Sijunzi decoction alleviates inflammation and intestinal epithelial barrier damage and modulates the gut microbiota in ulcerative colitis mice.

Ethnopharmacological relevance: As a representative classical prescription, Sijunzi decoction has powerful therapeutic effects on spleen-stomach qi insufficiency. Ulcerative colitis (UC) is a chronic, diffuse, and non-specifically inflammatory disorder, the etiology of which still remains unclear. In the traditional Chinese medicine (TCM) perspective, splenic asthenia is the primary cause of UC. Based on this, Sijunzi decoction has been extensively used in TCM clinical practice to alleviate UC in recent years. However, the pharmacological mechanism of Sijunzi decoction in modern medicine is still not completely clear, which limits its clinical application. Aim of the study: The purpose of this study was to investigate the Sijunzi decoction's curative effect on acute UC mice and probe into its potential pharmacological mechanism. Materials and methods: The UC mouse model was set up by freely ingesting a 3% dextran sulfate sodium (DSS) solution. The relieving role of Sijunzi decoction on UC in mice was analyzed by evaluating the changes in clinical parameters, colon morphology, histopathology, inflammatory factor content, intestinal epithelial barrier protein expression level, and gut microbiota balance state. Finally, multivariate statistical analysis was conducted to elucidate the relationship between inflammatory factors, intestinal epithelial barrier proteins, and gut microbiota. Results: First, the research findings revealed that Sijunzi decoction could visibly ease the clinical manifestation of UC, lower the DAI score, and attenuate colonic damage. Moreover, Sijunzi decoction could also significantly inhibit IL-6, IL-1ß, and TNF-α while increasing occludin and ZO-1 expression levels. Subsequently, further studies showed that Sijunzi decoction could remodel gut microbiota homeostasis. Sijunzi decoction was beneficial in regulating the levels of Alistipes, Akkermansia, Lachnospiraceae_NK4A136_group, and other bacteria. Finally, multivariate statistical analysis demonstrated that key gut microbes were closely associated with inflammatory factors and intestinal epithelial barrier proteins. Conclusion: Sijunzi decoction can significantly prevent and treat UC. Its mechanism is strongly associated with the improvement of inflammation and intestinal epithelial barrier damage by regulating the gut microbiota.

Effects of Tai chi in knee osteoarthritis patients: An overview of systematic reviews and meta-analyses.

OBJECTIVE: Tai Chi (TC) is a complementary therapy for knee osteoarthritis (KOA). Although systematic reviews (SRs) and meta-analyses (Mas) of efficacy studies have been published, the results remain uncertain, and their quality has not yet been fully evaluated. Here, we summarize the existing SRs/Mas, evaluate their quality and level of evidence, and provide a reference for the effectiveness of TC. METHODS: SRs/Mas of TC therapy for KOA published before February 2023 were retrieved from eight databases in Chinese and English. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, and the Risk of Bias in Systematic (ROBIS) scale were used to assess methodological quality, reporting quality, and risk of bias. RESULTS: Seven SRs/Mas were finally included. One was deemed high quality by AMASTAR-2, while the rest were of critically low quality. In the PRISMA2020 assessment, the response rate of "Yes" for Q7, Q15, Q22, Q24, and Q27 was less than 50%. In the ROBIS assessment, three reports in Phase 3 were high risk and four were low risk. In the efficacy assessment, TC has shown varying degrees of improvement in physical function, pain, stiffness, 6-minute walk test, mental quality of life, TUG, and balance in patients with KOA. CONCLUSION: TC effectively treats KOA-associated pain, stiffness, body function, and mental quality of life. However, the low methodological quality of the studies and the high risk of migration reduced their reliability. Therefore, these conclusions should be taken with caution. High-quality, large-sample research is needed to provide stronger and more scientific evidence.

Predictive value of TCM clinical index for diabetic peripheral neuropathy among the type 2 diabetes mellitus population: A new observation and insight.

Aims: The objectives of this study were to identify clinical predictors of the Traditional Chinese medicine (TCM) clinical index for diabetic peripheral neuropathy (DPN) in type 2 diabetes mellitus (T2DM) patients, develop a clinical prediction model, and construct a nomogram. Methods: We collected the TCM clinical index from 3590 T2DM recruited at the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2019 to October 2020. The participants were randomly assigned to either the training group (n = 3297) or the validation group (n = 1426). TCM symptoms and tongue characteristics were used to assess the risk of developing DPN in T2DM patients. Through 5-fold cross-validation in the training group, the least absolute shrinkage and selection operator (LASSO) regression analysis method was used to optimize variable selection. In addition, using multifactor logistic regression analysis, a predictive model and nomogram were developed. Results: A total of eight independent predictors were found to be associated with the DPN in multivariate logistic regression analyses: advanced age of grading (odds ratio/OR 1.575), smoke (OR 2.815), insomnia (OR 0.557), sweating (OR 0.535), loose teeth (OR 1.713), dry skin (OR 1.831), purple tongue (OR 2.278). And dark red tongue (OR 0.139). The model was constructed using these eight predictor's medium discriminative capabilities. The area under the curve (AUC) of the training set is 0.727, and the AUC of the validation set is 0.744 on the ROC curve. The calibration plot revealed that the model's goodness-of-fit is satisfactory. Conclusions: We established a TCM prediction model for DPN in patients with T2DM based on the TCM clinical index.

Current status and trends of artificial intelligence research on the four traditional Chinese medicine diagnostic methods: a scientometric study.

Background: With the development of technology and the renewal of traditional Chinese medicine (TCM) diagnostic equipment, artificial intelligence (AI) has been widely applied in TCM. Numerous articles employing this technology have been published. This study aimed to outline the knowledge and themes trends of the four TCM diagnostic methods to help researchers quickly master the hotspots and trends in this field. Four TCM diagnostic methods is a TCM diagnostic method through inspection, listening, smelling, inquiring and palpation, the purpose of which is to collect the patient's medical history, symptoms and signs. Then, it provides an analytical basis for later disease diagnosis and treatment plans. Methods: Publications related to AI-based research on the four TCM diagnostic methods were selected from the Web of Science Core Collection, without any restriction on the year of publication. VOSviewer and Citespace were primarily used to create graphical bibliometric maps in this field. Results: China was the most productive country in this field, and Evidence-Based Complementary and Alternative Medicine published the largest number of related papers, and the Shanghai University of Traditional Chinese Medicine is the dominant research organization. The Chengdu University of Traditional Chinese Medicine had the highest average number of citations. Jinhong Guo was the most influential author and Artificial Intelligence in Medicine was the most authoritative journal. Six clusters separated by keywords association showed the range of AI-based research on the four TCM diagnostic methods. The hotspots of AI-based research on the four TCM diagnostic methods included the classification and diagnosis of tongue images in patients with diabetes and machine learning for TCM symptom differentiation. Conclusions: This study demonstrated that AI-based research on the four TCM diagnostic methods is currently in the initial stage of rapid development and has bright prospects. Cross-country and regional cooperation should be strengthened in the future. It is foreseeable that more related research outputs will rely on the interdisciplinarity of TCM and the development of neural networks models.

An Overview of Systematic Reviews: Acupuncture in the Treatment of Essential Hypertension.

Objective: Acupuncture treatment is widely used for essential hypertension (EH), and numerous systematic reviews on acupuncture for EH have been published. This article provides an overview of the effectiveness and safety of acupuncture for EH and assesses the quality of reports, methodological bias, quality of evidence and risk of bias for inclusion in the evaluation. Methods: Two researchers independently computer searched Pubmed, EMbase, The Cochrane library, WOS, CBM, CNKI, Wangfang Data, VIP and other Chinese and English databases with a search time frame from the date of creation to 13th October 2022; and independently screened systematic reviews of acupuncture therapy for EH; and finally The Report Quality Assessment Tool (PRISMA 2020), Methodological Quality Assessment Tool (AMSTAR2), Grading of Evidence Assessment Tool (GRADE), and Bias Assessment Tool (ROBIS) were used independently to assess the bias of the included literature. Results: A total of 11 systematic reviews were included. The included studies mainly reported on outcome indicators such as efficiency rate, end SBP, end DBP, SBP change value, DBP change value, etc. Deficiencies in the quality of PRISMA 2020 reporting were mainly in the areas of independent screening by multiple researchers, use of GRADE for analysis, early registration, description of conflict of interest, and public access to information; the results of the AMSTAR 2 tool evaluation were mostly were very low, and of the 16 entries affecting the methodological quality of the systematic evaluation, entries 2/3/4/5/12/16 had the greatest methodological bias; GRADE assessed the quality of evidence for key outcome indicators, with a few being low and all others being very low; and ROBIS reported a high level of bias in the literature. Conclusion: Current acupuncture has some efficacy in the treatment of essential hypertension, but its quality of evidence is low. It is hoped that the quality of relevant literature reporting, methodological quality, quality of evidence, and bias will improve.

Vitamin A in children's pneumonia for a COVID-19 perspective: A systematic review and meta-analysis of 15 trials.

BACKGROUND: To systematically review and meta-analyze the efficacy of vitamin A as an adjuvant therapy for pneumonia in children. METHODS: We searched in PubMed, the Cochrane Library, Chinese National Knowledge Infrastructure, WanFang Database and Chongqing VIP information network from libraries building to March 2022, screening randomized controlled trials (RCT) about vitamin A combined with conventional therapy for pneumonia in children. Two researchers used the Cochrane risk of bias tool to assess the quality of included studies dependently. Data analysis was conducted in the RevMan 5.3. RESULTS: 15 trials involving 3496 patients (treated group: 1898; control group: 1598) were analyzed in this study. The Meta-analysis showed that vitamin A combined with conventional therapy improved clinical efficacy (P < .05), shortened the duration of fever and cough, negative time of chest X-ray, and the hospitalization, lung rale disappearance, choking milk disappearance, shortness of breath disappearance and perilabial cyanosis disappearance (P < .05). However, vitamin A combined with conventional therapy did not reduce the mortality of pneumonia in children (P > .05). CONCLUSION: Vitamin A contributes to relieve the clinical symptoms and signs, and also shorten the hospitalization.

[Evaluation of methodological and reporting quality of domestic clinical guidelines for hyperuricemia].

This study aims to evaluate the methodological and reporting quality of diagnosis and treatment guidelines for hyperuricemia as well as the expert consensuses and promote the understanding and application of the diagnosis and treatment guidelines for hyperuricemia. With "hyperuricemia" "guidelines" "consensus" "recommendations" as the key words in titles, the authors searched for the published clinical guidelines on hyperuricemia in Chinese against CNKI, Wanfang, VIP, Medlive and the official website of the industry association. The retrieval time limit was until May 31, 2021. The appraisal of guidelines for research and evaluation Ⅱ(AGREEⅡ) and the reporting items for practice guidelines in health care(RIGHT) were employed to evaluate the methodological quality and reporting quality of 14 guidelines/consensuses included. The average scores of the guidelines/consensuses were 80.85%(48.61%-98.61%) for the domain of scope and purpose, 34.52%(0-69.44%) for the domain of stakeholder involvement, 35.53%(6.25%-92.19%) for the domain of rigor of development, 55.85%(23.61%-86.11%) for the domain of clarity of presentation, 26.19%(0-76.04%) for the domain of applicability, and 21.42%(0-50.00%) for the domain of editorial independence. Nine guidelines/consensuses were of medium overall quality with grade B recommendation, and five guidelines/consensuses were of poor quality with grade C recommendation. The RIGHT classified the fourteen guidelines/consensuses into one of high reporting quality, three of medium reporting quality, and ten of low reporting quality. The results of this study indicate that the standardization and rigor of the methodological quality and the reporting quality of the clinical guidelines/consensuses for hyperuricemia in China remain to be strengthened.

Effects of vitamin D supplementation on blood markers in ulcerative colitis patients: a systematic review and meta-analysis.

OBJECTIVE: Observational studies have shown that vitamin D levels are inversely related to ulcerative colitis activity, yet evidence from population interventions remains inconsistent. We conducted a systematic review and meta-analysis of randomized-controlled trials to clarify the effect of vitamin D on blood markers in patients with ulcerative colitis. METHODS: The PubMed, Cochrane Library, Embase, CNKI, VIP, and Wanfang databases were searched for studies published before June 2020. Information was collected regarding serum vitamin D levels, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), and Ca (calcium), and parathyroid hormone (PTH), and ulcerative colitis disease activity index (UCDAI) research data. RESULTS: Seven studies (n = 539) were included in the meta-analysis. Vitamin D supplementation resulted in significant improvements in the serum vitamin D levels (standardized mean difference (SMD) = 0.69, 95% CI (0.36, 1.03), P < 0.001), ESR (weighted mean difference (WMD) = - 1.10, 95% CI (- 1.97, - 0.24), P = 0.01), CRP (SMD = - 0.43, 95% CI (- 0.67, - 0.20), P = 0.0003), and Ca (SMD = 0.92, 95% CI (0.09, 1.74), P = 0.03) but not in other outcomes. According to subgroup analysis, supplementation with vitamin D at a dose of ≥ 300,000 IU/day can improve serum vitamin D levels. Supplementation with a sufficient dose of vitamin D in a short period of time can also improve serum vitamin D levels. According to GRADE method evaluation, the evidence quality was classified as low for the Serum Vitamin D Level and ESR, and very low for the CRP, PTH, Ca, and UCDAI. CONCLUSIONS: Compared with placebo control interventions, vitamin D supplementation seemed to be an effective intervention for patients with ulcerative colitis. Different doses of vitamin D and durations of intervention produce different effects. However, due to the limitation of the quality of the included studies, the above conclusions still need to be verified by more high-quality studies and weak clinical recommendations.

Study of TCM Syndrome Identification Modes for Patients with Type 2 Diabetes Mellitus Based on Data Mining.

OBJECTIVE: To establish the diagnosis model for syndromes of type 2 diabetes mellitus (T2-DM) and explore symptoms, the pulse and tongue signs, and laboratory indexes related to syndromes of T2-DM. METHODS: A syndromatologic and laboratory investigation was conducted in 554 T2-DM patients with 58 symptoms, 14 tongue signs, 6 pulse signs, and 12 laboratory indexes. The clinical data on the syndrome were collected and analyzed by using logistic regression analysis, decision tree, and K-nearest neighbor to establish a diagnostic model for effectively distinguishing the typical syndromes in T2-DM patients. RESULTS: The most typical syndromes revealed in T2-DM were stomach heat flourishing (SHF) syndrome (261 patients, accounting for 47.1%) and Qi-Yin deficiency (QYD) syndrome (293 patients, 52.9%). According to the clinical data of the patients with these two syndromes, variables including 6 symptoms and signs, 2 pulse signs, 1 tongue sign, and 2 laboratory indicators were introduced into the logistic regression model. All of them were statistically significant. Then, a diagnostic model constructed by QUEST and CHAID algorithms of the decision tree for identifying the two syndromes was proved to have an accurate diagnostic rate of 85.2%. It was found that the following sign and symptoms were effective to differentiate these two syndromes: odor in the mouth, polyphagia, vulnerability to starvation, burning sensation in the stomach, fatigue, limb weakness, slippery and replete pulse, weak pulse, pink tongue, oral glucose tolerance test, and hemoglobin A1C. A classification model constructed by the K-nearest neighbor method to identify the two syndromes showed an accurate diagnostic rate of 88.3%. Three major statistically significant predictors included in the model were slippery and replete pulse, polyphagia, and weak pulse (P < 0.05). CONCLUSION: A model for distinguishing the two typical syndromes (SHF syndrome and QYD syndrome) in T2-DM patients was effectively established. This model could help to provide methodological support for the standardization of traditional Chinese medicine (TCM) syndrome differentiation methods.

Removal of personal care products in greywater using membrane bioreactor and constructed wetland methods.

Personal care products (PCPs) are contaminants of emerging concern because of their continuous input into the environment. In this study, membrane bioreactor (MBR) and constructed wetland (CW) methods were used to investigate the effect and mechanism of conventional pollutant and PCP removal from greywater. The effluent of both the MBR- and CW-treated greywater met the reclaimed water reuse standard in China. Conventional pollutants and five target PCPs had a higher removal efficiency in the MBR than in the CW. The removal rates of the PCPs, including Tuina musk (AHTN), were >80% using MBR and CW methods. The main pathway of removing PCPs in the MBR was sludge adsorption and biodegradation, whereas the contribution of the membrane module was weak. The main pathway of removing PCPs in the CW was the combined action of plant absorption, microbial biodegradation, and substrate adsorption, depending on the PCP type. Ethyl hexyl methoxycinnamate (EHMC) has strong biological oxidizability and was mainly removed by biodegradation, whereas Jiale musk (HHCB) and AHTN were mainly removed by adsorption. Six types of CW substrates were investigated, and perlite showed the best adsorption effect for the five target PCPs. The optimal substrate adsorption pH was 7. This study provides important technical information on the effective removal of conventional pollutants and PCPs in greywater and the preparation of high-quality reclaimed water.

Erratum to "Vitamin C as a Supplementary Therapy in Relieving Symptoms of the Common Cold: A Meta-Analysis of 10 Randomized Controlled Trials".

[This corrects the article DOI: 10.1155/2020/8573742.].

[Effect of nuciferine on gut microbiota and inflammatory response in obese model mice].

The aim of this study was to elucidate the mechanism of nuciferine on alleviating obesity based on modulating gut microbiota, ameliorating chronic inflammation, and improving gut permeability. In this study, the obese model mice were induced by high-fat diet and then randomly divided into model group, and nuciferine group; some other mice of the same week age were fed with normal diet as normal group. In the modeling process, the mice were administered intragastrically(ig) for 12 weeks. In the course of both modeling and treatment, the body weight and food intake of mice in each group were measured weekly. After modeling and treatment, the Lee's index, weight percentage of inguinal subcutaneous fat, and the level of blood lipid in each group were measured. The pathological changes of adipocytes were observed by HE staining to evaluate the efficacy of nuciferine treatment in obese model mice. 16 S rRNA sequencing analysis was conducted to study the changes in diversity and abundance of gut microbiota after nuciferine treatment. Enzyme-linked immunosorbent assay(ELISA) and quantitative Real-time polymerase chain reaction(qPCR) were used to detect the levels of inflammatory factors interleukin-6(IL-6), interleukin-1ß(IL-1ß), tumor necrosis factor-α(TNF-α) and the expression of related genes in adipose tissue of mice in each group, so as to evaluate the effect of nuciferine on chronic inflammation of mice in obese model group. qPCR was used to detect the expression of occludin and tight junction protein 1(ZO-1)gene in colon tissure, so as to evaluate the effect of nuciferine on intestinal permeability of mice in obese group. Nuciferine decreased the body weight of obese mice, Lee's index, weight percentage of inguinal subcutaneous fat(P<0.05), and reduced the volume of adipocytes, decreased the level of total cholesterol(TC), triglyceride(TG), and low density lipoprotein cholesterol(LDL-C)(P<0.05) in serum, improved dysbacteriosis, increased the relative abundance of Alloprevotella, Turicibacter, and Lactobacillus, lowered the relative abundance of Helicobac-ter, decreased the expression of inflammatory cytokines IL-6, IL-1ß, and TNF-α genes in adipose tissue(P<0.01), decreased the levels of inflammatory cytokines IL-6, IL-1ß, and TNF-α in serum(P<0.05), and increased the expression of occludin and ZO-1 genes related to tight junction in colon tissue(P<0.01). Nuciferine could treat obesity through modulating gut microbiota, decreasing gut permeability and ameliorating inflammation.

Jian-Gan-Xiao-Zhi Decoction Alleviates Inflammatory Response in Nonalcoholic Fatty Liver Disease Model Rats through Modulating Gut Microbiota.

BACKGROUND: Jian-Gan-Xiao-Zhi decoction (JGXZ), composed of Salvia miltiorrhiza Bunge, Panax notoginseng, Curcuma zedoaria, and other 9 types of herbs, has demonstrated beneficial effects on nonalcoholic fatty liver disease (NAFLD). However, the mechanisms behind JGXZ's impact on NAFLD remain unknown. METHODS: In this study, a NAFLD rat model induced by a high-fat diet (HFD) received oral treatment of JGXZ (8 or 16 g crude herb/kg) for 12 weeks. The therapeutic effects of JGXZ on NAFLD model rats were investigated through blood lipid levels and pathological liver changes. 16S rRNA analysis was used to study the changes in gut microbiota after JGXZ treatment. The expressions of occludin and tight junction protein 1 (ZO-1) in the colon were investigated using immunostaining to study the effects of JGXZ on gut permeability. The anti-inflammatory effects of JGXZ were also studied through measuring the levels of IL-1ß, IL-6, and TNF-α in the serum and liver. RESULTS: JGXZ treatment could decrease body weight and ameliorate dyslipidemia in NAFLD model rats. H&E and Oil Red O staining indicated that JGXZ reduced steatosis and infiltration of inflammatory cells in the liver. 16S rRNA analysis showed that JGXZ impacted the diversity of gut microbiota, decreasing the Firmicutes-to-Bacteroidetes ratio, and increasing the relative abundance of probiotics, such as Alloprevotella, Lactobacillus, and Turicibacter. Gut permeability evaluation found that the expressions of ZO-1 and occludin in the colon were increased after JGXZ treatment. Moreover, JGXZ treatment could decrease the levels of IL-1ß, IL-6, and TNF-α in the serum and liver. CONCLUSIONS: Our study illustrated that JGXZ could ameliorate NAFLD through modulating gut microbiota, decreasing gut permeability, and alleviating inflammatory response.

The Effect of Vitamin D Supplementation on Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis.

Objective Observational studies have shown that vitamin D levels are inversely related to rheumatoid arthritis activity, yet evidence from population interventions remains inconsistent. Methods: The PubMed, Cochrane Library, Embase, CNKI, VIP, and Wanfang databases were searched for studies published before June 2020. Information was collected about the pain visual analog scale (VAS), Disease Activity Score 28 (DAS28), serum vitamin D level, tender joint count (TJC), swollen joint count (SJC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and parathyroid hormone (PTH) research data. Results: Six studies (n = 438) were included in the meta-analysis. Vitamin D supplementation resulted in a significant improvement in the DAS28 (weighted mean difference (WMD) = -0.41, 95% CI (-0.59, -0.23), P < 0.001), ESR (WMD = -3.40, 95% CI (-6.62, -0.18), P = 0.04) and TJC (WMD = -1.44, 95% CI (-2.74, -0.14), P = 0.03) but not in other outcomes. According to the subgroup analyses, VAS and serum vitamin D were improved in the European ethnic subgroups. TJC and serum vitamin D were improved in the Asian ethnic subgroups. TJC and serum vitamin D were improved in the duration ≤ 12 w subgroups, and the VAS and DAS28 in the duration > 12 w subgroup were different from those of the control group. With a vitamin D dose ≤50,000 IU, only serum vitamin D and TJC improved, and with a vitamin D dose> 50,000 IU, the VAS and DAS28 improved. Conclusions: Compared with placebo control interventions, vitamin D supplementation seemed to be an effective intervention for patients with rheumatoid arthritis. Different doses of vitamin D and durations of intervention produce different effects.

Vitamin C as a Supplementary Therapy in Relieving Symptoms of the Common Cold: A Meta-Analysis of 10 Randomized Controlled Trials.

AIM: To investigate whether vitamin C performs well as a supplemental treatment for common cold. METHOD: After systematically searching through the National Library of Medicine (PubMed), Cochrane Library, Elsevier, China National Knowledge Infrastructure (CNKI), VIP databases, and Wanfang databases, 10 randomized controlled trials were selected for our meta-analysis with RevMan 5.3 software. Published in China, all 10 studies evaluated the effect of combined vitamin C and antiviral therapy for the treatment of common cold. RESULTS: The total efficacy (RR = 1.27, 95% CI (1.08, 1.48), P = 0.003), the time for symptom amelioration (MD = -15.84, 95% CI (-17.02, -14.66), P < 0.00001), and the time for healing (I, 95% CI (-14.98, -4.22), P = 0.0005) were better with vitamin C supplementation than with antiviral therapy alone. CONCLUSIONS: Vitamin C could be used as a supplementary therapy along with antiviral regimens to relieve patients from the symptoms of common cold.

The Efficacy and Safety of Mesalamine and Probiotics in Mild-to-Moderate Ulcerative Colitis: A Systematic Review and Meta-Analysis.

OBJECTIVE: To evaluate the efficacy and safety of mesalamine in conjunction with probiotics for ulcerative colitis. METHODS: Random controlled trials (RCTs) were searched in PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and VIP (VIP Database for Chinese Technical Periodicals) from inception to October 2019. Methodological quality was assessed by the Cochrane Collaboration tool. The quality of evidence was rated by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Data analysis was carried out in Review Manager 5.3. RESULTS: A total of fifteen studies met the criteria for inclusion. Thirteen studies reported the clinical efficacy, three studies provided data on the clinical symptom scores, two trials reported disease activity index, four studies evaluated endoscopic score, and twelve studies reported adverse events. For ulcerative colitis (UC), mesalamine and probiotics had better clinical efficacy than mesalamine alone (≤8 weeks: RR = 1.12, 95% CI: 1.07-1.18, P < 0.0001; >8 weeks: RR = 1.25, 95% CI: 1.11-1.41, P=0.0003). On the clinical symptom scores, disease activity index, and endoscopic score, UC patients receiving mesalamine and probiotics had significant difference than patients receiving mesalazine alone (MD = -2.02, 95% CI: -3.28 to -0.76, P=0.002; MD = -1.20, 95% CI: -1.76 to -0.65, P < 0.001; and MD = -0.42, 95% CI: -0.61 to -0.23, P < 0.0001, respectively). There was no statistically significant difference in adverse events between the two groups (RR = 0.88, 95% CI: 0.54 to 1.43, P=0.60). CONCLUSION: Our meta-analysis results supported that mesalamine and probiotics were effective and safe in treating ulcerative colitis.

Effects of Tai Chi on essential hypertension and related risk factors: A meta-analysis of randomized controlled trials.

BACKGROUND: Physical exercise is an important part of hypertension management. The impact of different training styles and durations of tai chi on essential hypertension has not been evaluated to date. OBJECTIVE: To analyse the influence of tai chi on blood pressure and related risk factors in patients with essential hypertension. METHODS: A systematic review to assess the existing literature on the impact of tai chi in patients with essential hypertension. Randomized controlled trials were identified in Chinese and English databases to study the impact of tai chi on essential hypertension. Two reviewers selected studies independently of each other. Qualified trials were selected and their methodological quality critically evaluated. RESULTS: Thirteen trials were included in the analysis. Following tai chi there was a significant difference between intervention and control groups with regard to change in systolic blood pressure (SBP) (weighted mean difference = -6.58, 95% confidence interval (95% CI) (-8.14, -5.02), p = 0.005) and diastolic blood pressure (DBP) (standardized mean difference = -0.57, 95% CI (-0.77, -0.37), p < 0.0001). Taking into account the subgroup analyses, the combined results showed that 24-movement or yang-style tai chi significantly reduced both systolic and diastolic blood pressure over a period < 12 weeks or > 12 weeks in all studies. However, other styles of tai chi did not significantly reduce systolic or diastolic blood pressure after a duration ≤ 12 weeks. CONCLUSION: Tai chi is an effective physical exercise in treating essential hypertension compared with control interventions. Different training durations and styles have different effects. Further randomized controlled trials are needed into the use of tai chi for the treatment and prevention of essential hypertension and other related chronic diseases.

Effects of vitamin C supplementation on essential hypertension: A systematic review and meta-analysis.

BACKGROUND: Vitamin C as a supplement to treat hypertension has been proposed. However, it remains controversial whether vitamin C can improve blood pressure in patients with primary hypertension. OBJECTIVES: To analyze the effect of vitamin C (VitC) supplementation on systolic (SBP) and diastolic (DBP) blood pressure in patients with essential hypertension. METHODS: We searched the Chinese Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, WANFANG Data, Cochrane Library, National Library of Medicine's PubMed, EMBASE, and other databases until June 2019. Eight RCTs involving 614 participants were analyzed. SBP and DBP before and after VitC supplementation were compared between the intervention and control groups. The risk of bias of individual studies was assessed using the Cochrane Collaboration risk of bias tool. Two reviewers selected studies independently of each other. The Cochrane Collaboration Review Manager 5.3 was used to perform the meta-analysis. RESULTS: There was a significant difference in the change of SBP (weighted mean difference [WMD] = -4.09; 95% confidence interval [CI] -5.56, -2.62; P < .001) and DBP (WMD = -2.30; 95% CI -4.27, -.331; P = .02) between the groups. Further, there was a significant difference in the SBP (WMD = -3.75, 95% CI -6.24, -1.26, P = .003) and DBP (WMD = -3.29, 95% CI -5.98, -.60, P = .02) for the subgroup with an age ≥60 years and that with ≥35 participants. In the subgroup analysis, result for SBP with a study duration ≥6 weeks was statistically significant different (WMD = -4.77; 95% CI -6.46, -3.08; P < .001). For an intervention dose of VitC ≥500 mg daily, SBP was statistically significant (WMD = -5.01; 95% CI -8.55, -1.48; P = .005). CONCLUSION: VitC supplementation resulted in a significant reduction of blood pressure in patients with essential hypertension.

Single application of airway stents in thoracogastric-airway fistula: results and prognostic factors for its healing.

BACKGROUND: Thoracogastric-airway fistula (TGAF) post-thoracic surgery is a rare and challenging complication for esophagectomy. The aim of this study was to explore the effectiveness of airway stenting for TGAF patients and find related factors coupled with healing of fistula. METHODS: This is a retrospective study involving patients with TGAF who were treated with airway stentings. Based on different TGAF locations and sizes on chest computed tomography, covered metallic or silicon airway stents were implanted to cover orifices under interventional bronchoscopy. TGAF healing was defined as the primary outcome, and complete sealing of TGAF as the second outcome. The predictors for TGAF healing were analyzed in univariate and multivariate analysis. RESULTS: A total of 58 TGAF patients were included, of whom 7 received straight covered metallic stents, 5 straight silicon stents, 3 L-shaped covered metallic stents, 21 large Y-shaped covered metallic stents, 17 large Y-shaped silicon stents, and 5 with Y-shaped covered metallic stents. Healing was achieved in 20 (34.5%) patients, and complete sealing in 45 (77.6%) patients. There were no significant differences in healing rate and complete sealing rate between patients receiving metallic stents and those with silicon stents. In univariate analysis, lacking a previous history of radiotherapy or chemotherapy, nonmalignant fistulas, small fistulas, and shorter postesophagectomy duration were found associated with a higher rate of TGAF healing. Only shorter postesophagectomy duration was associated with TGAF healing in multivariate analysis. CONCLUSIONS: Both silicon and covered metallic airway stenting are effective methods to close TGAF. A shorter postesophagectomy period may predict better TGAF healing. The reviews of this paper are available via the supplemental material section.