Intravenous immunoglobulin for treatment of hospitalized COVID-19 patients: an evidence mapping and meta-analysis.

BACKGROUND: The clinical efficacy and safety of intravenous immunoglobulin (IVIg) treatment for COVID-19 remain controversial. This study aimed to map the current status and gaps of available evidence, and conduct a meta-analysis to further investigate the benefit of IVIg in COVID-19 patients. METHODS: Electronic databases were searched for systematic reviews/meta-analyses (SR/MAs), primary studies with control groups, reporting on the use of IVIg in patients with COVID-19. A random-effects meta-analysis with subgroup analyses regarding study design and patient disease severity was performed. Our outcomes of interest determined by the evidence mapping, were mortality, length of hospitalization (days), length of intensive care unit (ICU) stay (days), number of patients requiring mechanical ventilation, and adverse events. RESULTS: We included 34 studies (12 SR/MAs, 8 prospective and 14 retrospective studies). A total of 5571 hospitalized patients were involved in 22 primary studies. Random-effects meta-analyses of very low to moderate evidence showed that there was little or no difference between IVIg and standard care or placebo in reducing mortality (relative risk [RR] 0.91; 95% CI 0.78-1.06; risk difference [RD] 3.3% fewer), length of hospital (mean difference [MD] 0.37; 95% CI - 2.56, 3.31) and ICU (MD 0.36; 95% CI - 0.81, 1.53) stays, mechanical ventilation use (RR 0.92; 95% CI 0.68-1.24; RD 2.8% fewer), and adverse events (RR 0.98; 95% CI 0.84-1.14; RD 0.5% fewer) of patients with COVID-19. Sensitivity analysis using a fixed-effects model indicated that IVIg may reduce mortality (RR 0.76; 95% CI 0.60-0.97), and increase length of hospital stay (MD 0.68; 95% CI 0.09-1.28). CONCLUSION: Very low to moderate certainty of evidence indicated IVIg may not improve the clinical outcomes of hospitalized patients with COVID-19. Given the discrepancy between the random- and fixed-effects model results, further large-scale and well-designed RCTs are warranted.

The glucagon-like peptide-1 (GLP-1) analog exenatide ameliorates intrauterine adhesions in mice.

OBJECTIVE: The purpose of the experiments in this study was to explore the effect of exenatide on intrauterine adhesions (IUAs) and to elucidate its mechanism to provide new ideas for the clinical treatment of IUAs. METHODS: In this study, an animal model of IUAs was established by double stimulation using mechanical curettage and inflammation. After modeling, the treatment group was injected subcutaneously with three doses of exenatide for two weeks. The model group was injected with sterile ultrapure water, and the sham operation group was treated the same as the normal group, except for the observation of abdominal wound changes. Two weeks later, all mice were sacrificed by cervical dysfunction. The obtained mouse uterine tissue was used for subsequent experimental detection, using HE and Masson staining for histomorphological and pathological analysis; qRT-PCR for the detection of TGF-ß1, α-SMA, and MMP-9 gene expression in uterine tissue; and western blotting analysis of TGF-ß1, α-SMA, and collagen 1 protein expression to verify whether exenatide has a therapeutic effect on IUAs in mice. RESULTS: In the high-dose exenatide treatment group, the endometrial glands significantly increased in size, and the deposition area of collagen fibers in the endometrial tissue was significantly reduced. We observed that the mRNA expression of TGF-ß1 and α-SMA in the endometrial tissue of IUAs mice in this group was significantly reduced, while the expression of MMP-9 was significantly increased. In addition, we found that the protein expression of TGF-ß1, α-SMA, and collagen 1 remarkably decreased after treatment with exenatide. CONCLUSION: Exenatide may reduce the deposition of collagen fibers in the uterus of IUAs mice and promote the proliferation of endometrial glands in mice.

[Effects of thinning and reshaping on canopy micro-domain environment and leaf physiological characteristics in dense Fuji apple orchard on Loess Plateau of eastern Gansu, China]. / é—´ä¼æ”¹å½¢å¯¹é™‡ä¸œé«˜åŽŸå¯†é—­å¯Œå£«è‹¹æžœå›­å† å±‚å¾®åŸŸçŽ¯å¢ƒåŠå¶ç‰‡ç”Ÿç†ç‰¹æ€§çš„å½±å“.

We examined the effects of thinning and reshaping on the canopy micro-domain environment, leaves micro-structure, physiological characteristics and photosynthetic capacity of 16 year-old Fuji apple dense orchards by measuring canopy relative light intensity, temperature, relative humidity, leaf chlorophyll content, micro-structure, and photosynthetic fluorescence. After thinning and reshaping, relative light intensity and temperature of tree canopy were significantly improved, and the distribution was balanced. Effective light intensity (>30%) was 57% higher than that of control (thinning and reshaping, CK), and temperature increased by 1.1 ℃. Due to the improvement of relative light intensity and temperature in the canopy, leaf chlorophyll, leaf thickness, and palisade tissue thickness of thinning trees were increased by 8.7%, 5.4%, and 9.2%, respectively. Net photosynthetic rate, transpiration rate and stomatal conductance of the leaves were also significantly increased, being 12.6%, 17.1% and 7.3% higher than CK, respectively. Leaf photosynthesis capacity of both treatments was limited by non-stomatal factors. After thinning and reshaping, Fm (maximum fluorescence) and qN(non-photochemical quenching coefficient) of PSⅡ in leaves were increased by 1.5% and 2.1%. Leaves did not suffer strong light photoinhibition, with ABS/RC (unit reaction center absorbs light energy), ETo/RC (energy used for electron transfer captured by unit reaction center) and TRo/RC (energy captured by the unit reaction center to reduce QA) of leaves being significantly improved. The physiological characteristics of leaves were closely related to light and temperature environment. After thinning, light and temperature of the orchard canopy were improved, which promoted leaves growth and development, improved foliar micro-structure and photosynthetic efficiency. Thinning and reshaping were suitable strategies for the adjustment and optimization of Fuji orchard density in Loess Plateau of eastern Gansu.

CONSORT extension for reporting N-of-1 trials for traditional Chinese medicine (CENT for TCM) : Recommendations, explanation and elaboration.

BACKGROUND: N-of-1 trial is a desired and appropriate approach to assessing the efficacy and safety of traditional Chinese medicine (TCM) interventions. There have been an increasing number of N-of-1 trials for TCM published. However, a lack of preferred reporting guidance led in the general poor reporting quality of these trials. Due to the unique characteristics of TCM, the working group developed this CONSORT Extension for reporting N-of-1 Trials for Traditional Chinese Medicine (CENT for TCM) to assist TCM researchers in reporting N-of-1 trials for TCM. METHODS: We registered CENT for TCM at the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network (available at equator-network.org). The development was a comprehensive process through collection of the initial reporting items, two-round scientific Delphi consensus survey with 17 panelists, revision and formation of the final reporting checklist. RESULTS: The checklist includes 25 items within six domains, eight items in which were extended and elaborated on the items of the CENT 2015 checklist. Explanation of the items were listed adequately considering the nature of TCM, introducing the concept of TCM syndrome differentiation and TCM interventions. CONCLUSIONS: CENT for TCM can be used to assess the completeness of the reporting of N-of-1 trials for TCM. The working group expect that CENT for TCM could be a practical tool to enhance the comprehensiveness and transparency of the design, implementation and reporting of N-of-1 trials for TCM.

[Effect of thinning and reshaping on the canopy structure and leaf quality at late growth stage in dense apple orchard in Loess Plateau of eastern Gansu, China.] / é—´ä¼æ”¹å½¢å¯¹é™‡ä¸œæ—±å¡¬å¯†é—­è‹¹æžœå›­æ ‘ä½“å† å±‚ç»“æž„å’Œå‘è‚²åŽæœŸå¶ç‰‡è´¨é‡çš„å½±å“.

In order to examine the effects of thinning and reshaping on canopy structure, leaf physio-logical property at late growth stage, characteristic of nutrient accumulation and distribution in leaf, and the spatial and temporal distribution of soil moisture, 18 year-old 'Fuji' apple trees in dense apple orchards were used to measure the canopy size, types and numbers of branches, leaf area index before and after the thinning and reshaping practices. The results showed that before pruning, the photosynthesis was limited by non-stomatal factors, with a reduction in Fv/Fm, Fv/Fo PIabs by 1.2%, 11.5%, 13.9%, respectively. However, the thinning and reshaping practices reduced leaf area index and canopy coverage, increased light interception up to 79% and improved tree construction. The total number of shoots decreased to 1100400 per hectare, while the individual shoot numbers were increased by 5.0% and the ratio of spur increased up to 73%. Due to the improvement of canopy lighting distribution, the average leaf area, specific leaf quality, hundred leaf mass and chlorophyll content were increased. With the increases of photosynthesis, the accumulation of photosynthate such as starch was increased by 143.5%. There was a close correlation between leaf development and light interception. Our results indicated that tree structure and canopy light interception could be improved by thinning and reshaping the dense trees, which resulted in higher leaf growth, development and photosynthetic capability but less water loss. Thinning and reshaping should be recommended to the renewal of the dense apple orchards in Loess Plateau of eastern Gansu.

Do the CONSORT and STRICTA Checklists Improve the Reporting Quality of Acupuncture and Moxibustion Randomized Controlled Trials Published in Chinese Journals? A Systematic Review and Analysis of Trends.

BACKGROUND: We investigated whether there had been an improvement in the quality of reporting for randomised controlled trials of acupuncture and moxibustion published in Chinese journals. We compared the compliance rate for the quality of reporting following the publication of both the STRICTA and CONSORT recommendations in China. METHODS: Four Chinese databases were searched for RCTs of acupuncture from January 1978 through to December 2012. The CONSORT and STRICTA checklists were used to assess the quality of reporting. Data were collected using a standardised form. All included RCTs were divided into three distinct time periods based on the time that CONSORT and STRICTA were introduced in China, respectively. Pearson's χ2 test and/or Fisher's exact test were used to assess differences in reporting among three groups. PRINCIPAL FINDINGS: A total of 1978 RCTs were identified. Although the percentage of all the items has increased over time with the introduction of CONSORT and STRICTA in China, the actual compliance in several important methodological components, including sample size calculation (0% vs. 0% vs. 1.2%, for pre-CONSORT and pre-STRICTA, post-CONSORT but pre-STRICTA, and post-CONSORT and post-STRICTA, respectively), randomisation sequence generation (1.4% vs. 15% vs. 26.3%) and implementation (0% vs. 0% vs. 1.3%), allocation concealment (0% vs. 1.4% vs. 4.9%), and blinding (0% vs. 5.7% vs. 9.1%), remains low. Moreover, no RCTs have reported the setting and context of treatment and no descriptions of the participating acupuncturists have been provided thus far. CONCLUSIONS: Overall, the quality of the reporting of RCTs of acupuncture and moxibustion published in Chinese journals has improved since CONSORT and STRICTA were introduced in China, though the actual compliance rate of some important items were still low as of 2012. In the future, Chinese journals should enhance the adoption of the CONSORT and STRICTA statement to improve the reporting quality of the RCTs of acupuncture and moxibustion and to ensure the truth and reliability of the conclusions.

[Response of distribution pattern and physiological characteristics of apple roots grown in the dry area of eastern Gansu to ground mulching]. / é™‡ä¸œæ—±å¡¬è‹¹æžœæ ¹ç³»åˆ†å¸ƒè§„å¾‹åŠç”Ÿç†ç‰¹æ€§å¯¹åœ°è¡¨è¦†ç›–çš„å“åº”.

The objective of the experiment is to ascertain the effects of different mulching materials on the distribution and physiological activity of apple roots as well as the soil physicochemical pro-perties in the rain-fed Longdong arid areas. With fourteen years old apple trees as test material, the different classes of roots were collected by using soil profile method and stratified sampling in soil profile to investigate the spatial distribution, root biomass, root length and surface area. The activity of root and antioxidant enzymes and some antioxidant indexes were measured. Soil bulk density and soil porosity in different soil layers were determined. The results indicated that ground covering treatment increased the soil moisture, porosity and organic matter content, and the amplification were 2.7%-11.6%, 3.2%-27.7%, 5.1%-36.0%, respectively compared with the control. The soil bulk density was reduced by 88.7%-96.4%. The roots of CK distributed mainly in soil layer of 0-60 cm in depth, 30-120 cm away from the trunk. However, with straw and plastic mulching the roots distributed mainly in the layer of 0-100 cm in depth, 0-150 cm and 0-60 cm away from the trunk, respectively, mostly concentrated in the 20-40 cm layer close to the ground. Plastic mul-ching made a narrower horizontal root distribution than CK and the total fine root amount was 96.4% of that of CK, and that in 0-60 cm layer accounted for 51.6% of the total fine root amount. More-over, the mulching resulted in a higher activity of root and antioxidant enzymes in 0-80 cm layer. The root activity with straw mulching was 111.3%-136.7% as much as the control. For sake of the efficacy on improving root distribution and physiological activity, the straw mulching was suggested as a better way for soil management in apple orchard in dry area of eastern Gansu.