Quality evaluation of Keteling capsules based on fingerprinting, multicomponent quantification, and quantitative prediction.

The Keteling capsule (KC) is a traditional Chinese medicine (TCM) made from the dried extract of Ficus microphylla and an appropriate amount of chlorpheniramine maleate. It is widely used to treat cough and relieve asthma. Despite its extensive usage, a rapid and comprehensive quality evaluation strategy for KC remains a challenge. This study introduces an electrochemical fingerprint analysis technique, in addition to the commonly employed HPLC fingerprints, for efficient and convenient quality evaluation. Moreover, a cost-effective, rapid, and accurate multi-component quantification technique known as the "Multi-markers assay by the monolinear method (MAML)" and the "FT-IR quantitative model" were explored. The HPLC fingerprints were evaluated using a systematically quantified fingerprint method, while the electrochemical fingerprints, based on the Belousov-Zhabotinsky oscillation reaction principle, were effectively analyzed and characterized using oxidation induction times and oscillation lifetimes. Multi-component quantitative analysis was carried out through the MAML and FT-IR quantitative models. The HPLC fingerprint successfully classified the 22 samples into eight grades with excellent discrimination. Active ingredient content analysis was achieved using reliable parameters obtained from electrochemical fingerprinting. The no significant difference in the quantitative results proves the accuracy of the MAML method. Additionally, successful FT-IR quantitative prediction models were developed for chlorogenic acid, isovitexin, and chlorpheniramine maleate. This study offers a dependable and effective approach for enhancing the quality control of KC, and it can provide new insights for improving the quality analysis methods in the field of TCM.

High performance liquid chromatography three-wavelength fusion fingerprint combined with electrochemical fingerprint and antioxidant method to evaluate the quality consistency of Mingmu Dihuang Pill.

In this paper, three-wavelength fusion fingerprint (TWFFP) combined with electrochemical fingerprint (ECFP) and antioxidant methods were used to jointly explore the quality consistency of Mingmu Dihuang Pill (MMDHP). The TWFFP fully demonstrated the maximum ultraviolet absorption characteristics at multiple wavelengths, supplemented the defects brought by the single-wavelength evaluation. ECFP was established to analyze the characteristic parameters in more depth, and all samples had inhibitory effects on the electrochemical oscillation system. Using 2,2-diaza-bis(3-ethylbenzothiazole-6-sulfonic acid) antioxidant test, combined with ECFP, the fingerprint-efficacy relationship was established with the peak areas of the TWFFP. As a result, 15 of the 36 common peaks made important contributions to both efficacy relationships at the same time. The TWFFP and ECFP were evaluated by a systematically quantified fingerprint method, and the ability of HPLC and electrochemical to distinguish samples was discussed by hierarchical clustering analysis. Content percentage was introduced to calculate the relationship between marker components and macro quantitative similarity. The method of quantitative analysis of multi-components by single marker was explored to analyze the accuracy of evaluating the marker components. This study provided a comprehensive and reliable method for the quality consistency control of complex Traditional Chinese Medicine and its compound preparations.

Quality grade evaluation and related antioxidant activity research of different medicinal parts of Catalpa fruit.

Catalpa fruit is a traditional Chinese medicine used in the treatment of diuresis and detumescence; however one-sided quantitative or qualitative investigation limits its overall quality evaluation. Hence, this study proposed to qualitatively and quantitatively evaluate the quality consistency of Catalpa fruit from the perspectives of chromatography and spectroscopy. First, the fusion fingerprints of 15 batches of Catalpa fruit pericarp and 15 batches of Catalpa fruit seed were established by high performance liquid chromatography (HPLC) and ultraviolet (UV) spectroscopy in equal weights, respectively, to avoid the unilaterality of a single analytical technique. The different medicinal parts of Catalpa fruit were graded and evaluated based on a systematically quantified fingerprint method, and the quality of the pericarp and seed was further investigated. The results revealed that the quality of most pericarp and seed samples was within the acceptable level range (grade ≤ 5), and that seed quality was clearly superior to pericarp quality. Furthermore, according to the research findings, the content of p-hydroxybenzoic acid in Catalpa fruit pericarp was generally higher than that in Catalpa fruit seed, while the content of catalposide was generally lower than that in Catalpa fruit seed. Additionally, the fingerprint-efficacy relationship with HPLC was discussed by binary correlation analysis, which indicated that catalposide had the strongest antioxidant activity. This study demonstrated that the analytical techniques based on chromatographic fingerprinting, spectral fingerprinting and antioxidant activity provided new theoretical foundation as well as technical guidance for Catalpa fruit quality control and rational utilization.

Compound synthesizing profiling based on quantitative HPLC fingerprints combined with antioxidant activity analysis for Zhizi Jinhua pills.

BACKGROUND: Compound drug Zhizi Jinhua Pills (ZZJHP) is composed of 8 herbal medicines (HMs), and it is necessary to control the HMs to ensure its holistic quality. PURPOSE: To establish a quality monitoring method for ZZJHP from precise control of multiple active ingredients to contour control of fingerprint, to calculate the contribution of HMs and predict the quality of compound drugs. METHODS: In this study, HPLC method was established for content determination of 11 analytes and fingerprint assessment. In vivo and in vitro studies of antioxidant activity were performed, Orthogonal Partial Least Squares analysis was applied for spectrum-effect correlation between antioxidant activity and HPLC fingerprint. The compound synthesizing fingerprint (CSF) of ZZJHP was fitted with 8 HMs, and the contribution of the single herb to prescription was evaluated by Sub-quantified profiling method. RESULTS: The content of 11 analytes and fingerprints of ZZJHP were measured simultaneously, 32 batches of samples were divided into 6 grades. In vivo and in vitro researches suggested significant antioxidant activity capacity of ZZJHP. Then, spectrum-effect relationship study showed that 24 of the 30 fingerprint peaks had antioxidant activity. By prescription and decomposition profiling, the qualitative and quantitative contributions of the 8 herbs were revealed in turn. The negative solution experiment proved that CSF could accurately predict the quality of composite drugs. CONCLUSION: The intelligent prediction strategy could intervene at the source to realize rapid screening of HMs and prediction of the quality of preparations, which could provide guidance for the use of HMs and improve the quality of composite drugs.

Electrochemical-based quantitative fingerprint evaluation strategy combined with multi-markers assay by monolinear method for quality control of herbal medicine.

BACKGROUND: Improving the quality control (QC) criterion of herbal medicine (HM) is an ongoing challenge. A rapid and convenient electrochemical analysis technique is now emerging as a promising application for HM QC. So far, extraction and analysis of the overall electroactive components is a key issue need to be solved to improve its application in integral HM QC. PURPOSE: In this work, using compound liquorice tablets (CLQTs) as an example, we like to put forward a more reliable and accurate quantification method of multi-components for the precise QC of HM. Furthermore, we propose an electrochemical fingerprint-based data mining, extract and synthesis strategy for in-depth and comprehensive QC of HM, qualitatively and quantitatively. METHODS AND DESIGN: Firstly, the electrochemical quantitative fingerprint of 54 batches of CLQTs from nine manufacturers were developed using B-Z oscillatory system. Secondly, eight characteristic parameters were recorded and compared among samples using intuitive information and PCA. Then, tund was used to establish the correlation with sample dosage for determination of the relative content of overall electroactive components (Rc). The quantitative determination of five quality markers (Q-markers) were also performed using the novel method, called multi-markers assay by monolinear method (MAML). Finally, after using area integral calculus for electrochemical fingerprint, average linear quantitative fingerprint method (ALQFM) was successfully proposed to extract all latent characteristics for integral quality evaluation of samples. RESULTS: The tund and dosage showed a good correlation, by which the obtained Rc displayed different fluctuation among nine manufacturers. Moreover, the contents of five Q-markers obtained by MAML displayed no significant difference with the traditional quantification method. Samples evaluated by ALQFM manifested the integral information and were divided into eight quality grades. The deduced results of correlation between Pl with P5C, Rc and PA were more persuasive for demonstrating the reliability and integrity of ALQFM in quality evaluation of HM electrochemical fingerprint. CONCLUSION: The study confirmed the idea that quantification of Q-markers combined electrochemical-based quality evaluation strategy could be used as a reliable method for HM QC qualitatively and quantitatively from point (precise) to face (integral).

A trinity fingerprint evaluation system of traditional Chinese medicine.

This study focused on developing a set of quality evaluation methods that can reflect the multi-levels and multi-characteristics of traditional Chinese medicine (TCM). Taking licorice (Glycyrrhiza glabra L.) as the method development sample, the feasibility of multi-markers assay by monolinear method (MAML) was explored through the standard curve relationship among active components for the first time. Using glycyrrhizic acid as measurement marker, MAML can simultaneously quantify five components of licorice, including isoliquiritigenin, isoliquiritin apioside, liquiritigenin, liquiritin and liquiritin apioside. Comparing MAML and quantitative analysis of multi-components by single-marker (QAMS) to the external standard method (ESM) respectively, it was found that there was no significant difference in the content of components that were calculated by MAML and ESM (the relative error (RE) was generally less than 2.00%). However, the RE of the component content calculated by QAMS fluctuated greatly, indicating that the MAML was more accurate than QAMS. In addition, UV and THz quantum fingerprints were initiated by the interval erasure method. Taking the systematically quantified fingerprint method as the core, a "Trinity" fingerprint quality evaluation system based on HPLC, UV and THz was developed. The system successfully distinguished the quality differences of licorice samples from 13 producing areas and two ecological models by the comprehensive evaluation results. Simultaneously, the quality information of licorice at different technical levels was revealed. Finally, bivariate correlation analysis was used to examine the linkage between UV/HPLC and antioxidant spectrum efficacy, and the two-dimensional activity spectrum of licorice was provided. It may furnish a more thorough and objective analytical technique for licorice and even other TCMs in chemical fingerprint features, chemical bond vibration characteristics and biological activity information.

Evaluation of quality consistency of herbal preparations using five-wavelength fusion HPLC fingerprint combined with ATR-FT-IR spectral quantized fingerprint: Belamcandae rhizoma antiviral injection as an example.

The present study was designed to establish a comprehensive and practical method for the quality evaluation and control of herbal preparation (HEP). The chemical information of belamcandae rhizoma antiviral injection (BRAI) was extracted using a dual-system control system comprised of HPLC chromatography and attenuated total reflection Fourier transform infrared (ATR-FT-IR) spectroscopy. To begin with, a quantitative analysis of six BRAI index components was accomplished. On this basis, HPLC five-wavelength fusion fingerprint was established to control the overall quality of BRAI. Secondly, the quality control system of ATR-FT-IR spectroscopy was constructed, that is, a quantitative analytic model to forecast the total amount of index components. Concurrently, the ATR-FT-IR quantized fingerprint was established for similarity analysis utilizing the Systematic quantified fingerprint method (SQFM). In addition, an integrated evaluation technique based on equal weights was presented to assure the comprehensiveness of chemical information. The 20 samples demonstrated good consistency in terms of quality, with a quality rating of grade 1-3. Notably, the rationality of the average method of Systematic quantified fingerprint method application in BRAI was further verified using PCA and low-level data fusion. Finally, this paper developed a model for intelligent analysis that is both quick and complete. We have redefined the quality standard of belamcandae rhizoma that can be put into production (70%< Pm<130%) in light of the influence of other HEM in the BRAI. This research demonstrated a quality analysis technique based on chromatography and spectrum, which was suited for HEP consistency control since it was easy, quick, accurate, and reliable.

Comprehensive evaluation of Loblolly fruit by high performance liquid chromatography four wavelength fusion fingerprint combined with gas chromatography fingerprinting and antioxidant activity analysis.

Loblolly fruit (LBF) is mainly used as raw material for beverage, but there are few researches on its quality evaluation or control. The aim of this study was to develop comprehensive evaluation methods for the quality control of Loblolly fruit. firstly, double wavelength coefficient ratio spectrum was used to identify the purity of chromatographic fingerprint peak. It is very important to identify the purity of fingerprint peaks because only the quantitative determination of pure chromatographic peaks is meaningful for its efficient quality control. Then, multi-wavelength fusion fingerprint was established to avoid one-sidedness of a single wavelength for further evaluation by systematically quantified fingerprint method (SQFM). According to the outcome of Pm, 25 batches of LBF were classified into two classifications by hierarchical cluster analysis, which was consistent with the SQFM evaluation results. Two active components, gallic acid (GAC) and ethyl gallate (EGA) in LBF, were quantitatively determined by quantitative analysis of multi-components by single marker (QAMS). In addition, the fingerprint efficacy relationship was established using an off-line antioxidant system and partial least-squares model to explore the connection between chemical components and antioxidant activities. Finally, the evaluation results of high-performance liquid chromatography and gas chromatography were integrated by the mean algorithm, which could reduce the error caused by single method. The results showed that the proposed strategy could provide a method for quality evaluation of LBF and even other traditional Chinese medicines (TCMs).

Evaluating the spectrum-effect profiling and pharmacokinetics of Tieshuang Anshen Prescription with better sedative-hypnotic effect based on Fe2+ than Hg2.

Although Zhusha Anshen Pill (ZSASP) is a commonly used traditional prescription for insomnia, the safety of cinnabar in the formula has always been controversial since its initial application in medical fields. Here, we developed a new prescription, Tieshuang Anshen Prescription (TSASP), by improving ZSASP with Fe2+ instead of Hg2+. Besides, TSASP was further optimized by establishing and testing the HPLC fingerprint and its sedative-hypnotic effect of formulas with different compatibility ratios and performing correlation spectrum analysis. The safety of TSASP was also evaluated by HE staining of liver and kidney. In addition, a validated and robust UHPLC-MS/MS method was established to demonstrate the pharmacokinetic characteristics of berberine, palmatine, jatrorrhizine, ligustilide, catalpol, loganin, liquiritin and liquiritigenin after oral administration of TSASP. Our study originally provides a new non-toxic prescription, TSASP, with better sedative-hypnotic effect in comparison with ZSASP, revealing that Fe2+ could replace Hg2+ to eliminate its toxicity and play a sedative role. Meanwhile, we believe that our pharmacokinetics results may contribute valuable reference to both TSASP's specific mechanism of action and its further clinical efficacy and effectiveness research.

A smart spectral analysis strategy-based UV and FT-IR spectroscopy fingerprint: Application to quality evaluation of compound liquorice tablets.

This study focuses on development of a smart spectral analysis strategy for rapid quality evaluation of complex sample. Firstly, the ultraviolet (UV) and Fourier Transform Infrared (FT-IR) spectroscopy were established. Secondly, the second derivative UV spectral was obtained and showed 7 major absorption peaks, which was the projection of the 3D-spectrum profile. It can perform peak matching like chromatogram, thus, helpful for 3D UV spectrum analysis, qualitatively and quantitatively. The qualitative and quantitative similarity results based on systematic quantified fingerprint method displayed basically a consistency with their hierarchical cluster analysis results. Notably, the quality evaluation of the first proposed FT-IR spectral quantized fingerprints and the good correlation of Pm% with PA (R2 = 0.80296), as well as the excellent quantitative prediction model for liquiritin, glycyrrhizinic acid and sodium benzoate all indicated the promising of FT-IR spectral quantized fingerprint in quantitative analysis and QC of compound liquorice tablets. Finally, an integrated evaluate strategy was developed by mean algorithm to reduce the error caused by single technique. 54 samples integrally had a good quality consistency as their quality ranged grade 1-5. This study illustrated that the smart data analysis strategy based on spectral fingerprint has potential to enhance existing methodologies for further rapid and integrated studies evaluating the quality of herbal medicine and its related products.

A novel method for quality consistency evaluation of Yankening Tablet by multi-wavelength fusion profiling combined with overall components dissolution method and antioxidant activity analysis.

Yankening Tablet (YKNT) is an anti-inflammatory Chinese medicine, which has the effect of heat-clearing and purging pathogenic fire. In this paper, a novel method for quality consistency evaluation of YKNT by multi-wavelength fusion profiling combined with multi-component quantification, overall components dissolution method and antioxidant activity analysis was established. The five-wavelength fusion fingerprint (FWFFP) of 19 batches of YKNT was established, which was evaluated qualitatively and quantitatively by systematic quantified fingerprint method (SQFM), and the quality of YKNTs was divided into different grades successfully. Three active components, Berberine (BBR), baicalin (BCL) and chrysophanol (CRP) in YKNT, were quantitatively determined by quantitative analysis of multi-components by single marker (QAMS). Principal component analysis divided the 19 batches of samples into two categories according to the content difference, which was consistent with the SQFM evaluation results. The combination of SQFM and QAMS successfully achieved the quantitative determination of YKNT from the whole to accurate. Partial least squares (PLS) model was developed to explore the relationship between the antioxidant ability and fingerprint of YKNT. Further overall dissolution UV fingerprints (ODUV-FP) were successfully established, in which the ultraviolet fingerprint (UV-FP) quantitative method was applied to determine the dissolution of the whole chemical substance of traditional Chinese medicine (TCM) preparation. HPLC fingerprints (HPLC-FP) and ODUV-FP were combined to realize the dual control of the quality and efficacy of YKNT, providing a new method for consistency evaluation of TCM.

Capillary electrophoresis fingerprints combined with Linear Quantitative Profiling Method to monitor the quality consistency and predict the antioxidant activity of Alkaloids of Sophora flavescens.

Alkaloids of Sophora flavescens (ASF) has various pharmacological effects, and it is widely used in clinical practice. The aim of this research was to develop an environmentally friendly methodology that enables not only identification but also the quality consistency assessment of Alkaloids of Sophora flavescens. A background electrolyte composed of 50 mmol/L sodium tetraborate solution, 500 mmol/L boric acid and 1.2 mmol/L citric acid was used to conduct the fingerprint analysis coupled with quantitative determination of three components. Linear quantitative profiling method was used for comprehensive quality discrimination of the test samples from both qualitative and quantitative perspectives, and the 27 batches of samples were well differentiated. In addition, the fingerprint-efficacy relationship between chemical components and antioxidant activity in vitro was established using partial least squares regression model, which provided important medicinal efficacy information for quality control.

[Separation of alkaloids using radial chromatography and its separation efficiency].

The radial thin layer chromatography (RTLC) is a chromatographic method for the simple, rapid and efficient separation of samples from the center along the radial direction. Simple device was assembled to separate the alkaloids contented in Zhusha Anshen Pills (ZSASP). Based on the theory of thin layer chromatography, the test was designed to compare the separation efficiency of radial chromatography and general thin layer chromatography. The RTLC is faster, more efficient, more economical, and more suitable for the separation of high polar samples like alkaloids as proved. The theoretical root of the high separation efficiency of radial thin layer method was explored, which also provided new methods and ideas for theoretical innovation.

Quality consistency evaluation of Isatidis Folium combined with equal weight quantified ratio fingerprint method and determination of antioxidant activity.

Isatidis Folium has been known as a valuable traditional Chinese medicine for thousands of years. Little attention, however, has been paid to its quality control. The aim of the present study was to establish a novel strategy to monitor and assess the quality consistency of Isatidis Folium. First, 20 samples were separated and identified simultaneously by high-performance liquid chromatography in an effective, quick and sensitive way. Then, Single-wavelength fingerprint was fused into multi-wavelength fingerprints to show fingerprints' information thoroughly. The similarity analyses of fingerprints were performed by equal weight quantified ration fingerprint method in terms of qualitative and quantitative aspects. The evaluation result showed that 20 batches of samples were classified into different grades. In addition, the relationship between fingerprints and antioxidant activity were investigated by partial least-squares model, which offered significant medicinal efficacy information for quality control. This comprehensive strategy provided a valuable reference for Isatidis Folium to ameliorate their quality control.

Efficacy and Safety of Xiaoyao Formula as an Adjuvant Treatment for Post-Stroke Depression: A Meta-Analysis.

OBJECTIVE: To systematically evaluate the efficacy and safety of Xiaoyao formula (XYF) as an adjuvant treatment of post-stroke depression (PSD) by conducting a meta-analysis. METHODS: Pubmed, Embase, Cochrane Library, CNKI, VIP, and Wanfang databases were searched up to May 2016. Randomized controlled trials investigating XYF plus antidepressants versus antidepressants alone for patients with PSD were considered. RESULTS: A total of 607 PSD patients were identified from 7 trials. Adjuvant treatment with XYF had additional benefits in terms of improved total response rates (risk ratio [RR] 1.21; 95% confidence interval [CI]: 1.12-1.30), reduced Hamilton's depressive scale (weighted mean difference [WMD] -5.21; 95% CI: -7.48 to -2.95), and decreased Scandinavian Stroke Scale (WMD -6.35; 95% CI: -8.27 to -4.43). No serious adverse events were observed in any of the included trials. CONCLUSIONS: Adjuvant treatment with XYF appears to have additional benefits in the treatment of PSD, without increasing serious adverse events.

[A novel pattern for predicting the quality of Chinese herba preparation intelligently by high performance liquid chromatographic formula fingerprints].

In order to build the fusion models, the high performance liquid chromatographic (HPLC) fingerprints of scutellariae radix (SR), rhei radix et rhizoma (RRR), coptidis rhizoma (CR) and their synthesizing fingerprints were developed in this study. After exploring the consistency between the fingerprints of compound synthesizing fingerprints (CSF) and the sample, the quality of traditional Chinese medicine preparation was predicted intelligently using CSF. HPLC coupled with diode array detector was used to obtain chromatograms of SR, RRR, CR and Yi Qing Tablet (YQT) samples at 268 nm. Meanwhile, the quality of CSF and the 15 batches of YQT samples was evaluated by systematically quantified fingerprint method (SQFM) qualitatively and quantitatively. The chromatograms showed that CSF covered the main fingerprints' information of each herb and the 55 common peaks of CSF covered the main information of the 50 common peaks in YQT sample. The evaluation results showed that among the 15 batches of YQT samples, only YQT-S01 was grade 5 and the others were all above grade 3. Most of the CSFs were grade 2 or grade 1 except CSF-2 which was grade 6. The fingerprints of Chinese herba preparation could be replaced by CSF to achieve a novel pattern for predicting the quality of TCM preparation intelligently by studying the relationship between the standard fingerprints and the CSF, and simultaneously developing first-class evaluation software.

[Quality evaluation of Yinqiaojiedu tablets by three wavelength fusion fingerprint combined with six components quantitative determination and principal component analysis].

The fusion high performance liquid chromatographic fingerprint combined with quantification and principal component analysis (PCA) was successfully developed, which was applied to assess the quality consistency of 25 Yinqiaojiedu tablets (YQJDTs). The resolution index I was employed as an objective function to evaluate chromatographic conditions. The chromatographic fingerprints were established by reversed-phase high performance liquid chromatography. The wavelengths were set at 230, 279 and 327 nm, separately. Then, the three wavelength fusion fingerprint was developed by the technique of multi-wavelength fusion fingerprint. The linearity, precision, repeatability, stability and accuracy of the method were proved to meet the fingerprint analysis criteria. Subsequently, the systematic quantified fingerprint method was applied for integrative quality discrimination of YQJDTs from both qualitative and quantitative perspectives. The results showed that the quality of 25 YQJDTs from the two manufacturers were completely qualified and well differentiated. The contents of six components were determined simultaneously and combined with fingerprint analysis. It was used to evaluate the quality of YQJDT from the overall and partial points of view. In addition, the PCA of the fusion fingerprint data was applied to get the score plot. It can be clearly distinguished the 25 YQJDT samples from the two manufacturers. The method proposed in this study was comprehensive and reliable, which could be used for a valuable reference to scientifically evaluate and effectively control the quality of YQJDT.

Novel strategy for quality consistency evaluation of Chinese medicine "YIQING" tablet that combines the simultaneous quantification and screening of ten bioactive constituents.

The UV characteristics for different categories compounds in complex traditional Chinese medicines and herbal preparations usually vary. Thus, to achieve the integral analysis of multiwavelength fingerprint characteristics, we introduced a novel strategy of multiwavelength total fusion profiling. The simultaneous separation and quantification of multiple components by reversed-phase high-performance liquid chromatography coupled with diode array detection was developed in an effective, accurate, and reliable way. Furthermore, a 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) scavenging assay was set up to detect and screen the bioactivity of similar-structure constituents (aloe-emodin, rhein, emodin, chrysophanol, baicalein, wogonin, baicalin, wogonoside, berberine hydrochloride, and jatrorrhizine hydrochloride). Moreover, the high-performance liquid chromatography DPPH assay was developed to monitor the relationship between the biological activity and the spatial structure, the number of hydroxyl groups, the concentration of the analytes in samples. The result of qualitative classification for 15 batches of "YIQING" tablets using principle component analysis was consistent with the quantitative fingerprint assessment using the average linear quantitative fingerprint method. Therefore, chemometrics, multiwavelength total fusion profiling in conjunction with average linear quantitative fingerprint method and antioxidant activity can control the quality of traditional Chinese medicines/herbal preparations comprehensively and practically.

Adjuvant Treatment with Qilin Pill for Men with Oligoasthenospermia: A Meta-Analysis of Randomized Controlled Trials.

Qilin pill has been used in the management of oligoasthenospermia. This meta-analysis aimed to evaluate the effects of Qilin pill as an adjunctive therapy on semen parameters in oligoasthenospermic men. A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, Wanfang, CNKI, and VIP databases until June 2016. Randomized controlled trials (RCTs) that evaluated Qilin pill as an adjunctive therapy in oligoasthenospermic were included. Dichotomous data and continuous data were calculated as the risk ratio (RR) and mean difference (MD) with their 95% confidence interval (CI), respectively. Eight RCTs involving 778 patients were identified. Adjunctive treatment with Qilin pill significantly improved the semen volume (MD 0.50 mL; 95% CI 0.42-0.59), sperm concentration (MD 5.01 × 106 /mL; 95% CI 3.28-6.75), sperm motility (MD 7.54%; 95% CI 5.64-9.45), grade A sperm (MD 9.75%; 95% CI 4.05-15.45), serum testosterone level (MD 1.66 nM; 95% CI 0.40-2.92), and pregnancy rate (RR 1.46; 95% CI 1.08-1.99) during follow-up. However, differences in the serum follicle-stimulating and luteinizing hormone levels were not significant. Adjunctive treatment with Qilin pill significantly improves the sperm quality in patients with oligoasthenospermia. However, further trials are necessary to investigate the efficacy of Qilin pill on oligoasthenospermia-induced male infertility. Copyright © 2017 John Wiley & Sons, Ltd.

Atorvastatin Treatment for Carotid Intima-Media Thickness in Chinese Patients With Type 2 Diabetes: A Meta-Analysis.

Impact of atorvastatin on carotid intima-media thickness (CIMT) in patients with type 2 diabetes is still debating.The aim of our study is to investigate atorvastatin as adjuvant treatment on CIMT in Chinese patients with type 2 diabetes by conducting a meta-analysis based on the randomized controlled trials (RCTs).A systematic search of electronic database of the Pubmed, EMBASE, Cochrane Library, VIP database, China National Knowledge Infrastructure, and Wangfang up to January 2015 was conducted. Randomized controlled trials (RCTs) comparing atorvastatin adjuvant treatment to the hypoglycemic therapies or high-dose atorvastatin versus low-dose atorvastatin therapies for patients with type 2 diabetes were selected.A total of 14 RCTs involving 1345 patients were included. Adjuvant treatment with atorvastatin was associated with a significant reduction in CIMT (weighted mean difference [WMD] = -0.17 mm; 95% confidence interval [CI] -0.22 to -0.12). Compared with the low-dose atorvastatin, high-dose atorvastatin treatment was associated with a significant reduction in CIMT (WMD = -0.17 mm; 95% CI: -0.32 to -0.02). Adjuvant treatment with atorvastatin reduced serum total cholesterol, triglyceride, low-density lipoproteins, and high sensitivity C-reactive protein levels. However, atorvastatin had no significant impact on blood glucose levels.This meta-analysis demonstrated that treatment with atorvastatin significantly reduced CIMT in Chinese patients with type 2 diabetes. Moreover, high-dose atorvastatin appeared to have additional benefits in reducing CIMT than the low-dose atorvastatin.