The clinical effectiveness and safety of traditional Chinese medicine uremic clearance granule combined with high-flux hemodialysis in the treatment of uremic pruritus: A protocol for systematic review and meta analysis.

BACKGROUND: Skin pruritus is a common complication in patients with uremia. When the hemodialysis time of patients is extended, and the probability of skin pruritus is greater. Patients often have the symptoms of skin pruritus intolerable, affecting the normal sleep and normal life of patients. The patients with uremic pruritus often constant scratching and pruritus skin, resulting in broken skin, and further symptoms such as infection, and subsequent skin shedding, prurigo nodularis, and other adverse complications, aggravating the patient's condition. Some patients will experience symptoms such as depression and insomnia due to skin pruritus, and simply scratching the skin lead to infection. Severely affected patients may even show suicidal tendency, endangering the physical and mental health of patients, and it is needed to give the effective treatment to patients. Hemodialysis is a common treatment for uremic pruritus, which can effectively relieve the pruritus symptoms of patients. The drugs can also relieve the symptoms and improve the degree of pruritus in patients. And some studies show that traditional Chinese medicine UCG combined with HFH in the treatment of uremic pruritus has a very good effect, Therefore, this study will systematically evaluate the clinical efficacy and safety of UCG combined with HFH and HFH alone in the treatment of uremic pruritus. METHODS: Use computer to search English and Chinese databases, English databases include: PubMed, Web of Science, EMbase, The Cochrane Library. Chinese databases include: CNKI, CBM, WanFang Data and VIP databases, collecting the RCT on the clinical effectiveness and safety of UCG combined with HFH and HFH alone in the treatment of uremic pruritus. The retrieval time is from the beginning of each database to May 1, 2021. In order to improve the retrieval rate of the literature, the references cited in the included research are also collected and screened. Set Chinese and English as the search language. Two members of the research group independently collected, included and excluded the literatures. In case of disagreement, consulting the third party to assist in the judgment. For the literature with missing data, the original author should be contacted as far as possible to obtain complete data. Two evaluators evaluate the bias risk of included studies according to the Cochrane Handbook bias risk assessment tool for RCT. RevMan 5.3 software is used for statistical analysis and the forest plot is drawn to show the outcome indicators and funnel plot is drawn to show the publication bias. RESULTS: This study evaluates the advantages and disadvantages of traditional Chinese medicine UCG combined with HFH and HFH alone in the treatment of uremic pruritus through the clinical effectiveness and safety-related indicators. CONCLUSION: This study will give a positive conclusion on the efficacy and safety of uremic clearance granule in the treatment of uremic pruritus, and the research results will be published in professional journals in the form of academic papers, thus benefiting more patients. ETHICS AND DISSEMINATION: This study belongs to meta-analysis and all data comes from academic papers published publicly in formal academic journals, so there are no ethical issues involved in this study and no ethical review or approval is required. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/W8P5G.

A case report of scrotal tumoral calcinosis in a patient on maintenance hemodialysis.

Giant tumoral calcinosis is frequently seen around the joints in patients on maintenance hemodialysis (MHD), while it is rarely seen in the scrotum alone. In this paper, we report a 46-year-old male MHD patient who had a giant painless mass in the right scrotum for 2 years, which was removed by a single complete resection and was pathologically confirmed to be tumoral calcinosis. The prognosis of the patient was satisfactory. Uremic scrotal mass should be distinguished from this disease.

[Effects of electroacupuncture on the immunoreactivity of focal cutaneous CB2 receptor positive cells in arthritis rats].

OBJECTIVE: To study the effects of electroacupuncture (EA) on the immunoreactivity of focal cutaneous cannabinoid receptor 2 (CB2) positive cells in adjuvant arthritis (AA) rats. METHODS: A total of 48 adult female SD rats were randomly divided into control group (n = 12), model group (n = 12), acupoint group (n = 12), and non-acupoint group (n = 12). Arthritis model was established by hypodermic injection of complete Freund's adjuvant (CFA, 50 microL) into the left ankle joint. EA (2/ 15 Hz, 1 mA) was applied to "Huantiao" (GB 30) and "Yanglingquan" (GB 34) or two control points 5 mm left to GB30 and GB34 on the diseased side for 30 min, once every other day from the second day on after injection of CFA. Behavioral performance (pain test score) was assesed by using dorsiflexion and plantarflexion pain tests. On the 6th and 16th day after injection of CAF, the animals were anesthetized with 20% urethane (1 g/kg) for collecting the focal skin and subcutaneous tissue samples which were cut into sections (5 microm) to be stained with HE (haematoxylin & cosin) method and immunohistochemical technique respectively for observing changes of the focal cells of the inflamatory tissue and the immunoactivity of the focal cutaneous CB receptor positive cells. RESULTS: 1) In comparison with control group, the scores of both dorsiflexion and plantarflexion pain tests in model, acupoint and non-acupoint groups increased evidently after modeling (P < 0.05). Compared with model group, the scores of dorsiflexion test on the 3rd day and 5th day and plantarflexion test on the 5th day in EA-acupoint group were considerably lower (P < 0.05), and the scores of the two tests on the 3rd day and 5th day of acupoint group were also markedly lower than those of non-acupoint group (P < 0.05), suggesting a marked pain-relief after EA; while no significant differences were found between non-acupoint and model groups. 2) HE staining showed that the inflammatory cells in the dermal layer of the focus of acupoint group were evidently fewer than those of model and non-acupoint groups on the 6th day and 16th day after modeling. 3) The immunohistochemical results revealed that compared with control group, on the 6th day, the percentages of CB2 receptor positive cell area in the focus of model, non-acupoint and acupoint groups were significantly higher (P < 0.05), and that of acupoint group was markedly higher than those of model and non-acupoint groups (P < 0.05), suggesting further upregulation of the expression of CB2 receptor positive cells; no significant differences of percentages of CB2 receptor immunoreaction positive cell area among model, non-acupoint and acupoint groups were found on the 16th day (P > 0.05). CONCLUSION: EA of GB30 and GB34 can raise the immunoactivity of cutaneous CB2 receptor positive cells in the inflammatory tissue which maybe contribute to its effects in relieving inflammatory pain and suppressing focal inflammation and adjusting the balance of nociception and antinociception in AA rats.