Moderate selenium mitigates hand grip strength impairment associated with elevated blood cadmium and lead levels in middle-aged and elderly individuals: insights from NHANES 2011-2014.

Background: Selenium (Se) has been reported to have an antagonistic effect on heavy metals in animals. Nevertheless, there is a lack of epidemiological research examining whether Se can mitigate the adverse effects of cadmium (Cd) and lead (Pb) on hand grip strength (HGS) in middle-aged and elderly individuals. Methods: This study used data from the 2011-2014 National Health and Nutrition Examination Survey (NHANES). HGS measurements were conducted by trained examiners with a dynamometer. Concentrations of Se, Cd, and Pb in blood were determined via inductively coupled plasma mass spectrometry. We employed linear regression, restricted cubic splines, and quantile g-computation (qgcomp) to assess individual and combined associations between heavy metals and HGS. The study also explored the potential influence of Se on these associations. Results: In both individual metal and multi-metal models adjusted for confounders, general linear regression showed Se's positive association with HGS, while Cd and Pb inversely related to it. At varying Se-Cd and Se-Pb concentrations, high Se relative to low Se can attenuate Cd and Pb's HGS impact. An inverted U-shaped correlation exists between Se and both maximum and combined HGS, with Se's benefit plateauing beyond approximately 200 µg/L. Stratified analysis by Se quartiles reveals Cd and Pb's adverse HGS effects diminishing as Se levels increase. Qgcomp regression analysis detected Se alleviating HGS damage from combined Cd and Pb exposure. Subsequent subgroup analyses identified the sensitivity of women, the elderly, and those at risk of diabetes to HGS impairment caused by heavy metals, with moderate Se supplementation beneficial in mitigating this effect. In the population at risk for diabetes, the protective role of Se against heavy metal toxicity-induced HGS reduction is inhibited, suggesting that diabetic individuals should particularly avoid heavy metal-induced handgrip impairment. Conclusion: Blood Cd and Pb levels are negatively correlated with HGS. Se can mitigate this negative impact, but its effectiveness plateaus beyond 200 µg/L. Women, the elderly, and those at risk of diabetes are more vulnerable to HGS damage from heavy metals. While Se supplementation can help, its protective effect is limited in high diabetes risk groups.

A Core Drug Discovery Framework from Large-Scale Literature for Cold Pathogenic Disease Treatment in Traditional Chinese Medicine.

Cold pathogenic disease is a widespread disease in traditional Chinese medicine, which includes influenza and respiratory infection associated with high incidence and mortality. Discovering effective core drugs in Chinese medicine prescriptions for treating the disease and reducing patients' symptoms has attracted great interest. In this paper, we explore the core drugs for curing various syndromes of cold pathogenic disease from large-scale literature. We propose a core drug discovery framework incorporating word embedding and community detection algorithms, which contains three parts: disease corpus construction, drug network generation, and core drug discovery. First, disease corpus is established by collecting and preprocessing large-scale literature about the Chinese medicine treatment of cold pathogenic disease from China National Knowledge Infrastructure. Second, we adopt the Chinese word embedding model SSP2VEC for mining the drug implication implied in the literature; then, a drug network is established by the semantic similarity among drugs. Third, the community detection method COPRA based on label propagation is adopted to reveal drug communities and identify core drugs in the drug network. We compute the community size, closeness centrality, and degree distributions of the drug network to analyse the patterns of core drugs. We acquire 4681 literature from China national knowledge infrastructure. Twelve significant drug communities are discovered, in which the top-10 drugs in every drug community are recognized as core drugs with high accuracy, and four classical prescriptions for treating different syndromes of cold pathogenic disease are discovered. The proposed framework can identify effective core drugs for curing cold pathogenic disease, and the research can help doctors to verify the compatibility laws of Chinese medicine prescriptions.

Spraying rhubarb powder solution under gastroscope in the treatment of acute non-varicose upper gastrointestinal bleeding: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: Systematically assessing the safety and effectiveness of spraying rhubarb powder solution under gastroscope for the treatment of acute non-varicose upper gastrointestinal bleeding, and confirmation for further clinical research and application. METHODS: We searched the following databases up till November 2019: PubMed, the Cochrane Library, EMBASE, CNKI, WanFang Data, VIP and SinoMed. Randomized controlled trials (RCTs) were used to compare the curative effect of spraying rhubarb powder solution with other drugs under gastroscope for the treatment of acute non-varicose upper gastrointestinal bleeding. RESULTS: Out of 171 articles, 14 RCTs involving 1493 patients were included. All control groups included in the RCTs were treated with norepinephrine solution. The hemostatic effect of spraying rhubarb powder solution under gastroscope was examined for 24 h at high concentration (0.1 g/mL). The hemostatic effect at higher conc. (0.1 g/mL) found far more better than low conc.(RR = 1.48;95 %CI:1.25,1.75;P﹤0.00001) (0.03 g/mL)as homeostatic effect at low conc.is same that of norepinephrine solution (RR = 1.02;95 %CI:0.94,1.10;P = 0.62). Moreover within 48 h, rhubarb powder solution with 0.1 g/mL or 0.15 g/mL conc. have of significantly higher hemostatic effects than norepinephrine solution (RR = 1.18;95 % CI: 1.08, 1.30;P = 0.0003). Occurrence of rebleeding event within 48 h after successful hemostasis (RR = 0.42;95 %CI:0.24,0.74;P = 0.003) reduced exceptionally. After that the hemostatic effect of rhubarb powder solution with 0.1 g/mL conc.examined within 72 h again exhibited significant improvement than norepinephrine solution (RR = 1.19;95 %CI:1.12,1.26;P < 0.00001). On par with immediate hemostasis time, rhubarb powder solution took unprecedented less time than norepinephrine solution;(MD=-5.56S;95 %CI:-6.16, -4.95;P﹤0.00001). Additionally, the adverse reaction produced by rhubarb powder solution is much lower than norepinephrine solution (RR = 0.22;95 %CI:0.11,0.42;P < 0.00001). CONCLUSIONS: According to meta-analysis, Spraying rhubarb powder solution under gastroscope in the treatment of acute non-varicose upper gastrointestinal bleeding is superior to norepinephrine solution in improving hemostasis effect. Shortening immediate hemostasis time and reducing rebleeding,and is safe to use. Based on the results of this study, physicians can treat patients with acute non-varicose upper gastrointestinal bleeding by spraying rhubarb powder solution under gastroscope according to the patients' condition.However, the sample size included in this study is small and of substandard quality qu, and a large sample size clinical trial with strict design and normative report is needed to verify the safety and efficacy of rhubarb powder solution under gastroscope for acute non-varicose upper gastrointestinal bleeding.

A Semantic Analysis and Community Detection-Based Artificial Intelligence Model for Core Herb Discovery from the Literature: Taking Chronic Glomerulonephritis Treatment as a Case Study.

The Traditional Chinese Medicine (TCM) formula is the main treatment method of TCM. A formula often contains multiple herbs where core herbs play a critical therapeutic effect for treating diseases. It is of great significance to find out the core herbs in formulae for providing evidences and references for the clinical application of Chinese herbs and formulae. In this paper, we propose a core herb discovery model CHDSC based on semantic analysis and community detection to discover the core herbs for treating a certain disease from large-scale literature, which includes three stages: corpus construction, herb network establishment, and core herb discovery. In CHDSC, two artificial intelligence modules are used, where the Chinese word embedding algorithm ESSP2VEC is designed to analyse the semantics of herbs in Chinese literature based on the stroke, structure, and pinyin features of Chinese characters, and the label propagation-based algorithm LILPA is adopted to detect herb communities and core herbs in the herbal semantic network constructed from large-scale literature. To validate the proposed model, we choose chronic glomerulonephritis (CGN) as an example, search 1126 articles about how to treat CGN in TCM from the China National Knowledge Infrastructure (CNKI), and apply CHDSC to analyse the collected literature. Experimental results reveal that CHDSC discovers three major herb communities and eighteen core herbs for treating different CGN syndromes with high accuracy. The community size, degree, and closeness centrality distributions of the herb network are analysed to mine the laws of core herbs. As a result, we can observe that core herbs mainly exist in the communities with more than 25 herbs. The degree and closeness centrality of core herb nodes concentrate on the range of [15, 40] and [0.25, 0.45], respectively. Thus, semantic analysis and community detection are helpful for mining effective core herbs for treating a certain disease from large-scale literature.

Probiotic supplements for relieving stress in healthy participants: A protocol for systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Psychological stress is a ubiquitous subjectively negative emotional experience, but excessive psychological stress has adverse effects on the happiness in our lives and physical and mental health, and may cause many health problems. Studies have found that probiotics have a certain role in alleviating negative emotions, reducing abnormal behaviors, improving cognitive function, and also showing the great potential of probiotics in relieving psychological stress. At present, many clinical trials have been carried out to intervene in populations with psychological stress with probiotic supplements, but there still lack of targeted systematic review and meta-analysis. METHODS AND ANALYSIS: The Cochrane Central Register of Controlled Trials, Embase, MEDLINE, Psycoinfo, Cumulative Index to Nursing and Allied Health Literature will be searched to obtain the eligible randomized controlled trials published up to March 1, 2019. Meanwhile, the references to relevant publications will also be reviewed to identify other studies, and will re-search before finial summary for analysis. EndNote X7 will be used as a document manager for duplicate checking and screening of literature. The risk of bias will be assessed and the date of included studies will be analyzed by Revman V5.3.5. RESULTS: The primary outcome will be subjective stress level, general mild psychiatric symptoms of participants. The secondary outcome will be cortisol level and adverse effects likely to be related to treatment. CONCLUSION: The systematic review and meta-analysis will provide evidence to assess the efficacy and safety of probiotics in relieving psychological stress. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019122930.

Twelve Chinese herbal preparations for the treatment of depression or depressive symptoms in cancer patients: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Patients with cancer are vulnerable to depression or other depressive conditions. The aim of this paper was to evaluate the efficacy and safety of Chinese herbal medicine (CHM) for the treatment of depression or depressive symptoms in cancer patients. METHODS: CENTRAL, MEDLINE, EMBASE, PsycINFO, CNKI, VIP, SinoMed, and online clinical trial registry websites were searched for relevant RCTs until May 2017. The methodological quality of each included study was assessed with the "risk of bias" tool. Review Manager 5.3.5 was used to analyze the data. RESULTS: We identified 18 RCTs that included data from 1441 participants. Twelve different types of Chinese herbal preparations were investigated by these studies, and they showed a better therapeutic effect in most comparisons when measured in terms of depression rating scale scores, with SMDs (95% CI) of - 2.30 (- 3.54, - 1.05) (CHM versus no treatment), - 0.61 (- 1.03, - 0.18) (CHM versus antidepressants), and - 0.55 (- 1.07, - 0.02) (CHM plus psychological treatments versus psychological treatments), or when measured in terms of treatment response rate, with RRs (95% CI) of 1.65 (1.19, 2.29) (CHM versus no treatment), 1.15 (1.03, 1.28) (CHM versus psychological treatments), 1.32 (1.07, 1.63) (CHM plus antidepressants versus antidepressants), and 1.70 (1.02, 2.85) (CHM plus psychological treatments versus psychological treatments). Compared with antidepressants, these CHMs showed borderline superiority for improving the response rate, with an RR (95% CI) of 1.08 (0.93, 1.26). Subgroup analysis based on psychiatric diagnosis (depression versus depressive symptoms) did not modify the direction of these estimates and neither could it explain the high level of heterogeneity. Patients in the CHM group experienced fewer adverse events of cardiac toxicity (P = 0.02), functional gastrointestinal disorders (P = 0.008), sleep disturbances (P = 0.02), blurred vision (P = 0.02) and fatigue (P = 0.03) than the patients in the no treatment group or the antidepressants group. CONCLUSIONS: According to the investigation of the twelve herbal preparations, the CHM intervention appears to alleviate depressive symptoms in cancer patients, either alone or combined with antidepressants or psychological treatments. However, a high risk of bias and high heterogeneity made the mean estimates uncertain. Well-designed trials with comprehensive and transparent reporting are warranted in the future.

A systematic review and meta-analysis of randomized controlled trials: Skin-patch of Chinese herbal medicine for patients with acute gouty arthritis.

AIMS: To evaluate the evidence of the effectiveness and safety of Chinese herbal medicine skin-patches for patients with acute gouty arthritis. BACKGROUND: Acute gouty arthritis is a problem that can limit the level of activity and impair the quality of life. In China, many clinical studies have demonstrated that skin-patches of Chinese herbal medicines benefit patients with acute gouty arthritis. However, the reported clinical effects vary. DESIGN: A systematic review and meta-analysis of randomized controlled trials. DATA SOURCES: Three English databases including CENTRAL (1993 to February 2017), PubMed (1966 to February 2017) and EMBASE (1974 to February 2017) and four Chinese databases including Chinese National Knowledge Infrastructure, Chinese VIP Information, SinoMed and Wanfang (all, 1949 - February 2017) were searched. Randomized controlled trials that compared skin-patches of Chinese herbal medicine with or without conventional treatments to conventional treatments, no treatment or a placebo treatment for patients with acute gouty arthritis were included. REVIEW METHODS: We conducted a systematic review and meta-analysis following the Cochrane process. Two authors selected the studies, extracted the data and evaluated the risk of bias of the included trials. RESULTS: Nineteen studies met our inclusion criteria. After synthesizing the data, the results showed that skin-patches of CHM combined with Western medicine seemed to be more effective than Western medicine alone for pain relief in patients with acute gouty arthritis and had fewer adverse events. CONCLUSION: Due to the quality of the data, larger and more rigorously designed clinical trials with proper outcome measures are necessary.

Chinese Herbal Medicine for the Treatment of Depression: Applications, Efficacies and Mechanisms.

Depression is a common psychiatric disorder and a leading cause of disability worldwide. Traditional Chinese medicine is one of the commonly used complementary and alternative medicine therapies for depression. Clinical trials have been carried out to assess the efficacy and safety of Chinese herbal medicine currently. The exploration of herbal mechanisms of action used for the treatment of depression has also received great attention. This study is performed to summarize the frequently used formulae, patent drugs and single herbs in treating depression, review the literatures of clinical trials in treating depressive disorders, and to list the possible mechanisms involved during the treatment. Besides, we will analyze the limitations of present studies and the obstacles in the modernization of traditional Chinese medicine.

Chinese Herbal Medicine for Postpartum Depression: A Systematic Review of Randomized Controlled Trials.

Background. Postpartum depression (PPD) does great harm to women following childbirth. The aim of this study was to conduct a systematic review of the literature to assess the efficacy and safety of CHM for the treatment of PPD. Methods. Published or ongoing registered trials were searched for from the inception of the various databases to December 31, 2015. Data extraction and methodology assessment were conducted independently by two researchers. RevMan 5.3 software was used to analyze the data. Results. Forty-seven registered clinical trials (RCTs) were identified and reviewed. The results showed CHM alone or in combination with routine treatments could reduce HAMD score, EPDS score, incidence of adverse events, TESS, and SERS. CHM combined with routine treatment was more effective in increasing serum estradiol levels and reducing progesterone levels than routine treatment alone. Meanwhile, pooled data revealed that MRLQS combined with routine treatments or MRLQS plus MSHS combined with routine treatments were more effective than other therapeutic methods in TCM. MRLQS plus MSHS alone was found to be an effective alternative when compared to routine treatments. Conclusions. This review suggested that CHM was safe and effective in the treatment of PPD. However, this could not be proven conclusively. To ensure evidence-based clinical practice, more rigorously designed trials are warranted.

Wendan decoction (温胆汤) for treatment of schizophrenia: a systematic review of randomized controlled trials.

OBJECTIVE: To assess the beneficial and adverse effects of Wendan Decoction (温胆汤, WDD) for the treatment of schizophrenia. METHODS: Five electronic databases were searched until May 2014, including the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the Chinese Scientist Journal Database, PubMed, and the Cochrane Central Register of Controlled Trials in the Cochrane Library. The randomized controlled trials (RCTs) testing WDD against placebo, antipsychotic drugs, or WDD combined with antipsychotic drugs against antipsychotic drugs alone were included. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. RESULTS: Thirteen RCTs (involving 1,174 patients) were included and the methodological quality was evaluated as generally low. The pooled results showed that WDD combined with antipsychotic drugs were more effective in clinical comprehensive effect, Positive and Negative Syndrome Scale (PANSS) scores and Brief Psychiatric Rating Scale scores compared with antipsychotic drugs alone. However, WDD had less effectiveness compared with antipsychotics in clinical comprehensive effect; and WDD was not different from antipsychotic drugs for PANSS scores. The side effects were significantly reduced in the intervention group compared with the control group. CONCLUSIONS: WDD appears to be effective on improving symptoms in patients with schizophrenia. However, due to poor methodological quality in the majority of the included trials, the potential benefit from WDD needs to be confirmed in rigorous trials and the design and reporting of trials should follow the international standards.

[The relationship between meridians and mental state discused from the treatment of depression with acupuncture and moxibustion].

The acupoints and meridians selected in the treatment of depression with acupuncture and moxibustion recorded in the domestic clinical literatures from 2001 to 2011 were summarized and analyzed so as to provide the references for the treatment of depression with acupuncture and moxibustion and discuss the relationship between meridians and mental state. SPSS 17.0 statistical analyzing software was used and the statistical description of enumeration data was applied for statistical analysis. It was found that all of the twelve regular meridians and the eight extraordinary meridians were involved in the treatment of depression with acupuncture and moxibustion, of which the application frequency of the Governor Vessel was the highest and that of the Foot-Taiyang Meridian, Foot-Yangming Meridian, Foot-Shaoyang Meridian and the Conception Vessel were followed. It is concluded that depression is Yin disease treated by regulating Yang meridians and it is found that the Governor Vessel, three foot yang-meridians and the Conception Vessel are closely related to mental disorders.