the inclusion and exclusion criteria. The methodological quality of the literature was evaluated using Cochrane Handbook 5.3.0 bias risk assessment tool, RevMan 5.3.0 software was used for meta-analysis and GRADE3.6 evidence quality grading system was used to evaluate the quality. RESULTS: This study intended to evaluate the efficacy and safety of XKS in the treatment of AP of CHD from many aspects, including the frequency of AP, the duration of AP, the dosage of nitroglycerin, and the efficacy of ECG (total effective rate = markedly effective + effective). The secondary indicators included the efficacy of AP (total effective rate = significant + effective), blood lipids (triglyceride, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol), hemorheology (whole blood viscosity, plasma viscosity, and fibrinogen), serum factors (C-reactive protein, endothelin-1, homocysteine, and nitric oxide), and adverse drug reactions. CONCLUSION: The conclusion of the systematic review intended to provide clear evidence of clinical application of XKS combined with conventional western medicine in the treatment of AP of CHD, which can be widely used in the clinic.

Efficacy and safety of Xuanfei Baidu granules for treating COVID-19: A protocol for systematic review and meta-analysis.

BACKGROUND: Corona Virus Disease 2019 (COVID-19) is currently prevalent in most countries around the world. It has become a common threat to global human health because there is no specific cure and no targeted treatment for this disease at this stage. Xuanfei Baidu granule (XFBD) included the traditional Chinese medicine prescription in COVID-19 diagnosis and treatment Plan (trial eighth Edition) released in August 2020, which has played a great role in the diagnosis and treatment of COVID-19 in Wuhan, China. This paper intends to evaluate the efficacy and safety of Xuanfei Baidu granule in the treatment of COVID-19. METHODS: The search strategies of different websites were searched on Cochrane Central controlled Trials Registry, PubMed, excerpt database, Web of science, China National knowledge Infrastructure, Chinese Science and Technology Journal Database, WanFang and other websites. All qualified studies were confirmed to include randomized controlled trials. The search time range was from January 1, 2019 to February 28, 2021. In the meanwhile, the list of references and related reviews was checked. Two evaluators were responsible for the extraction and management of the data independently. The literature quality was evaluated according to Cochrane manual 4.2.2. Heterogeneity test and Meta analysis were carried out by Review Manager V.5.3 software. The bias risk included in the study was evaluated by Cochrane "bias risk" tool, and the relevant statistical data were evaluated by GRADE3.6 evidence quality grading system. RESULTS: This study intends to evaluate the efficacy and safety of XFBD in the treatment of COVID-19 from 4 aspects, including nucleic acid negative conversion time, average hospital stay, clinical symptom improvement rate and lung computed tomography improvement rate. CONCLUSION: The conclusion of this scheme intends to provide evidence for judging whether the intervention of XFBD on COVID-19 patients is effective or not. PROSPERO REGISTRATION NUMBER: CRD42021245640.

Efficacy and safety of Shugan Jieyu capsule in the treatment of essential hypertension with insomnia, anxiety or depression: A protocol for systematic review and meta-analysis.

BACKGROUND: Shugan Jieyu capsule can reduce blood pressure and improve its concomitant symptoms. However, it is not widely used in clinic because of its incomplete understanding of its nature. There are many reports on the clinical trials of Shugan Jieyu capsule in the treatment of essential hypertension with insomnia, anxiety or depression in recent years. However, the lack of systematic review and meta-analysis has not provided effective evidence. As a consequence, we provide a protocol to evaluate the efficacy and safety of Shugan Jieyu capsule (SJC) in the treatment of essential hypertension (EH) with insomnia, anxiety or depression. METHODS: The search time range of Cochrane Library, PubMed, excerpt Database (EMBASE), Chinese Biomedical Literature Database (CBM), China National knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Database (VIP), and Wanfang Database (WanFang), was searched by computer from the establishment of the database to December 31, 2020. In the meanwhile, the list of references and related reviews were checked. The data were extracted by 2 evaluators independently, and the literature quality was evaluated according to Cochrane manual 4.2.2. In addition, CochraneRevman5.3 software was used for heterogeneity test, meta-analysis, publication bias analysis and GRADE3.6 evidence quality classification system evaluation related statistical data. RESULTS: This study intends to evaluate the efficacy and safety of SJC in the treatment of EH from many aspects, including changes in blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)], effective rate of blood pressure reduction, improvement rate of concomitant symptoms and adverse reactions. CONCLUSION: The conclusion of systematic review intends to provide evidence for judging that SJC is an effective intervention for EH patients with insomnia, anxiety and depression. PROSPERO REGISTRATION NUMBER: PROSPERO CRD 42021219704.

Efficacy and safety of Yangxue Qingnao granules for the treatment of essential hypertension: A protocol for systematic review and meta-analysis.

BACKGROUND: Essential hypertension is a major risk factor for many fatal cardiovascular and cerebrovascular diseases and has become a heavy burden on families and society. At present, the prevention and treatment of essential hypertension is still unsatisfactory. Yangxue Qingnao granules is a kind of Chinese patent medicine that has been used to treat essential hypertension. The objective of this protocol is to systematically evaluate the efficacy and safety of Yangxue Qingnao granules in the treatment of essential hypertension. METHODS: Randomized controlled trials on Yangxue Qingnao granules for essential hypertension will be searched from the following databases: PubMed, EMbase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database, and China Biology Medicine disc from inception to August 27, 2021, regardless of language. Study screening and data extraction will be carried out by two independent reviewers. The quality of the included studies will be assessed using Cochrane risk-of-bias tool for randomized trials. Statistic analysis will be performed using RevMan 5.3 software. The quality of evidence will be assessed using GRADE approach. RESULTS: This study will systematically evaluate the efficacy and safety of Yangxue Qingnao granules in the treatment of essential hypertension and provide high-quality evidence for clinical practice. CONCLUSION: The findings of this systematic review will provide high-quality evidence to verify the efficacy and safety of Yangxue Qingnao granules in the treatment of essential hypertension. INPLASY REGISTRATION NUMBER: INPLASY202190015.