Impact of the intensive use of urban construction land on carbon emission efficiency: evidence from the urban agglomeration in the middle reaches of the Yangtze River.

Urban construction land, as the main carrier of socioeconomic activities, is also a land type that is associated with large carbon emissions. This study uses statistical data of the urban agglomeration in the middle reaches of the Yangtze River (UAMRYR) from 2006 to 2020 to examine the mechanism of the intensive use of urban construction land (IUUCL) on carbon emission efficiency (CEE) from the perspective of urban land resource utilization. The study shows that the capital-intensive and technology-intensive use of urban construction land can significantly increase CEE, while increased labor and energy intensification inhibits CEE. In addition, there is regional heterogeneity in the effect of the IUUCL on CEE. The external control factor industrial structure has the most obvious inhibiting effect on the CEE of the Wuhan urban circle, the intensive use of energy has become the crucial constraint on the carbon emission reduction of the city cluster around Poyang Lake, and the intensive use of science and technology is the key factor in realizing the green and low-carbon development of the Chang-Zhu-Tan city cluster. This study innovatively constructs a theoretical framework of IUUCL versus CEE and conducts a heterogeneous study on the CEE of intensive use of construction land from the perspective of urban agglomerations. By providing a better understanding of the intrinsic influence mechanism of both these processes, this study provides a new perspective for reducing carbon emissions.

Spatiotemporal heterogeneity and decoupling decomposition of industrial carbon emissions in the Yangtze River Delta urban agglomeration of China.

The objective of this study is to identify the spatiotemporal change law and the leading factors of industrial carbon emission decoupling. Based on the industrial carbon emission level of the Yangtze River Delta urban agglomeration (YRDUA) from 2006 to 2020, the spatiotemporal heterogeneity was explored with the help of the spatial Markov chain, the Tapio decoupling model was used to analyze its decoupling state from the industrial economy, and its driving factors were decomposed using the Kaya identity and logarithmic mean Divisia index (LMDI) model. The results show that (1) in 51.9% of the YRDUA's cities, the industrial carbon emission situation was stable, the emission reduction observation area (medium carbon) occupied a dominant position, and the emission reduction key area (relatively high carbon) gradually decreased. (2) Industrial carbon emissions had spatial overflow and path dependency characteristics, and the probability of carbon emission type transfer maintaining the original state reached 80.0%. From 2006 to 2011, the average probability of the downward migration of high-carbon cities was 5.0%. From 2011 to 2020, the average probability of the upward transfer of low-carbon cities was 9.4%. (3) The negative decoupling rate of carbon emissions in the YRDUA experienced a transition from 3.7% to 44.4% and then back to 7.4%, showing spatial imbalance. Unsatisfactory decoupling cities were concentrated along the Yangtze River and in coastal areas. (4) The promoting efficiency of energy intensity, carbon emission coefficient, and employment structure was gradually strengthened, and the carbon-increasing effect of labor input was gradually weakened. (5) The decoupling mode of heavy difficult cities is dominated by the three-factor balanced type, which is jointly affected by industrial production, labor input, and carbon emission coefficient. The findings in this study can provide inspiration for industrial carbon emission reduction in megalopolises.

Electrochemical and Photoelectrochemical Detection of Hydrogen Peroxide Using Cu2O/Cu Nanowires Decorated with TiO2-x Deriving from MXenes.

H2O2 is a major transmitter of redox signals in electrochemical processes, whose detection is relevant for various industries. Herein, we developed a new fabrication method for a Cu2O/Cu nanowire-based nonenzymatic H2O2 electrochemical sensor that was decorated with irregular TiO2-x nanoparticles deriving form Ti3C2 MXene. The TiO2-x/Cu2O/Cu-NW electrodes possess excellent selectivity, stability, and reproducibility for H2O2 detection in both EC and PEC operational modes. In the EC detection of H2O2, the TiO2-x/Cu2O/Cu-NW electrode shows a linear relationship in the range from 10 µM to 42.19 mM and a low detection limit of 0.79 µM (S/N = 3), which has a similar sensitivity but a much broader linear range compared with the commercial H2O2 analyzer (0-5.88 mM, Q45H/84, US-QContums). It also shows excellent recovery in detecting H2O2 in the real orange juice and milk samples with the recovery ranging from 96.9 to 105%, indicating the potential for practical applications. In the PEC detection of H2O2, the TiO2-x/Cu2O/Cu-NW electrode shows a lower detection limit of 59 nM (S/N = 3), which is 13 times more sensitive than the EC electrode. The enhanced PEC performance can be attributed to the formation of p-n heterojunction between TiO2-x and Cu2O, which improves light utilization and inhibits the recombination of photo-induced electrons and holes. This work illuminates the extraordinary potential of MXene-derived TiO2 in electrochemical and photoelectrochemical applications.

Spatiotemporal dynamics and decoupling mechanism of economic growth and carbon emissions in an urban agglomeration of China.

Carbon emissions and economic growth are two contradictions in urban development, and their decoupling is related to the sustainable development of cities. This paper took urban agglomeration in the middle reaches of the Yangtze River (UAMRYR), China, as the study area. The Kaya model, the Tapio decoupling model, and the Logarithmic Mean Divisia Index (LMDI) model were adopted to analyze the spatiotemporal differentiation of carbon emissions, the decoupling of economic activities, and driving factors. The results indicate that (1) carbon emissions increased by 66% in the study period, but the growth momentum was curbed after 2015. Low level and medium level areas continue to decrease, and relatively high level area gradually become dominant. (2) Spatially, carbon emissions are in a pattern of middle-hot and east-cold. Jiangxi is in the sub-cold and coldspot area, while the hotspot area is driven by the transformation from Wuhan's single-core to Wuhan and Changsha's dual-core. (3) Since 2010, most cities have been in a good decoupling state, and weak decoupling cities have risen from 35.5% in the initial period to 87.1% in 2010-2011, but the decoupling situation of industrial cities with more high-energy-consuming industries still rebounded slightly. (4) The economic level and energy intensity effect had the most significant impact on the economic decoupling of carbon emissions, whose absolute contribution rates were greater than 35%. Urbanization and economic level both play a positive role in promoting carbon emissions, and the energy intensity plays a negative role in retarding carbon emissions. The population effect was mainly manifested in carbon increase from 2006 to 2011, and 45.2% of the cities from 2011 to 2017 turned into carbon suppression. Finally, we suggest that decoupling carbon emissions from economic growth requires developing green urbanization and a decarbonized economy, optimizing the structure of energy consumption and guiding rational population flow.

Spatiotemporal pattern of regional carbon emissions and its influencing factors in the Yangtze River Delta urban agglomeration of China.

Urbanization is a critical factor affecting regional carbon emissions. Clarifying the linkage between urbanization and carbon emissions can provide a decision-making reference to realize China's goal of carbon neutrality. This article examines the spatiotemporal patterns of urbanization and carbon emissions in the Yangtze River Delta urban agglomeration from 2008 to 2018. A complete set of variables is considered to construct relevant land and ecological urbanization variables, and the Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) model and spatial Durbin model (SDM) are adopted to explore the impact of various driving factors on carbon emissions. The results indicate that (1) during the study period, the carbon emissions in the Yangtze River Delta urban agglomeration exhibited a fluctuating increase and that the incremental carbon emissions followed a downward trend. (2) Carbon emissions exhibited a positive spatial correlation. Cold- and hotspot areas indicated a three-gradient pattern from west to east, and a concentric circle radiation pattern occurred with Shanghai as the core. Carbon emissions were spatially imbalanced, but the centre of gravity slightly fluctuated, with a total migration distance of 38.48 km, indicating a migration trend towards the southeast. (3) Regarding the two considered dimensions of urbanization, all driving factors except urbanization played a role in carbon emission enhancement. Consequently, for every 1% increase in economic factors, the carbon emissions correspondingly increased by 0.43-0.57%. Hence, economic factors are the most important factors promoting increased carbon emissions. In the ecological urbanization dimension, urbanization caused a non-significant decrease in carbon emissions, while there was no spillover effect on carbon emissions in neighbouring areas. Accordingly, carbon emission reduction efforts should promote the transformation of urbanization from a land-driven process to an ecologically driven process and realize the synergies among carbon emission reductions, urban development, and land use.

Spatial spillover effects of urbanization on carbon emissions in the Yangtze River Delta urban agglomeration, China.

To achieve a win-win situation for both urbanization and carbon emissions reduction from a spatiotemporal perspective, we need to identify the salient links between urbanization and carbon emissions in different dimensions. Using 2008-2018 panel data on the Yangtze River Delta urban agglomeration, this paper constructs a Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) model based on four dimensions of urbanization: population, economy, land, and ecology. Additionally, it uses a whole group of variables for reference, constructs a Spatial Durbin model (SDM) to estimate the spatial effect, and empirically investigates the spatial dependence of carbon emissions and the influence of various driving factors. The results show that (1) in the temporal dimension, the historical carbon emissions of the study area continue to increase. However, the extent to which they are doing so is slowing, the number of low carbon emissions areas has significantly decreased, the number of medium carbon emissions areas have significantly increased, the number of high and relatively high carbon emissions areas are relatively stable, and energy intensity continues to decline. (2) In the spatial dimension, Shanghai, Suzhou, and their surrounding cities have always been carbon emissions hotspots, high and relatively high carbon emissions areas are mainly concentrated in these cities. Low carbon emissions areas and cold spots are mainly distributed in Anhui Province. Medium carbon emissions areas show a great spatial and temporal evolution and are distributed in all provinces. (3) In the four dimensions of urbanization, per capita GDP will not only affect regional carbon emissions but also have a spatial spillover effect. For every 1% increase in the economic factors, carbon emissions in neighboring regions will increase by 0.38-0.43%. Population, economic, and technological factors have significant positive effects on carbon emissions, and economic factor is the most important factor. (4) In different dimensions of urbanization, there are obvious heterogeneities in the impacts of different factors on carbon emissions. Among them, the elasticity coefficient of per capita GDP and energy intensity is the smallest among the dimension of land urbanization, and the elasticity coefficient of the total population is the smallest among the dimension of population urbanization. Therefore, when formulating carbon emissions reduction policies, it is necessary to fully consider the spatial spillover effects, determine the optimal population size threshold, advocate for a low-carbon lifestyle, promote clean technology, and realize information exchange and policy interaction across regions from the perspective of holistic governance.

Clinical Studies on the Treatment of Novel Coronavirus Pneumonia With Traditional Chinese Medicine-A Literature Analysis.

OBJECTIVE: This study aims to analyze the current situation and characteristics of traditional Chinese medicine for treatment of novel coronavirus pneumonia, clarify its clinical advantages and provide a reference for clinical treatment. METHODS: Clinical randomized controlled trials, clinical control trials and case series research involving the use of Chinese medicine for novel coronavirus pneumonia treatment were selected from PubMed, Chinese Journal Service Platform of CNKI, VIP, and WanFang Data Knowledge Service Platform from the establishment of the library to 11:00 am on April 15, 2020. The published information, research design, intervention measures and research observation index were statistically analyzed. RESULTS: Twenty studies were included. The research methods were mainly clinical controlled trials. The observation indicators were mostly fever improvement time, cough improvement time, shortness of breath improvement time, chest CT and CRP examination. Maxing Ganshi (Ephedrae Herba, Armeniacae Semen Amarum, Glycyrrhizae Radix Et Rhizoma, and Gypsum Fibrosum) decoction was the core prescription. The most frequently used drugs were Glycyrrhizae Radix Et Rhizoma (Gancao), Ephedrae Herba (Mahuang), Armeniacae Semen Amarum (Kuxingren), Atractylodis Rhizoma (Cangzhu), and Scutellariae Radix (Huangqin). The most frequently used drug combination was Ephedrae Herba (Mahuang)-Armeniacae Semen Amarum (Kuxingren). The most frequently used Chinese patent medicine was Lianhua Qingwen capsule/granule. CONCLUSIONS: Traditional Chinese medicine has widely used for novel coronavirus pneumonia in China. It is worthy of global attention. Also, high-quality randomized controlled clinical trials on the effectiveness and safety of traditional Chinese medicine in the treatment of novel coronavirus pneumonia need to carry out.

Study of efficacy and safety of Jiaotai pill in the treatment of depression.

BACKGROUND: Depression is a common affective disorder characterized by marked and lasting melancholia, with corresponding thought and behavior changes. Due to an accelerated pace of life and increased work pressure, the incidence of depression has risen sharply, causing great harm to family and social life. Jiaotai pill (JTP) is a Chinese herbal formula that is commonly prescribed for depression and insomnia in clinical treatment, and exhibits antidepressant effects as shown in animal experimental research. However, there are no standard clinical trials to confirm its efficacy in treating depression. OBJECTIVE: This study aims to assess the efficacy and safety of JTP in the treatment of depression, so as to tap the clinical efficacy advantages of JTP and provide data support for its clinical application. METHODS: A randomized, multicenter clinical trial with parallel groups was designed in this study. A total of 40 patients with depression were included and randomly divided to either the treatment or the control group with a ratio of 1:1. The patients received JTP plus fluoxetine or fluoxetine alone once per day for 8 weeks. The primary outcome included the Hamilton Depression Rating Scale score for patients and brain structure and function by functional magnetic resonance imaging. The secondary outcomes included Traditional Chinese medicine syndrome integral scale scores, Wisconsin Card Sorting Test, blood metabonomics, urine metabonomics. CONCLUSION: The results of this trial will find changes in brain structure, brain function, and metabolism in patients with depression, and provide critical evidence for JTP in the treatment of depression.

Clinical practice of Chinese medicine navel therapy for chronic diarrhea: A literature review.

Chronic diarrhea is one of the most common complaints in clinical practice for both adults and children. The purpose of this study was to assess the commonly used Chinese herbal medicine navel therapy for the treatment of chronic diarrhea (traditional Chinese medicine syndrome of spleen deficiency). The literature search was up to June 2018. Four types of studies (clinical trials, case series, case reports, and experts' experience) researched on Chinese medicine navel therapy used alone or combined with other therapies for the treatment of chronic diarrhea all included. Information on prescriptions, effectiveness, and safety of intervention was collected. Traditional Chinese Medicine Inheritance Support System V2.5 was used to do data analysis. We included 416 studies. All these studies carried out in 194 cities of China. We obtained the most commonly used single herbs, herbal medicine combination, and Chinese patent medicine for both adults and children. The top 3 single herbs were Caryophylli Flos (Dingxiang), Cinnamomi Cortex (Rougui), and Euodiae Fructus (Wuzhuyu). The most frequently used Chinese patent medicines were Ding Gui Infantile Navel Paste and Huoxiang Zhengqi Liquid. The effectiveness assessment was based on clinical trials, but we did not perform a meta-analysis because of different study design and unsatisfactory methodological quality. No serious adverse reaction happened in original studies. The application of Chinese medicine navel therapy could be one of the ideal treatments for chronic diarrhea in the future, especially for children. However, high-quality studies are very needed to provide clear evidence.

Consensus-based recommendations for case report in Chinese medicine (CARC).

Case reports are valuable clinical evidence in traditional Chinese medicine (TCM). However, the general reporting quality is suboptimal. A working group comprising 20 members was set up to develop systematic recommendations on case report in Chinese medicine (CARC). The working group (CARC group) developed a primary checklist based on reviewing the general reporting quality of case reports in TCM and thorough internal discussion. Two-round consensus process had been carried out among clinical experts, evidence-based medicine methodologists, medical journal editors and clinical practitioners with designated questionnaire embedded with the primary checklist. In total, 118 participants from 17 provinces of China and Korea completed the questionnaires. Their feedback was analyzed and discussed by the CARC group. The checklist was amended accordingly, and the final version, comprising 16-item, is presented here. Under the framework of CARC recommendations, the reporting quality of case reports in TCM can be improved.

Urgent need to improve the quality of case report in traditional Chinese medicine: Assessment on reporting quality of 3,417 cases.

OBJECTIVE: To survey the reporting quality of traditional Chinese medicine (TCM) case reports published in recent years and understand the common problems. The assessment results would lay the foundation for the development of recommendations for case report in Chinese medicine. METHODS: This survey determined the reporting quality of cases with Chinese herbal decoction, Chinese proprietary medicine, acupuncture, moxibustion and other traditional therapies published in 20 core medical journals of China by searching the China Academic Journals Full-text Database from 2006 to 2010. Fifty survey items in 16 domains were used to determine the reporting quality. One point was assigned to each item (Yes=1 point; No=0 point), and total score was 50 points. The domain of treatment was assessed independently, ranging from 2 to 9 items for different TCM interventions. RESULTS: The total of 1,858 case reports, covering 3,417 cases were included to analyze from 13 out of 20 core medical journals of China. There were 74.8% of them did not identify the nature of study in title, while 73.9% did not comprise an abstract. Incomplete reporting was found in discussions/ comment, and only 38.9% had made recommendations or take-away messages. Figures and tables were infrequently used. Three cases cited the full names of patients, but without declaring that any consent was obtained. Over 90% reported the symptoms and signs of TCM, and characteristics on tongue and pulse, but less than 50% did mention other medical history and diagnostic rationale. More than 90% treatments of the included cases were herbal decoction, with clear reporting on the ingredients and dosages. However, the reporting rate of the dosages of each ingredient was just 48.4%. Almost none reported the quality control of crude herbs, manufacturers and lot numbers of herbal proprietary medicine. Besides, advices and precautions on diet, emotions and living were rare to be illustrated. CONCLUSION: Systematic reporting recommendations are urged to develop for improving the contents and format of case reports in TCM.

A randomized, double-blind, placebo-controlled trial of Chinese herbal medicine granules for the treatment of menopausal symptoms by stages.

OBJECTIVE: The study aims to evaluate the effectiveness and safety of Chinese herbal medicine granules Danzhi Qing'e formula (DZQE), Erzhi formula (EZ), and their combination (Combined formula) in the treatment of menopausal symptoms at different stages of menopause. METHODS: Women between the ages of 40 to 60 years, who met menopausal symptoms diagnostic criteria and experienced hot flushes at least 14 times/week in the last 4 weeks, were recruited to participate in a stratified randomized, double-blind, placebo-controlled clinical trial (n = 389). They received a treatment period of 8 weeks and were followed up for 4 weeks. Participants were categorized into two subgroups: 197 in the perimenopausal subgroup (menstrual disorder to 1 y after amenorrhea) and 192 in the early postmenopausal subgroup (1-5 y after amenorrhea). Participants were randomly assigned to placebo or one of the three herbal formula treatments. The primary outcome instrument was the Menopause-Specific Quality of Life (MENQOL) questionnaire. RESULTS: When analyzing the two subgroups together, DZQE markedly decreased the MENQOL total score at the end of 12th week with statistical significance (P = 0.02) and improved vasomotor symptoms after 8 weeks treatment and 4 weeks follow-up (P < 0.05). What is more, the combined formula also greatly improved the participants' vasomotor symptoms compared with placebo after the 4 weeks follow-up. No statistically meaningful difference was observed in any other outcomes among the groups. The results of subgroup analysis showed that DZQE and Combined formula were more effective than placebo in improving MENQOL total score for perimenopausal women at the end of week 12. For typical menopausal symptoms such as hot flushes and night sweats, DZQE displayed more favorable effects on early postmenopausal participants. Compared to placebo, the DZQE both showed statistically significant differences after 8 weeks treatment and 4 weeks follow-up. Although at the end of 12th week, DZQE also had better effects than placebo in the perimenopausal subgroup on vasomotor symptoms. Participants in the EZ group did not show a significant difference of any domains in MENQOL compared with participants in the placebo group. CONCLUSIONS: The DZQE formula improves the quality of life for menopausal women, especially for those with vasomotor symptoms during the whole menopausal period. The DZQE and EZ combination formula is effective only on perimenopausal symptoms.

An Overview of Meta-Analyses of Danhong Injection for Unstable Angina.

Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI) for unstable angina (UA). Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved.

Extending the CONSORT Statement to moxibustion.

The STandards for Reporting Interventions in Clinical Trials Of Moxibustion (STRICTOM), in the form of a checklist and descriptions of checklist items, were designed to improve reporting of moxibustion trials, and thereby facilitating their interpretation and replication. The STRICTOM checklist included 7 items and 16 sub-items. These set out reporting guidelines for the moxibustion rationale, details of moxibustion, treatment regimen, other components of treatment, treatment provider background, control and comparator interventions, and precaution measures. In addition, there were descriptions of each item and examples of good reporting. It is intended that the STRICTOM can be used in conjunction with the main CONSORT Statement, extensions for nonpharmacologic treatment and pragmatic trials, and thereby raise the quality of reporting of clinical trials of moxibustion. Further comments will be solicited from the experts of the CONSORT Group, the STRICTA Group, acupuncture and moxibustion societies, and clinical trial authors for optimizing the STRICTOM.

A randomized double-blind placebo-controlled trial of a Chinese herbal medicine preparation (Jiawei Qing'e Fang) for hot flashes and quality of life in perimenopausal women.

OBJECTIVE: This study aimed to evaluate the effectiveness and safety of a Chinese herbal medicine preparation, Jiawei Qing'e Fang (JQF), on menopausal symptoms in perimenopausal women. METHODS: A randomized double-blind placebo-controlled trial was performed over 12 weeks in 72 perimenopausal women who reported 14 or more hot flashes per week. The participants were randomly allocated to receive JQF or placebo for 8 weeks. Posttreatment follow-up was performed 4 weeks after intervention. The primary outcome was the Menopause-Specific Quality of Life. Secondary outcomes included hot flash and plasma lipids. RESULTS: There was greater improvement in hot flash score in the JQF group compared with the placebo group, and the difference between the two groups was statistically significant (P = 0.048). There were between-group differences in vasomotor (P = 0.011) and physical (P = 0.034) domains. The triglyceride (TG) level in the JQF group showed a significant reduction (P = 0.036) in women with a baseline TG greater than 150 mg/dL (1.7 mmol/L). CONCLUSIONS: The Chinese herbal medicine preparation JQF was found to be superior to placebo in reducing hot flashes and improving menopausal symptoms in the vasomotor and physical aspects and might have a potential benefit in reducing TG levels. The herbal medicine preparation was well tolerated, with no serious adverse events noted during the study period.

Traditional Chinese medicine syndrome distribution in chronic hepatitis B populations: a systematic review.

Many patients with chronic hepatitis B (CHB) seek help from traditional Chinese medicine (TCM). TCM treatment is based on syndrome differentiation. This study aimed to investigate the syndrome distribution in populations of CHB patients. The pre-specific search strategy was set, and 93 studies (20,106 participants) were identified by electronic and hand searches. The methodological quality of included studies was assessed. Data on syndrome distribution and correlations between syndromes and severity of CHB, were extracted and analyzed. Forty-seven syndromes were identified under 24 different syndrome diagnosis systems for CHB. The majority of included studies reported Liver Depression and Spleen Deficiency (LDSD) (52.54% of studies) or Liver-Gallbladder Dampness Heat (LGDH)/Dampness-Heat Obstructing Middle Energizer (DHME) (32.20%) as the major syndromes in CHB patients without cirrhosis. Pooled analysis revealed that LDSD and LGDH/DHME accounted for 61.19% of participants without cirrhosis. In addition, Liver-Kidney Yin Deficiency (LKYinD) (40.99%) and Spleen-Kidney Yang Deficiency (SKYangD) (40.43%) syndromes were common in patients with severe CHB. The percentage of patients with Blood Stasis syndrome increased as the disease progressed to cirrhosis (32.09%). To conclude, LDSD and LGDH/DHME syndromes are found in a significant majority of CHB patients, particularly in the early stages. LKYinD, SKYangD and Blood Stasis dominate in patients at more advanced stages. More epidemiological studies of high methodological quality on syndrome distribution in CHB and standardization of syndrome differentiation for CHB are required to confirm the trends indicated by the studies reviewed here; confirming these trends can increase the efficacy of treatment and give guidance to doctors.

Huangqi injection (a traditional Chinese patent medicine) for chronic heart failure: a systematic review.

BACKGROUND: Chronic heart failure (CHF) is a global public health problem. Therefore, novel and effective drugs that show few side-effects are needed. Early literature studies indicated that Huangqi injection is one of the most commonly used traditional Chinese patent medicines for CHF in China. As a large number of clinical studies has been carried out and published, it is essential to evaluate the effectiveness and safety of Huangqi injection. Therefore, we carried out this systematic review under the support of the framework of the Joint Sino-Italian Laboratory (JoSIL). OBJECTIVES: To evaluate the efficacy and safety of Huangqi injection for CHF according to the available scientific knowledge. METHODS: An extensive search including PubMed, EMBASE, CBM, the Cochrane Library and Chinese literature databases was performed up to July 2008. Clinical trials regarding Huangqi injection for the treatment of CHF were searched for, irrespective of languages. The quality of each trial was assessed according to the Cochrane Reviewers' Handbook 5.0, and RevMan 5.0 provided by the Cochrane Collaboration and STATA 9.2 were used for data analysis. RESULTS: After selection of 1,205 articles, 62 RCTs and quasi-RCTs conducted in China and published in Chinese journals were included in the review. The methodological quality of the trials was low. In most trials inclusion and exclusion criteria were not specified. Furthermore, only one study evaluated the outcomes for drug efficacy after an adequate period of time. For these reasons and because of the different baseline characteristics we did not conduct a meta-analysis. CONCLUSIONS: Although available studies are not adequate to draw a conclusion on the efficacy and safety of Huangqi injection (a traditional Chinese patent medicine), we hope that our work could provide useful experience on further studies on Huangqi injections. The overall level of TCM clinical research needs to be improved so that the efficacy of TCM can be evaluated by the international community and possibly some TCM can enter into the international market.

Clinical practice of traditional Chinese medicines for chronic heart failure.

BACKGROUND: Chinese medicines have been used for chronic heart failure (CHF) for thousands of years; however, the status of traditional Chinese medicines (TCMs) used for CHF has not been reported. This review was carried out in the framework of a joint Sino-Italian Laboratory. OBJECTIVE: To investigate the baseline of clinical practice of TCMs for CHF, and to provide valuable information for research and clinical practice. METHODS: The authors included articles about the use of TCMs for the treatment of CHF by searching the Chinese Journal Full-text Database (1994 to November 2007). RESULTS: In all, 1029 papers were included, with 239 herbs retrieved from these. The most commonly used herbs included Huangqi (Radix Astragali), Fuling (Poria), Danshen (Radix Salviae Miltiorrhiae), Fuzi (Radix Aconiti Lateralis Preparata) and Tinglizi (Semen Lepidii). Modern Chinese patent medicines (produced by pharmaceutical companies) and traditional prescriptions (comprising several herbs) are the application forms of these drugs. Shenmai, Shengmai and Astragalus injections were the most commonly used Chinese patent medicines. Some classic prescriptions (including Zhenwu decoction, Shengmai powder and Lingguizhugan decoction) were also frequently used. The effectiveness and safety of the TCMs were both satisfactory, and the traditional Chinese medicine and western medicine therapy could significantly improve the clinical effectiveness and reduce some of the adverse reactions from western medicines used alone. CONCLUSION: The authors have acquired overall information about the clinical application of TCMs for CHF. Modern pharmacology has provided limited evidence for the rationality of this clinical use. Further research is needed to provide more evidence.