Essential oils for treating anxiety: a systematic review of randomized controlled trials and network meta-analysis.

Background and purpose: The findings of clinical studies exploring essential oils (EOs) for anxiety remain disputed, and no studies have yet clarified the differences in the efficacy of EOs. The purpose of the study was to directly or indirectly compare the efficacy of different types of EOs on anxiety by pooling the results of randomized controlled trials (RCTs). Methods: PubMed, Cochrane Library, Embase, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to November 2022. Only full texts of RCTs that investigated the effects of EOs on anxiety were included. The trial data were extracted and the risk of bias was assessed by two reviewers independently. Pairwise meta-analysis and network meta-analysis were performed by Stata 15.1 or R 4.1.2 software. Results: Forty-four RCTs (fifty study arms) involving 10 kinds of EOs and 3419 anxiety patients (1815 patients in EOs group and 1604 patients in control group) were included. Pairwise meta-analyses showed that EOs were effective in reducing State Anxiety Inventory scores (SAIS) [WMD = -6.63, 95% CI-8.17, -5.08] and Trait Anxiety Inventory scores (TAIS) [WMD = -4.97, 95% CI-6.73, -3.20]. Additionally, EOs could decrease systolic blood pressure (SBP) [WMD = -6.83, (95% CI -10.53, -3.12), P < 0.001] and heart rate (HR) [WMD = -3.43, (95% CI -5.51, -1.36), P < 0.001]. Network meta-analyses demonstrated that regarding the outcome of SAIS, Jasminum sambac (L.)Ait. (jasmine) was the most effective with a weighted mean difference (WMD) of-13.61 (95% CrI-24.79, -2.48). Followed by Citrus (citrus aurantium L.), which had a WMD of-9.62 (95% CrI-13.32, -5.93). Moderate effect sizes were observed for Rosa rugosa Thunb. (damask rose) (WMD = -6.78, 95% CrI-10.14, -3.49) and Lavandula angustifolia Mill. (lavender) (WMD = -5.41, 95% CrI-7.86, -2.98). Regarding the results of TAIS, citrus aurantium L. was the best ranked intervention with a WMD of-9.62 (95% CrI-15.62, -3.7). Moderate-to-large effect sizes were observed for Citrus limon (L.) Burm. F. (lemon) (WMD:-8.48; 95% CrI-16.67, -0.33) and lavender (WMD:-5.5; 95% CrI-8.7, -2.46). Conclusion: According to the comprehensive analysis, EOs are effective in reducing both state anxiety and trait anxiety, and citrus aurantium L. essential oil seems to be the most recommended type of EO for treating anxiety because of its significant effects in reducing SAIS and TAIS. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022331319.

[Knowledge graph analysis of pyroptosis research in traditional Chinese medicine based on VOSviewer and CiteSpace].

To explore the research hotspots and frontier directions of pyroptosis in the field of traditional Chinese medicine(TCM), the authors searched CNKI and Web of Science for literature related to pyroptosis in TCM, screened literature according to the search strategy and inclusion criteria, and analyzed the publication trend of the included literature. VOSviewer was used to draw author cooperation and keyword co-occurrence network diagrams, and CiteSpace was employed for keyword clustering, emergence, and timeline view. Finally, 507 Chinese literature and 464 English literature were included, and it was found that the number of Chinese and English literature was increasing rapidly year by year. The co-occurrence of the authors showed that in terms of Chinese literature, there was a representative research team composed of DU Guan-hua, WANG Shou-bao and FANG Lian-hua, and for English literature, the representative research team was composed of XIAO Xiao-he, BAI Zhao-fang and XU Guang. The network visualization of Chinese and English keywords revealed that inflammation, apoptosis, oxidative stress, autophagy, organ damage, fibrosis, atherosclerosis, and ischemia-reperfusion injury were the primary research diseases and pathological processes in TCM; berberine, resveratrol, puerarin, na-ringenin, astragaloside Ⅳ, and baicalin were the representative active ingredients; NLRP3/caspase-1/GSDMD, TLR4/NF-κB/NLRP3, and p38/MAPK signaling pathways were the main research pathways. Keyword clustering, emergence, and timeline analysis indicated that the pyroptosis research in TCM focused on the mechanism of TCM monomers and compounds intervening in diseases and pathological processes. Pyroptosis is a research hotspot in the area of TCM, and the current discussion mainly focuses on the mechanism of the therapeutic effect of TCM.

Growth factor for therapeutic angiogenesis in ischemic heart disease: A meta-analysis of randomized controlled trials.

Aim: This study was designed to systematically evaluate the effects of growth factor (GF) for therapeutic angiogenesis on ischemic heart disease (IHD) by pooling the results of randomized controlled trials (RCTs). Methods and Results: PubMed, EMBASE, and CENTRAL databases were searched from inception to October 2022. RCTs, investigating the effects of GF therapy on IHD, were included. The risk bias of included study was assessed according to Cochrane tool. Weighted mean difference (WMD), calculated with fixed effect model or random effect model, was used to evaluate the effects of GF therapy on left ventricular ejection fraction (LVEF) and Canadian Cardiovascular Society (CCS) angina class. Relative risk (RR) was used to evaluate the effects of GF therapy on all-cause mortality, major adverse cardiovascular events (MACE) and revascularization. Meta-analysis, meta-regression analysis and publication bias analysis were performed by RevMan 5.3 or Stata 15.1 software. Twenty-nine studies involving 2899 IHD patients (1,577 patients in GF group and 1,322 patients in control group) were included. Compared with the control group, GF therapy did not reduce all-cause mortality (RR: 0.82; 95% CI: 0.54-1.24; p = 0.341), MACE [(RR: 0.83; 95% CI: 0.61-1.12; p = 0.227), revascularization (RR: 1.27, 95% CI: 0.82-1.96, p = 0.290) and CCS angina class (WMD: -0.08, 95% CI: -0.36 to 0.20, p = 0.560). However, GF therapy could increase LVEF during short-term follow-up (<1 year). Conclusion: GF for therapeutic angiogenesis was beneficial for increasing LVEF during short-term follow-up (<1 year), however, the therapy was not efficacious in decreasing all-cause mortality, MACE and revascularization.

[Evidence mapping of clinical research on 20 Chinese patent medicines for hypertension].

In this study, evidence mapping was employed to sort out and summarise the evidence from clinical studies of Chinese patent medicines for hypertension and to understand the evidence distribution in related studies. Chinese patent medicines for hypertension were searched from Medicine Catalogue for National Basic Medical Insurance, Employment Injury Insurance, and Maternity Insu-rance(2021) and Chinese Pharmacopoeia(2020). Relevant articles(published from January 1, 2016 to February 14, 2022) were retrieved from Cochrane Library, PubMed, Web of Science, CNKI, Wanfang, VIP, and SinoMed. Then, the evidence distribution was analysed based on description, tables, and bubble charts. A total of 31 Chinese patent medicines were identified and 20 were finally included, involving 111 articles. The basic information of the 20 Chinese patent medicines, the number of related articles, the hypertension staging and traditional Chinese medicine(TCM) syndrome types of the subjects, sample size, interventions, and outcome indicators were compared. The results showed Chinese patent medicines with the function of pacifying liver and eliminating wind were frequently studied, and most of them were single-center, small-sample, short-period randomized controlled trials. They failed to highlight the key and advantages of TCM. A wide variety of outcome indicators were involved, and in addition to blood pressure, surrogate outcome indicators and composite outcome indicators were emphasized. However, health economic indicators, quality of life, and damage to target organs such as blood vessels and heart, were rarely used.

Association of body mass index trajectory and hypertension risk: A systematic review of cohort studies and network meta-analysis of 89,094 participants.

Introduction: Body mass index (BMI) trajectories, such as non-linear time trends and nonlinear changes in BMI with age, can provide information on the underlying temporal health patterns. The relationship between BMI trajectories and the risk of hypertension remains controversial. Methods: PubMed, Embase, Cochrane, Scopus, and Web of Science databases were searched from their inception to January 31, 2022. We categorized BMI trajectories as "Stable high," "table normal," "Stable low," "Fluctuated (sharp increase)," and "Fluctuated (elevated-decrease)." The main outcome was the relative risk for the prevalence of hypertension in the different BMI trajectories. Potential sources of heterogeneity were examined using meta-regression and subgroup analysis. A publication bias test and Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were also used. Results: The 18 cohort studies included 89,094 participants. Compared with the "Stable normal" trajectory, "Stable high," "Fluctuated (sharp increase)," and "Fluctuated (elevated-decrease)" trajectories were associated with an increased relative risk of hypertension: [RR (95% CI)]: 1.80 (1.29 2.50), p < 0.001; 1.53 (1.27 1.83), p < 0.001; 1.30 (1.24 1.37), p = 0.001, respectively. The "Stable low" trajectory was associated with a reduced risk of hypertension [0.83 (0.79 0.83), p < 0.001]. The "Stable high" trajectory (surface under the cumulative ranking curve = 88.1%) had the highest probability of developing hypertension in the population. The certainty of the evidence for direct comparisons of the incidence of hypertension between various BMI trajectories was generally very low. Conclusion: Our findings suggested that "Stable high," "Fluctuated (sharp increase)," and "Fluctuated (elevated-decrease)" trajectories were associated with an increased relative risk of hypertension, with the "Stable high" trajectory most likely associated with hypertension. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=308575], identifier [CRD42022308575].

[Clinical comprehensive evaluation of Wenxin Granules in treatment of arrhythmia with deficiency of Qi and Yin].

This study evaluated the safety, effectiveness, economy, innovation, suitability, accessibility, and characteristics of traditional Chinese medicine of Wenxin Granules in the treatment of arrhythmia(ventricular premature beat and atrial premature beat) with deficiency of Qi and Yin. The multi-criteria decision analysis(MCDA) model was adopted, and the criterion layer and index layer were weighted by experts. CSC v2.0 was used for clinical comprehensive evaluation. This study embodies the clinical value of Wenxin Granules, promotes its safe, effective and rational use, and provides a basis for national medical decision-making. The multi-source evidence shows that the major adverse reaction of Wenxin Granules is gastrointestinal damage. According to the available studies, Wenxin Granules has controllable risk and thus is rated as grade B in terms of safety. The systematic evaluation of effectiveness shows that compared with antiarrhythmic western medicine, Wenxin Granules demonstrates improved clinical efficacy and electrocardiogram efficacy, which is supported by high-quality evidence, and thus the effectiveness of Wenxin Granules is evaluated as grade A. Economic research shows that Wenxin Granules is more economical than antiarrhythmic western medicine, which is supported by sufficient evidence and clear results, and thus the economy of this preparation is rated as grade B. The indications and contraindications of Wenxin Granules are clear and detailed to different types of arrhythmia, which, together with the precise positioning and prominent clinical innovation and industrial innovation, rates it as grade A in terms of innovation. The suitability of drug storage, prescription circulation, dosage form and course of treatment basically meet the clinical medication needs of doctors and patients, and thus the suitability of Wenxin Granules is evaluated as grade B. Because of the few restrictions and the sustainable resources of medicinal materials, the accessibility of Wenxin Granules is evaluated as grade A. The prescription compatibility focuses on the pathogenesis characteristics of deficiency of Qi and Yin, and there are more than 3 000 cases studied. Therefore, the characteristics of traditional Chinese medicine of Wenxin Granules are evaluated as grade B. Based on the evidence from all the above dimensions, Wenxin Granules has the clinical comprehensive value of class A and prominent characteristics of traditional Chinese medicine. It is suggested to include Wenxin Granules into the policy results related to basic clinical medication management according to the procedure.

Metabonomics: A Useful Tool to Reveal Underlying Relationships between Altered Chinese Medicine Syndromes and Ultrafiltration in Treatment of Heart Failure.

OBJECTIVE: To reveal the underlying relationships between Chinese medicine (CM) syndromes and ultrafiltration (UF) in the treatment of heart failure based on a metabonomic approach. METHODS: Seventeen acute decompensated heart failure (ADHF) patients were enrolled, and their CM syndromes before and after UF were collected. In addition, their venous plasma collected before and after UF was used for liquid chromatographmass spectrometer-based metabonomic analysis. Both reversed phase liquid chromatography and hydrophilic interaction liquid chromatography were used to analyze the plasma samples. Partial least-squares to latent structure-discriminant analyses were used for data analysis. RESULTS: An obvious difference was observed pre- and post-treatment. A total of 17 potential biomarkers associating with alterd syndromes with UF including hypoxanthine, 1-methylhistidine, phytosphingosine, O-decanoyl-R-carnitine, etc. were screened out, showing a significant change after UF. The major adjusted metabolic pathways were purine metabolism, histidine metabolism, leucine and isoleucine metabolism, arginine and proline metabolism, carnitine shuttle, sphingolipid metabolism and phospholipid metabolism. CONCLUSIONS: Metabonomic approach is a useful tool to identify potential biomarkers of altered syndromes link to UF and could provide a theoretical basis for further research on the therapeutic mechanism of UF combined with CM.

[The Mie scattering lidar return signal denoising research based on EMD-DISPO].

Lidar echo signal is a typical non-steady-state, non-stationary signal, and difficult to be dealt with by the traditional filtering methods. As a new signal processing theory proposed in recent years, empirical mode decomposition method can adaptively divide the lidar echo signal into different intrinsic mode function (IMF) components according to different time scale, and noise mainly concentrates in the high-frequency component. However, when filtered with simply removing high frequency component, the useful signal will be possibly reduced. In the present paper, a new method which combines empirical mode decomposition (EMD) with Savitzky-Golay filter is proposed. With experiments, it is indicated that our approach not only removes the noise component effectively but also maintains the useful signal, then will improve the accuracy in the next phase of data processing.

[Clinical study on effect of qingxuan tiaoya recipe in treating menopausal women with hypertension].

OBJECTIVE: To investigate the effect and mechanism of Qingxuan Tiaoya Recipe (QXTYR) on depressing blood pressure in menopausal women with hypertension. METHODS: Patients were randomly assigned to two groups, the 44 patients in the test group were administered with perindopril tablet and QXTYR granule, while the 43 in the control group were administered with the same program, but a simulator of QXTYR was used to replace for the real one. The treatment course for them all was 2 months. Before and after treatment, the ambulatory blood pressure (ABMP), heart rate, related clinical symptoms, blood lipids, serum estradiol (E2), high-sensitivity C-reactive protein ( Hs-CRP), homocysteine (HCY) and angiotensin II (Ang II) were measured. RESULTS: The treatment in the test group showed an effect better than that in the control group in terms of reducing blood pressure variability and night-time blood pressure decrease rate (P <0.05), with the total effective rate and markedly effective rate in lowering blood pressure superior to the control group (P<0.05), alleviating symptoms as headache, soreness and weakness of the waist and knees, and insomnia (P <0.05), and decreasing levels of heart rate, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), Hs-CRP and Ang II (P <0.05), The plasma level of endogenous E2 was elevated after treatment in the test group (P< 0.05), but showed no statistical difference in the control group. CONCLUSIONS: QXTYR shows favorable effect in depressing blood pressure of menopausal women with hypertension, it can reduce blood pressure variability, improve the symptoms of the menopause syndrome, blood lipid metabolism and plasma levels of Hs-CRP, E2, and Ang II in patients, suggesting that its mechanism may be related to the functional regulation of sympathetic-vagus nerve and neuro-endocrine-immune system, and also the inhibition on the circulatory renin-angiotensin-aldosterone system activity.

A clinical study of Yigu capsule in treating postmenopausal osteoporosis.

OBJECTIVE: To observe the efficacy and safety of Yigu capsule (YGC), a Chinese herbal compound preparation, in treating postmenopausal osteoporosis (PMO) and to explore its possible mechanism. METHODS: The clinical study was conducted in a prospective, randomized, double blinded method lasting for 6 months with placebo and positive control. Two hundred and ten PMO patients with confirmed diagnosis were assigned into the YGC group, the calciferol group and the placebo group. Besides being administered element calcium, they were treated with YGC, calciferol capsule and placebo capsule respectively. And such symptoms as newly found fracture and ostealgia, bone mineral density (BMD) of the 2nd-4th lumbar vertebrae (L(2-4)) and upper femur, blood and urinary indexes for bone metabolism, sex hormone level and adverse reaction that occurred in patients were observed. RESULTS: In the YGC group, the total effective rate was 95.50%, with no new occurrence of fractures, which was significantly better than that in the other two groups (P < 0.05). Moreover, in the YGC group, the increase rate of BMD was 9.83% in L(2-4), 4.09% in femoral neck, 4.60% in Wards triangle, 3.00% in greater trochanter, which was also better than that in the placebo group (P < 0.05, P < 0.01). As compared with the placebo group, levels in the YGC group of urinary oxyproline hydroxyproline/creatinine, urinary calcium/creatinine were significantly lower, serum and bone alkaline phosphatase, osteocalcin, estradiol and estradiol/testosterone were significantly higher, but no difference was shown in the comparison of testosterone level. In the observation period, no abnormality in blood or urine routine, liver or renal function was found. Only mild, transient gastro-intestinal response occurred in individual patients, but it did not affect the treatment. CONCLUSION: YGC could treat PMO effectively, as it could obviously increase the BMD of lumbar vertebrae and coxafemoral bone, elevate the alleviating rate of ostealgia and incessant motion time, yet causing no newly found compressive fracture of vertebrae, or and any related adverse reaction. YGC could not only promote the formation, but also inhibit the absorption of bone as well as increase the sex hormone level. Therefore, it is a pure Chinese herbal compound preparation worthy of further research and development.

[Preliminary study on change of serum proteome in noxious heat blood stasis syndrome treated by radix Paeoniae rubra].

OBJECTIVE: To study the effect of red peony root (RPR) on serum proteome in rat suffering from noxious heat with blood stasis Syndrome (NH-BS). METHODS: The differences of serum proteome among rats in four groups, treated with lipopolysaccharide (LPS), RPR, LPS + RPR and saline respectively, were analyzed by bi-dimensional electrophoresis (2DE) assay. LPS was administered by intravenous injection and RPR by oral intake. RESULTS: (1) Serum of rats with LPS induced NH-BS showed significant changes in volume of serum protein (xPr) in 13 points on 2DE collagen, the volume of xPr 16 and 19 were significantly lower, volume of xPr 1, 2, 3, 4, 6, 7, 8, 9, 11, 12 and 23 were significantly higher respectively, as compared with those in the normal control group. (2) After being treated with RPR, the increased volume of xPr 1, 2, 3, 4 and 9 significantly decreased, and the decreased xPr 16 significantly increased, with xPr 2, 3 restored to normal level but the xPr16 still lower and xPr 1, 4, 9 higher than those in the normal group. RPR showed interaction with LPS on xPr 1, 3, 9, and 16. (3) For xPr 19, the interaction of RPR with LPS might be synergistic. (4) In the group treated with RPR, volumes of xPr 13 and 14 were significantly higher and those of 15, 17 were significantly lower than those in the normal group respectively, but the similar changes didn't found in the LPS group. CONCLUSION: The molecular basis of therapeutic effect of RPR on NH-BS might be through the regulation of xPr 1, 2, 3, 4, 9 and 16.

[Clinical study on effect of qingxin capsule in treating patients with hypertension of mild or moderate degree].

OBJECTIVE: To observe the therapeutic effect of qingxin capsule (QXC) in treating patients with hypertension of mild or moderate degree, and to explore its mechanism in lowering blood pressure. METHODS: Adopting randomized double-blind double-simulated positive controlled clinical trial design, 98 patients were randomly divided into three groups, they were treated by QXC (n = 34), captopril (n = 32) and QXC plus captopril (n = 32), respectively for 12 weeks. Changes of blood pressure, clinical symptoms, quality of life (QOF), plasma levels of calcitonin gene-related peptide (CGRP), angiotensin II (Ang II) and endothelin (ET) in patients before and after treatment were observed, and the adverse reactions to the treatment were recorded. RESULTS: The markedly effective rate in lowering blood pressure of QXC, captopril and QXC plus captopril was 44.1%, 53.1% and 75.0% respectively, the markedly effective rate in ameliorating symptoms was 56.0%, 47.0% and 50.0% respectively. In respect of reducing symptomatic scores, QXC > captopril > QXC + captopril, in respect of ameliorating QOF, QXC was superior to captopril (P < 0.05). Single or combined use of QXC and captopril could increase the plasma CGRP level. QXC could also reduce the plasma levels of Ang II and ET, showing statistical significance in comparing the levels before and after treatment (P < 0.05). CONCLUSION: QXC can safely and effectively lower blood pressure of patients with mild or moderate degree of hypertension. QXC alone or combined with captopril could improve clinical symptoms and raise QOF in patients more potently than that of captopril alone. The mechanism of QXC might be related with its inhibition on the activity of circulatory renin-angiotensin system and adjustment on ET/CGRP imbalance.

[Study on serum proteome of rat endotoxemia treated by figwort root].

OBJECTIVE: To study the serum proteome of rat endotoxemia treated by figwort root (FR). METHOD: The differences of serum proteome among rats treated with lipopolysaccharide (LPS), FR, LPS + FR and saline respectively were analyzed by two-dimensional electrophoresis (2DE) assay. RESULT: The volumes of sixteen serum proteins (xPr) in LPS induced-endotoxemia group were greatly changed compared with those of the control group. Among them, the volumes of xPr 16, 19 were significantly decreased, and the volumes of xPr 1, 2, 3, 4, 5, 6, 7, 8, 9, 11, 12, 14, 18, 23 were significantly increased. When treated with FR, the volumes of xPr 1, 6, 7, 8, 9, 11, 12, 14, 18, 23 were significantly decreased, and the volumes of xPr 8, 9, 11, 12, 23, 14 were back to normal level. Two factors statistic analysis showed that FR had interaction with LPS for xPr 1, 5, 8, 10, 11, 12, 18, 19, 20, 21, 22, and FR might be the functional antagonist of LPS. We also observed that the volumes of xPr 10, 13, 15, 20, 21, 22 were found to change significantly only in FR treated group but not in LPS treated group or control group. Interestingly, the volume of xPr 13, 20, 21, 22 were increased and the volume of xPr 10, 15 were decreased. CONCLUSION: The molecular basis of therapeutic effect of FR on endotoxemia might be through the regulation of xPr 1, 6, 7, 8, 9, 11, 12, 14, 18, 23. We can use proteomic techniques to study the molecular mechanisms of diseases treated by functional Chinese herbs and the combination of different herbs is necessary for the treatment of endotoxemia, as FR can not regulated all the changed proteins induced by LPS.