Progress and challenges of network meta-analysis.

In the past years, network meta-analysis (NMA) has been widely used among clinicians, guideline makers, and health technology assessment agencies and has played an important role in clinical decision-making and guideline development. To inform further development of NMAs, we conducted a bibliometric analysis to assess the current status of published NMA methodological studies, summarized the methodological progress of seven types of NMAs, and discussed the current challenges of NMAs.

The toxicity assessment of extract of Peganum harmala L. seeds in Caenorhabditis elegans.

BACKGROUND: Peganum harmala L. is a medicinal herb extensively used in traditional Chinese medicine (TCM). So far, relevant reports on the toxicity of Peganum harmala L. seeds (PHS) are hardly available. Especially, we still know little about the in vivo mechanism for PHS toxicity. This study aims to evaluate the toxicity effects of PHS in Caenorhabditis elegans (C. elegans), investigate the possible mechanism of the toxicity effects of PHS, and provide reference for the pharmacological research of PHS. METHODS: In the present study, the C. elegans was exposed to 0.25, 0.50, 1.00 mg/mL of PHS in nematode growth medium (NGM) at 22 °C in the presence of food. Lethality, lifespan, growth, reproduction, and locomotion behavior assays were performed to evaluate the toxicity effects of PHS in C. elegans. We then determined the mechanism of the toxicity effect of PHS by quantitative real-time polymerase chain reaction (qRT-PCR), acetylcholinesterase (AChE) activity assay, and oxidative stress resistance assays. The main components of PHS were detected by high performance liquid chromatography (HPLC). RESULTS: Compared with the control group, the lethality of C. elegans was significantly increased when they were exposed to the ethanol extract of PHS at 0.25, 0.50 and 1.00 mg/mL (P < 0.01), and the mean lifespan was significantly decreased (P < 0.01). We also observed that PHS exposure could induce the toxicity on body length, brood size, and locomotion behavior. CONCLUSION: Our study shows that the ethanol extract of PHS exerts obvious toxic effects on C. elegans, which would provide new ideas and methods for the biological evaluation of the toxicity of Chinese medicinal materials.

[Analysis on medication rules of state medical master Yan Zhenghua from prescriptions with citri reticulatae pericarpium based on data mining].

The prescriptions containing pericarpium citri reticulatae that built by Professor. Yan were collected to build a database based on traditional Chinese medicine (TCM) inheritance assist system. After analyzed by data mining, such as apriori algorithm, the frequency of single medicine, the frequency of drug combination, the association rules between drugs and core drug combinations can be get from the database. Through the analysis of 1 027 prescriptions with pericarpium citri reticulatae, these prescriptions were commonly used to treat stomach aches, cough and other syndromes. The most frequency drug combinations were "Citri Reticulatae Pericarpium-Poria", "Paeoniae Radix Rubra-Citri Reticulatae Pericarpium" and so on. The drug association rules that the confidence was 1 were "Glycyrrhizae Radix ex Rhizoma --> Citri Reticulatae Pericarpium", "Paeoniae Alba Radix-Cyperi Rhizoma --> Citri Reticulatae Pericarpium", "Poria --> Citri Reticulatae Pericarpium", and so on. The drugs in the prescriptions containing pericarpium citri reticulatae that built by Professor Yan mostly had the effects of regulating the flow of Qi and invigorate blood circulation, which reflected the clearly thought when making prescriptions.

Systematic assessment of dexmedetomidine as an anesthetic agent: a meta-analysis of randomized controlled trials.

INTRODUCTION: Here we aimed to study the effectiveness of dexmedetomidine as an anesthetic adjunct in surgery. MATERIAL AND METHODS: A systematic evaluation was performed on published clinical trials. Major databases such as Medline database were employed to search and identify relevant studies and then Rev.Man 5 was used for meta-analysis as well as forest plots. Mean difference (MD) was chosen as the effect size for measurement data, while odds ratio (OR) was calculated for enumeration data. RESULTS: A total of 18 studies met the inclusion criteria. The postoperative heart rate and mean arterial pressure for the dexmedetomidine group were significantly lower than the control group (combined MDs were -14.12 and -9.96). The incidence rates of postoperative nausea and vomiting, chills, and shivering of the dexmedetomidine group were lower than the control group (pooled ORs were 0.41, 0.21 and 0.14, respectively). However, the occurrence rates of bradycardia and hypotension in the dexmedetomidine group were higher than the control group (pooled ORs were 5.14 and 3.00). CONCLUSIONS: Dexmedetomidine can stabilize blood pressure and heart rate, and prevent postoperative adverse reactions. However, patients with original hypovolemia or heart block should be cautious. Besides, the quality of such studies should be improved in methodology to evaluate their efficacy and safety comprehensively.