Type 2 diabetes associated with areca nut usage: A systematic review and meta-analysis.

AIMS/HYPOTHESIS: This study aimed to evaluate the potential association between chewing areca nuts and the occurrence of type 2 diabetes and to investigate whether chewing status (current chewers or ex-chewers) affects this association. METHODS: We searched The Cochrane Library, PubMed, and EMBASE databases for relevant studies up to May 21, 2023, using predefined inclusion and exclusion criteria. Three population-based studies conducted in Taiwan were included in the systematic review and meta-analysis. RESULTS: When combined current or ex-chewers were more likely to develop diabetes (Odds Ratio [OR] = 1.45; 95% confidence interval [CI]: 1.30-1.62) compared to the never chewers. Ex-chewers had a higher risk of diabetes (OR: 1.53, 95% CI: 1.45-1.62) compared to never chewers. However, there was no evidence that current chewers were associated with a higher risk of diabetes compared to never chewers. Male current and ex-chewers were associated with higher risk of diabetes compared with never chewers (OR: 1.55, 95% CI: 1.49-1.61). For females there was insufficient evidence. CONCLUSIONS/INTERPRETATION: Existing evidence suggests a link between chewing areca nuts and the development of type 2 diabetes. Therefore, areca chewers should monitor diabetes-related biomarkers.

Electrotaxis of alveolar epithelial cells in direct-current electric fields.

PURPOSE: This study aims to elucidate the electrotaxis response of alveolar epithelial cells (AECs) in direct-current electric fields (EFs), explore the impact of EFs on the cell fate of AECs, and lay the foundation for future exploitation of EFs for the treatment of acute lung injury. METHODS: AECs were extracted from rat lung tissues using magnetic-activated cell sorting. To elucidate the electrotaxis responses of AECs, different voltages of EFs (0, 50, 100, and 200 mV/mm) were applied to two types of AECs, respectively. Cell migrations were recorded and trajectories were pooled to better demonstrate cellular activities through graphs. Cell directionality was calculated as the cosine value of the angle formed by the EF vector and cell migration. To further demonstrate the impact of EFs on the pulmonary tissue, the human bronchial epithelial cells transformed with Ad12-SV40 2B (BEAS-2B cells) were obtained and experimented under the same conditions as AECs. To determine the influence on cell fate, cells underwent electric stimulation were collected to perform Western blot analysis. RESULTS: The successful separation and culturing of AECs were confirmed through immunofluorescence staining. Compared with the control, AECs in EFs demonstrated a significant directionality in a voltage-dependent way. In general, type Ⅰ alveolar epithelial cells migrated faster than type Ⅱ alveolar epithelial cells, and under EFs, these two types of cells exhibited different response threshold. For type Ⅱ alveolar epithelial cells, only EFs at 200 mV/mm resulted a significant difference to the velocity, whereas for, EFs at both 100 mV/mm and 200 mV/mm gave rise to a significant difference. Western blotting suggested that EFs led to an increased expression of a AKT and myeloid leukemia 1 and a decreased expression of Bcl-2-associated X protein and Bcl-2-like protein 11. CONCLUSION: EFs could guide and accelerate the directional migration of AECs and exert antiapoptotic effects, which indicated that EFs are important biophysical signals in the re-epithelialization of alveolar epithelium in lung injury.

Integrin CD11b Deficiency Aggravates Retinal Microglial Activation and RGCs Degeneration After Acute Optic Nerve Injury.

Neuroinflammation plays a vital role in the process of a variety of retinal ganglion cells (RGCs) degenerative diseases including traumatic optic neuropathy (TON). Retinal microglial activation is believed as a harbinger of TON, and robust microglial activation can aggravate trauma-induced RGCs degeneration, which ultimately leads to RGCs loss. Toll like receptor 4 (TLR4)-triggered inflammation is of great importance in retinal inflammatory response after optic nerve injury. CD11b on macrophage and brain microglia can inhibit TLR4-triggered inflammation. However, the functional role of CD11b in retinal microglia is not well understood. Here, using an optic nerve crush model and CD11b gene deficient mice, we found that CD11b protein expression was mainly on retinal microglia, significantly increased after optic nerve injury, and still maintained at a high level till at least 28 days post crush. Compared with wild type mice, following acute optic nerve injury, CD11b deficient retinae exhibited more exacerbated microglial activation, accelerated RGCs degeneration, less growth associated protein-43 expression, as well as more proinflammatory cytokines such as interleukin-6 and tumor necrosis factor α while less anti-inflammatory factors such as arginase-1 and interleukin-10 production. We conclude that CD11b is essential in regulating retinal microglial activation and neuroinflammatory responses after acute optic nerve injury, which is critical for subsequent RGCs degeneration and loss.

Combination of liver graft sonographic grading and point shear wave elastography to reduce early allograft dysfunction after liver transplantation.

OBJECTIVE: To analyze the performance of a liver graft sonographic grading system and point shear wave elastography (PSWE) in predicting early allograft dysfunction (EAD) after liver transplantation (LT). METHODS: Successive brain-dead donors and liver recipients in our hospital from March 2017 to May 2018 were retrospectively recruited. All donors underwent PSWE examination, abdominal ultrasonography, and sonographic grading (grade 0 to grade 5). Donors with ≥ 10 valid PSWE examinations and a failure rate of < 60% were included. For all recipients, abdominal ultrasonography and blood tests for biologic parameters were performed preoperatively and daily postoperatively to screen for EAD. The recipients and their grafts were classified into EAD and non-EAD groups. Statistical analyses were performed to analyze the correlations among liver stiffness (LS), liver graft sonographic grading, and EAD. RESULTS: Thirty-two donors and 32 corresponding liver recipients were enrolled (15 cases in the EAD group; 17 in the non-EAD group). There were no grade 0, 1, or 2 cases in the two groups. For prediction of EAD in recipients after LT, the AUC for PSWE was 0.929 and the AUC for combination of PSWE and sonographic grading system was 0.935. CONCLUSIONS: Combination of PSWE and sonographic grading system can predict postoperative EAD in LT recipients with high sensitivity. Abnormal results may suggest a need for liver biopsy preoperatively, thus avoiding unnecessary surgical preparation for liver procurement. KEY POINTS: • Combination of PSWE with new sonographic grading system is useful for preoperative evaluation of liver grafts from brain-dead donors. • EAD is as a criterion for evaluating the diagnostic value of PSWE and sonographic grading system. • Combination of PSWE and sonographic grading system can predict postoperative EAD in LT recipients with high sensitivity.

A Study on the Model of Detecting the Liquid Level of Sealed Containers Based on Kirchhoff Approximation Theory.

By simulating the sound field of a round piston transducer with the Kirchhoff integral theorem and analyzing the shape of ultrasound beams and propagation characteristics in a metal container wall, this study presents a model for calculating the echo sound pressure by using the Kirchhoff paraxial approximation theory, based on which and according to different ultrasonic impedance between gas and liquid media, a method for detecting the liquid level from outside of sealed containers is proposed. Then, the proposed method is evaluated through two groups of experiments. In the first group, three kinds of liquid media with different ultrasonic impedance are used as detected objects; the echo sound pressure is calculated by using the proposed model under conditions of four sets of different wall thicknesses. The changing characteristics of the echo sound pressure in the entire detection process are analyzed, and the effects of different ultrasonic impedance of liquids on the echo sound pressure are compared. In the second group, taking water as an example, two transducers with different radii are selected to measure the liquid level under four sets of wall thickness. Combining with sound field characteristics, the influence of different size transducers on the pressure calculation and detection resolution are discussed and analyzed. Finally, the experimental results indicate that measurement uncertainly is better than ±5 mm, which meets the industrial inspection requirements.

A Liquid Level Measurement Technique Outside a Sealed Metal Container Based on Ultrasonic Impedance and Echo Energy.

The proposed method for measuring the liquid level focuses on the ultrasonic impedance and echo energy inside a metal wall, to which the sensor is attached directly, not on ultrasonic waves that penetrate the gas-liquid medium of a container. Firstly, by analyzing the sound field distribution characteristics of the sensor in a metal wall, this paper proposes the concept of an "energy circle" and discusses how to calculate echo energy under three different states in detail. Meanwhile, an ultrasonic transmitting and receiving circuit is designed to convert the echo energy inside the energy circle into its equivalent electric power. Secondly, in order to find the two critical states of the energy circle in the process of liquid level detection, a program is designed to help with calculating two critical positions automatically. Finally, the proposed method is evaluated through a series of experiments, and the experimental results indicate that the proposed method is effective and accurate in calibration of the liquid level outside a sealed metal container.

A Novel Ultrasonic Method for Liquid Level Measurement Based on the Balance of Echo Energy.

This study presents a novel method for determining the liquid level from the outside of a sealed container, which is based on the balance of echo energy received by two receiving sensors. The proposed method uses one transmitting transducer and two receiving sensors that are encapsulated in a coupling plane and arranged by certain rules. The calculation and comparison of echo energy are grounded on the difference ultrasonic impedance between gas and liquid media. First, by analyzing the propagation and attenuation characteristics of ultrasonic waves in a solid, an acoustic model for calculating the echo energy is established and simulated in MATLAB. Second, the proposed method is evaluated through a series of experiments. The difference and ratio of echo energy received by two receiving sensors are calculated and compared under two different coupling conditions. Two kinds of the sensors that are arranged by different rules are selected for measuring the liquid level, and the measurement are analyzed and discussed in detail. Finally, the experimental results indicate that the proposed method can meet the proposed accuracy requirements and can effectively solve the problems caused by some poor coupling conditions.

Polymer optical fiber twisted macro-bend coupling system for liquid level detection.

The liquid level detection principle of cladding mode frustrated total internal reflection (CMFTIR) effect is proposed. The significant enhancement of CMFTIR effect is realized through macro-bend coupling system in which the dark-field coupling phenomenon between two multimode polymer optic fibers is observed through experiment. Especially twisted macro-bend coupling structure (TMBCS) is adopted to achieve stable coupling of two naked POF. The testing result showed that the dark-filed forward coupling efficiency reached 2‰ and the extinction ratio of the liquid level probe reached 4.18 dB. Compared with existing optical fiber liquid level sensors, the TMBCS probe is simpler, robuster, and cheaper. In addition, the TMBCS has the potential for displacement or stress sensing.

Modified approach of regenerative treatment for distal intrabony defect beneath non-keratinized mucosa at terminal molar: A case report.

BACKGROUND: Intrabony defects beneath non-keratinized mucosa are frequently observed at the distal site of terminal molars. Consequently, the application of regenerative treatment using the modified wedge-flap technique is considered impractical for these specific dental conditions. CASE SUMMARY: This article proposes a modified surgical procedure aimed at exposing the distal intrabony defect by making a vertical incision in the keratinized buccal gingiva. The primary objective is to maintain gingival flap stability, thereby facilitating periodontal regeneration. The described technique was successfully employed in a case involving the left mandibular second molar, which presented with an intrabony defect without keratinized gingiva at the distal site. In this case, an incision was made on the disto-buccal gingival tissue, creating a tunnel-like separation of the distal non-keratinized soft tissue to expose the intrabony defect. Subsequently, bone grafting and guided tissue regeneration surgeries were performed, resulting in satisfactory bone fill at 9 mo postoperatively. CONCLUSION: This technique offers a regenerative opportunity for the intrabony defects beneath non-keratinized mucosa and is recommended for further research.

Mitigating cadmium accumulation in dicotyledonous vegetables by iron fertilizer through inhibiting Fe transporter IRT1-mediated Cd uptake.

The solubility of cadmium (Cd) in soil and its transfer to plants are influenced by soil pH. While increasing soil pH reduces Cd solubility and accumulation in rice plants grown in acidic soils, its effect on Cd accumulation in vegetables remains inconclusive. Here, we investigated the impact of soil pH on Cd accumulation in dicotyledonous vegetables and elucidated the underlying molecular mechanisms. Soils collected from various locations were supplemented with varying quantities of lime to achieve soil pH values of around 5.0, 6.0, 7.0, and 8.0. Raising soil pH from around 5.0 to 8.0 markedly decreased extractable Cd. However, increasing soil pH tended to promote shoot Cd accumulation in dicotyledonous vegetable species including lettuce, pakchoi, and Chinese cabbage, and the model dicotyledonous plant Arabidopsis thaliana. Conversely, soil pH increase resulted in a monotonic decrease in rice Cd accumulation. In our hydroponic experiments, we discovered that iron (Fe) deficiency substantially increased Cd uptake and accumulation in dicotyledonous plants but not in rice. Increasing soil pH reduced soil Fe availability and induced the Fe transporter gene IRT1 expression in dicotyledonous vegetables roots, which led to an increase in IRT1-mediated Cd uptake and subsequently increased Cd accumulation as soil pH increases. A comprehensive model incorporating extractable Cd and root IRT1 expression better explained Cd accumulation in vegetable shoots. The application of 50 mg/kg of Fe fertilizer in neutral or alkaline soils resulted in a significant reduction in Cd accumulation by 34-58% in dicotyledonous vegetables. These findings reveal that increasing soil pH has two opposite effects, decreasing soil Cd availability while promoting Cd uptake through IRT1 upregulation, reconciling the inconsistency in its effect on Cd accumulation in dicotyledonous plants. Our findings provide important insights for understanding the factors affecting Cd uptake in plants and offer a practical solution to mitigate Cd contamination in vegetables.

Romidepsin exhibits anti-esophageal squamous cell carcinoma activity through the DDIT4-mTORC1 pathway.

Esophageal squamous cell carcinoma (ESCC) is one of the most common human malignancies worldwide and is associated with high morbidity and mortality. Current treatment options are limited, highlighting the need for development of novel effective agents. Here, a high-throughput drug screening (HTS) was performed using ESCC cell lines in both two- and three-dimensional culture systems to screen compounds that have anti-ESCC activity. Our screen identified romidepsin, a histone deactylase inhibitor, as a potential anti-ESCC agent. Romidepsin treatment decreased cell viability, induced apoptosis and cell cycle arrest in ESCC cell lines, and these findings were confirmed in ESCC cell line-derived xenografted (CDX) mouse models. Mechanically, romidepsin induced transcriptional upregulation of DNA damage-inducible transcript 4 (DDIT4) gene by histone hyperacetylation at its promoter region, leading to the inhibition of mammalian target of rapamycin complex 1 (mTORC1) pathway. Furthermore, romidepsin exhibited better efficacy and safety compared to the conventional therapeutic drugs in ESCC patient-derived xenografted (PDX) mouse models. These data indicate that romidepsin may be a novel option for anti-ESCC therapy.

The expression levels of chemotaxis-related molecules CXC chemokine receptor 1, interleukin-8, and pro-platelet basic protein in gingival tissues.

Background/purpose: Excessive host immune response is thought to be an important cause of periodontal tissue damage during periodontitis. The potent chemotaxis produced by locally released chemokines is the key signal to trigger this response. Here, we aimed to investigate the expression of CXC chemokine receptor 1 (CXCR1), and chemokines interleukin-8 (IL-8) and pro-platelet basic protein (PPBP) in human inflammatory gingival tissues compared with healthy tissues. Materials and methods: A total of 54 human gingival tissues, 27 healthy and 27 inflammatory samples, were collected. Fifteen specimens of each group were employed for quantitative reverse transcription polymerase chain reaction to determine the mRNA levels of CXCR1, IL-8, and PPBP. Six samples of each group were used for Western blotting to investigate the protein expression of CXCR1 and for enzyme-linked immunosorbent assay to evaluate the protein levels of IL-8 and PPBP, respectively. Results: The mRNA levels of chemokine receptor CXCR1, chemokine IL-8, and PPBP in inflammatory gingival tissues were significantly higher than those in healthy controls (P < 0.05). The protein levels of CXCR1, IL-8, and PPBP in inflammatory gingival tissues were also significantly higher than those in healthy gingival tissues (P < 0.05). Conclusion: When compared to healthy gingival tissues, the expression of CXCR1, IL-8, and PPBP in inflammatory gingival tissues is higher.

Association between COVID-19 and sexual health: an umbrella review.

PURPOSE: We conducted this umbrella review to review the current evidence on the relationship between COVID-19 and sexual health in both men and women. METHODS: We conducted searches in Pubmed, Embase, and the Cochrane dataset for meta-analyses that met our pre-set inclusion criteria. We included studies with detailed information investigating the link between COVID-19 and sexual health in men/women. We did not limit the language. RESULTS: The results of the included studies frequently relied on the Female Sexual Function Index to assess sexual health in women. For men, the International Index of Male Function and hospital diagnoses were commonly used to assess sexual health. Currently, there is conflicting evidence regarding the impact of COVID-19 on sexual health. However, since most studies were observational in nature, additional study designs are necessary to draw definitive conclusions across different contexts. CONCLUSION: Our findings highlight the importance of sexual health among COVID-19 patients and people affected due to COVID-19. Further critical studies should investigate the mechanism underlying the association between COVID-19 and sexual health.

Effectiveness and Safety of COVID-19 Vaccinations: An Umbrella Meta-Analysis.

Objectives: This umbrella meta-analysis aims to provide comprehensive and synthesized evidence regarding the effectiveness and safety of COVID-19 vaccinations based on current studies. Methods: Studies from the Cochrane Library, PubMed, and EMBASE, published before 10 December 2021, were included in the analysis. The pooled results of effectiveness and safety were estimated and shown in forest plots. Results: We included nineteen studies (fifteen studies regarding safety and nine regarding effectiveness) in the analysis. The mRNA vaccines, adenovirus vector vaccines, subunit vaccines, and inactivated vaccines were found to be effective; however, mRNA vaccines, adenovirus vector vaccines and subunit vaccines were associated with local adverse events and systemic events when compared with inactivated vaccines. Conclusion: Our study suggested that till date, COVID-19 vaccination is still a preferred pharmaceutical way to control the widespread pandemic. However, all reported adverse events should be revisited to provide further evidence for mass vaccinations.

Effect of asthma education on health outcomes in children: a systematic review.

BACKGROUND: It remains unknown whether child-oriented asthma education is associated with better health outcomes. This meta-analysis investigated the effects of asthma education on hospitalisation and emergency department and clinic visits. METHODS: We searched the Cochrane Library, PubMed and EMBASE for relevant studies from inception to 4 July 2021, and selected studies that reported hospitalisation or emergency department or clinic visits as outcomes. The participants were only children. Two authors independently selected the studies, assessed the quality of the included studies and retrieved the data. A third senior author was engaged to resolve disagreements. Fifteen longitudinal studies were included for the systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 was used as the standard of reporting (PRISMA registration ID is 284509). FINDINGS: Compared with the control group, the asthma education group had 54% lower hospitalisation risk (95% CI 0.32 to 0.66), and 31% lower emergency department visit risk (95% CI 0.59 to 0.81). Sensitivity analysis showed that the asthma education group had a reduced clinic visit risk (risk ratio (RR)=0.80, 95% CI 0.67 to 0.97). Subgroup analysis showed that asthma education involving both children and parents/guardians was associated with fewer hospitalisations (RR=0.38, 95% CI 0.24 to 0.59) and emergency department visits (RR=0.69, 95% CI 0.57 to 0.83). Asthma education in hospitals or non-hospitals can reduce the risk of hospitalisation and emergency department visits. However, only education in the hospitals was associated with the reduction of clinical visits (RR=0.45, 95% CI 0.22 to 0.92). INTERPRETATION: Education is effective for controlling asthma, especially for reducing hospitalisation and emergency department and clinic visits. Education involving both children and parents/guardians is more effective than that involving only children. The setting of asthma education does not impact its effect to a large extent.

Association Between Air Pollutants and Pediatric Respiratory Outpatient Visits in Zhoushan, China.

Objective: This study aimed to explore the time-series relationship between air pollutants and the number of children's respiratory outpatient visits in coastal cities. Methods: We used time series analysis to investigate the association between air pollution levels and pediatric respiratory outpatient visits in Zhoushan city, China. The population was selected from children aged 0-18 who had been in pediatric respiratory clinics for eight consecutive years from 2014 to 2020. After describing the population and weather characteristics, a lag model was used to explore the relationship between outpatient visits and air pollution. Results: We recorded annual outpatient visits for different respiratory diseases in children. The best synergy lag model found a 10 µg/m3 increase in PM2.5 for every 4-10% increase in the number of pediatric respiratory outpatient visits (P < 0.05). The cumulative effect of an increase in the number of daily pediatric respiratory clinics with a lag of 1-7 days was the best model. Conclusions: PM2.5 is significantly related to the number of respiratory outpatient visits of children, which can aid in formulating policies for health resource allocation and health risk assessment strategies.

Systematic review for the prevention and management of falls and fear of falling in patients with Parkinson's disease.

OBJECTIVE: To synthesize recent empirical evidence for the prevention and management of falls and fear of falling in patients with Parkinson's disease (PD). DATA SOURCE: Database from PubMed, Cochrane Library, and EMBASE. STUDY DESIGN: Systematic review. DATA COLLECTION: We searched the PubMed, Cochrane Library, and EMBASE databases for studies published from inception to February 27, 2021. Inclusion criteria were nonreview articles on prevention and management measures related to falls and fall prevention in Parkinson's disease patients. PRINCIPAL FINDINGS: We selected 45 articles and conducted in-depth research and discussion. According to the causes of falls in PD patients, they were divided into five directions, namely physical status, pre-existing conditions, environment, medical care, and cognition. In the cognitive domain, we focused on the fear of falling. On the above basis, we constructed a fall prevention model, which is a tertiary prevention health care network, based on The Johns Hopkins Fall Risk Assessment Tool to provide ideas for the prevention and management of falling and fear of falling in PD patients in clinical practice CONCLUSIONS: Falls and fear of falls in patients with Parkinson's disease can be reduced by effective clinical prevention and management. Future studies are needed to explore the efficacy of treatment and prevention of falls and fear of falls.

The Relationship Between Knowledge, Attitude, Practice, and Fall Prevention for Childhood in Shanghai, China.

Background: Early childhood fall is a pressing global public health problem and one of the leading causes of child injury. China has a high proportion of children and a high burden of illness from falls. Therefore, educational interventions to prevent childhood fall would be beneficial. Methods: We used the outcome of knowledge, attitude and practice questionnaire, which was conducted by Pudong New District of Shanghai Municipal Government, to summarize demographic and baseline characteristics grouped by intervention or not, and analyzed descriptive statistics of continuous and categorical variables. A logistic stepwise function model was established to study the influence of different covariables on the degree of injury, and AIC/BIC/AICC was used to select the optimal model. Finally, we carried out single-factor analysis and established a multifactor model by the stepwise function method. Results: Attitude and actual behavior scores had significant differences. The intervention and control groups had 20.79 ± 3.20 and 20.39 ± 2.89 attitude scores, respectively. Compared to the control group (5.97 ± 1.32), the intervention group had higher actual behavior scores (5.75 ± 1.50). In the univariate analysis results, fathers' education level, mothers' education level, actual behavior and what cares for children had a significant influence on whether children got injured. In multivariate analysis, attitude had a positive influence on whether injured [odds ratio: 1.13 (1.05-1.21), P < 0.001]. Conclusion: Educational intervention for children and their guardians can effectively reduce the risk of childhood falls, and changes in behavior and attitude are the result of educational influence. Education of childhood fall prevention can be used as a public health intervention to improve children's health.

Healthcare practice strategies for integrating personalized medicine: Management of COVID-19.

Personalized medicine is the tailor-made clinical treatment to the individual characteristics of each patient. It may be considered an extension of traditional approaches to knowing and treating diseases. Personalized medicine has the potential to change the way of identification and management of health problems. Coronavirus disease 2019 (COVID-19) is an infectious disease that primarily affects the patients' lungs. The first case of pneumonia of unknown cause was reported in Wuhan, China on December 31, 2019. As thus, we are quickly approaching the era of personalized medicine. This review discusses the practices currently used in the management of COVID-19 and how they relate to personalized medicine.

Safety of Cinnamon: An Umbrella Review of Meta-Analyses and Systematic Reviews of Randomized Clinical Trials.

Purpose: Many evidence-based studies have indicated that cinnamon has therapeutic effects. However, it may not be entirely safe and its adverse effects may be ignored. The present umbrella review was conducted to elucidate the safety of cinnamon. Methods: Pertinent meta-analyses and systematic reviews of randomized controlled trials on cinnamon use in humans were identified by searching PubMed, EMBASE, and the Cochrane Library from their inception to September 15, 2021. All meta-analyses and systematic reviews on the safety or adverse effects of cinnamon were considered. PRISMA 2020 was used as the standard of reporting (PRISMA registration ID: 286746). Results: We identified three meta-analyses and one systematic review that described the safety of cinnamon. The quality of the meta-analysis and systematic reviews was evaluated using "Assessing the Methodological Quality of Systematic Reviews." Their quality was rated as low in two (50%) instances and moderate in two (50%). There were no significant toxic- or side effects between cinnamon group and placebo group regardless of dose and duration. Conclusion: There is evidence to support that the use of cinnamon has no adverse reactions. It can improve the health status of patients as an adjuvant treatment. Future studies exploring better profile risks and protective factors for cinnamon use-related adverse effect are needed, in order that preventive approaches can be developed.