[Network Meta-analysis of single Hirudo prescriptions in treatment of ischemic cerebrovascular disease].

This study intended to evaluate the efficacy and safety of single Hirudo prescriptions in the treatment of ischemic cerebrovascular disease(ICVD) by frequency network Meta-analysis and traditional Meta-analysis. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library databases were searched to collect the randomized controlled trial(RCT) of single Hirudo prescriptions for ICVD from the inception of the databases to May 2022. The quality of the included literature was evaluated by Cochrane risk of bias tool. Finally, 54 RCTs and 3 single Hirudo prescriptions were included. Statistical analysis was conducted by RevMan 5.3 and Stata SE 15. Network Meta-analysis showed that in terms of the clinical effective rate, the surface under the cumulative ranking curve(SUCRA) of intervention measures was as follows: Huoxue Tongmai Capsules+conventional treatment>Maixuekang Capsules+conventional treatment>Naoxuekang Capsules+conventional treatment>conventional treatment. Traditional Meta-analysis revealed that in terms of the safety of ICVD treatment, Maixuekang Capsules+conventional treatment had higher safety than conventional treatment alone. According to the network Meta-analysis and traditional Meta-analysis, it was found that conventional treatment combined with single Hirudo prescriptions improved the clinical efficacy of ICVD patients, and compared with that of conventional treatment alone, the incidence of adverse reactions of combined treatment was low and the safety was high. However, the methodological quality of the articles included in this study was generally low and there were large differences in the number of articles on the three combined medication. Therefore, the conclusion of this study needed to be confirmed by subsequent RCT.

Patients with different types of arthritis may be at risk for major depression: results from the National Health and Nutrition Examination Survey 2007-2018.

BACKGROUND: Arthritis is one of the common causes of physical pain and disability, which often makes patients fall into major depression. However, the correlation between arthritis and major depression, and how different types of arthritis correspond to major depression remain to be explored. The purpose of this study is to explore the relationship between arthritis and major depression. METHODS: Arthritis status was reported by participants themselves, and the Patient Health Questionnaire-9 in National Health and Nutrition Examination Survey (NHANES) was used to evaluate major depression, logistic regression was used to evaluate the relationship between arthritis and major depression. RESULTS: We analyzed the data of 25,990 adults who participated in the NHANES from 2007 to 2018. Participants with major depression were more likely to be female, Hispanic, smoker, less educated, less recreational activities, poverty-to-income ratio <5, coronary heart disease, stroke, cancer or malignant tumor, diabetes, hypertension and higher body mass index (BMI). Arthritis was significantly correlated with major depression (25.4% vs. 44.9%; P<0.001), even after adjusting for gender, age, race, BMI, PIR, education, marriage, moderate recreational activities, smoking, history of coronary heart disease, stroke, cancer or malignant tumor, diabetes, and hypertension (OR =2.30, 95% CI, 2.06-2.56, P<0.001). Subgroup analysis showed that compared with degenerative arthritis, rheumatoid arthritis (RA), or other arthritis, psoriatic arthritis (PsA) had the greatest influence on major depression patients. CONCLUSIONS: All patients with arthritis, especially PsA, may have the risk of major depression. Psychological intervention necessary for patients with arthritis.