ABSTRACT
OBJECTIVES: To systematically collate, appraise, and synthesize the current evidence on the Xuebijing injection (XBJI) for sepsis. METHODS: Eight databases were searched for systematic reviews (SRs) or meta-analyses (MAs) on XBJI for sepsis. Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2), Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA), and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methods were used to assess the methodological quality, reporting quality, and evidence quality of the enrolled studies, respectively. RESULTS: Out of the 13 studies that were included, all studies were rated critically low quality based on AMSTAR-2 results. Based on the results obtained from PRISMA, all studies were reported to be over 80%, while the GRADE system yielded three outcome measures rated high-quality, 16 were of moderate quality, and the rest were of low or critically low quality. CONCLUSIONS: The combination of XBJI and Western medicine (WM) showed significant synergy for the treatment of sepsis compared to WM alone. However, this conclusion should be treated with caution since the quality of the SRs/MAs providing the evidence was relatively low.
ABSTRACT
Food grade titanium dioxide (TiO2) containing nanofractions, is commonly applied to whiten and brighten food products, which put consumers under health risks of ingesting TiO2 nanoparticles (NPs). Although the oral toxicity of TiO2-NPs has been evaluated in several studies, gaps in knowledge exist regarding interactions between NPs and food components. Therefore, this study aimed to estimate the influence of TiO2-NPs on nutrient absorption and metabolism through an in situ intestinal loop experiment which conducted on adult Sprague Dawley (SD) rats after 30-d gastrointestinal exposure to TiO2-NPs of two different sizes (N-TiO2 and M-TiO2). Results showed that exposure to TiO2-NPs caused flat apical membranes with sparse and short microvilli and inflammatory infiltration in small intestine. Both particles were absorbed into small intestinal cells, but N-TiO2 with smaller size could more easily be transported through gut and raise the blood titanium (Ti) levels. Changes in serum levels of amino acid were also different after exposure to these two particles. After injecting mixed solution of nutrients into in situ intestinal loop, the N-TiO2 exposure groups displayed significant absorption inhibition of the added histidine (His) and metabolism disorder of some non-added amino acid. However, no influence was observed on metal elements or glucose levels. This study identified TiO2-NPs with small sizes could affect nutrient absorption and metabolism by inducing intestinal epithelium injury, and amino acids were more susceptible than metal elements and glucose. These findings suggested that foods supplemented with TiO2-NPs should be carefully consumed by people with high protein requirements, such as children, the elderly, and patients with high metabolic disease or intestinal inflammation.