Dietary therapy of the herbal porridge improves the symptoms of functional dyspepsia: A randomized, double-blind, placebo-controlled, clinical trial.

This study (ISRCTN17174559) aimed to explore the efficacy and safety of a kind of herbal porridge (Hou Gu Mi Xi) on the clinical symptoms of functional dyspepsia (FD). This was a single-center, single-dose, prospective, double-blind, randomized controlled trial involving 64 participants with FD (35 cases and 29 controls) for 2 months of intervention and 1 month of follow-up. The 7-point Global Overall Symptom Scale (GOSS), 36-Item Short Form Survey (SF-36), and other indicators were assessed at baseline (day 0), at days 15, 30, and 60 of treatment, and at follow-up 1 month after the end of the intervention. Many participants with FD achieved remission of their epigastric symptoms at follow-up on the 90th day after treatment with herbal porridge compared to the placebo group (45.71% vs. 20.69%, p = .036). Furthermore, herbal porridge appeared to be effective in improving the quality of life of participants with FD, which was reflected in the rising SF-36 scores for physical role, bodily pain, emotional role, and mental health. Although adverse events were reported, there was no overall difference in the number of adverse events between the two groups (p = .578). Herbal porridge is another effective and safe method for improving the symptoms and quality of life in patients with FD.

[Systematic review and Meta-analysis of efficacy and safety of Shuxuetong Injection in treatment of diabetic peripheral neuropathy].

The present study evaluated the efficacy and safety of Shuxuetong Injection in the treatment of diabetic peripheral neuropathy(DPN). PubMed, Cochrane Library, EMbase, CNKI, VIP, SinoMed, and Wanfang were searched for randomized controlled trials(RCTs) of Shuxuetong Injection in the treatment of DPN from database inception to July 18, 2021. Literature screening was carried out according to the inclusion and exclusion criteria, and the required information was extracted. Cochrane risk-of-bias tool was used to evaluate the quality of the included trials, and RevMan 5.3 was used for Meta-analysis. Finally, six articles were included, involving 507 patients. The overall quality of included RCTs was not high. As revealed by Meta-analysis results, in terms of DPN score, one trial showed a significant difference in the experimental group before and after treatment, and the symptom of the experimental group was significantly improved compared with that in the control group after treatment. After treatment, a significant difference in DPN scores of the experimental group and the control group was observed(P<0.05), and the symptom improvement of the experimental group was significantly better than that of the control group. In terms of sensory nerve conduction velocity(SCV), the experimental group was superior to the control group in improving conduction velocities(MD_(median SCV)=4.45, 95%CI[2.79, 6.10], P<0.000 01; MD_(peroneal SCV)=6.70, 95%CI[5.64, 7.75], P<0.000 01; MD_(posterior tibial SCV)=4.03, 95%CI[0.56, 7.49], P=0.02). In terms of motor nerve conduction velocity(MCV), compared with the conditions before treatment, the conduction velocities of median nerve, peroneal nerve, and posterior tibial nerve in both groups increased after treatment(P<0.01). The experimental group was superior to the control group in improving MCV after treatment(P<0.05). In terms of average blood glucose change, there is no statistical significance of the improvement of average blood glucose between experimental group and the control group(MD=-0.15, 95%CI[-0.82, 0.51], P=0.65). In terms of overall response rate, the curative effect of the experimental group in the treatment of DPN was superior to that of the control group(RR=1.23, 95%CI[1.11, 1.37], P=0.000 1). In terms of adverse events, no obvious adverse events were reported in the included RCTs. In light of existing data and indexes, the clinical efficacy of Shuxuetong Injection combined with western medicine in the treatment of DPN may be superior to that of conventional western medicine. It can improve the clinical symptoms, SCV, MCV, and average blood glucose of DPN, with good safety. However, existing clinical trials are few and the quality is low. It is recommended to further verify the above conclusions with internationally recognized outcome indicators.

[Exploration and reflection on evaluation methodology of human use experience for new Chinese drug development].

The "triple combination" review system provides an opportunity for the transformation of human use experience into new Chinese drugs. However, there are some methodological and technical limitations in the assessment of human experience. Hence, the efficacy and safety evaluation methods should be established in accordance with the characteristics of Chinese herbs. This study summarized some evidence-based methodology to promote the transformation of human use experience to new Chinese drugs, mainly including the individualized pragmatic randomized controlled trial(RCT), cluster RCT, single-case RCT, single arm RCT with objective performance criteria, and partially nested RCT. As the real world data can be used to support the transformation of human experience, attention should be paid to convenient and efficient collection of data, prudent selection of design types, and adoption of appropriate ana-lysis methods to deal with confounding bias, including multi-factor regression model and propensity score. The newly proposed mixed research method can also be utilized to assess the human use experience, which is suitable for mining the theory of traditional Chinese medicine(TCM) and expert experience from different aspects. Meanwhile, considering the study design requirements and TCM cha-racteristics, this study put forward the common problems and solutions in the development of new Chinese drugs based on human use experience, including how to select the feasible outcome indicators, how to collect prescription data in the case of herb and dosage adjustment, and how to evaluate the comprehensive effectiveness of TCM from the perspective of "combination of disease and syndrome".

[Application and significance of mixed methods research in traditional Chinese medicine and narrative medicine].

Since narrative medicine was introduced in China, it has been widely used in medical education and clinical practice. The research on narrative medicine in China is especially characterized by its combination with traditional Chinese medicine(TCM). At present, the research on narrative medicine in China is still in the stage of small-scale practicing and theory advocating. Besides, there is also a lack of guidance on experimental design methodology for clinical application, which leads to few high-quality studies in this field. The present study reviewed the current high-quality research on narrative medicine to discuss the value and prospects of mixed methods research in narrative medicine. In addition, the common design, application procedures, and notes of mixed methods research were explained to provide references for the extensive applications of narrative medicine in the medical field, especially TCM clinical practice, education, and scientific research.

[A new phloroglucinol compound from Dryopteris fragrans].

Two phloroglucinol compounds(1-2) were isolated and purified from 95% ethanol extract of Dryopteris fragrans through various column chromatographies on silica gel, Sephadex LH-20, medium pressure column chromatography, and preparative HPLC. Their structures were elucidated as 2',4',6'-trihydroxy-5'-methyl acetate-3'-methyl-1'-butyrophenone(1) and aspidinol B(2) based on their chemical and physicochemical methods and spectroscopic data. Compound 1 is a new phloroglucinol compound named "dryofraginol".

[Thoughts and suggestions on arrangement, analysis and summary of medical data during COVID-19 epidemic].

The analysis and utilization of clinical scientific research data is an effective means to promote the progress of diagnosis and treatment, and a key step in the development of medical sciences. During the epidemic of coronavirus disease 2019(COVID-19), how to transform the limited diagnostic data into clinical research resources has attracted much attention. Based on the low efficiency of data collection and extraction, the inconsistency of data analysis, the irregularity of data report and the high timeliness of data update during the epidemic, this paper briefly analyzed the background and reasons of data application under the current situation, and then discusses the problems and feasible solutions of clinical data applications under the epidemic situation and, more importantly, for future medical clinical research methods. We put forward several methodological suggestions: ① gradually improve the medical big data model and establish the national medical health data center; ② improve the scientific research literacy of medical staff and popularize the basic skills and knowledge of GCP; ③ promote a scientific, networked and shared data collection and management mode; ④ use the mixed research method and collective analysis to improve the efficiency of clinical data analysis; ⑤ pay attention to narration of the medical feelings and emphasize the humanistic data of clinical medicine. It is expected to promote the standardized and reasonable use of clinical scientific research data, the rigorous integration of expert opinions, and ultimately the development of big data for national health care.

[Thoughts and suggestions on analysis of death cases report during COVID-19 epidemic].

It is an essential task to discuss the death cases for clinicians. During the emergent public events, the report and analysis of death cases is of far-reaching significance. The epidemic of coronavirus disease 2019(COVID-19) has brought huge losses to China, and the medical system has been sustaining tremendous pressure. The best weapon to defeat the epidemic is medical data and related scientific research, of which the systematic analysis and efficient use of death cases is a key step. Based on the incomplete record of death case report, the lack of humanistic perspective and patient report, every department and institution is facing great challenge in terms of data management. Given that the relevant systems need to be improved, and that the integration of standardized reports and clinical research is not mature,as well as other problems, we put forward several methodological suggestions: ① Establish national medical and health data center and improve relevant laws and regulations. ② Increase investment in medical data management and start data collection and analysis as early as possible during the epidemic. ③ Refine the content of death case report and promote the standardization of report. ④ Pay close attention to the report of death cases, review, summary and analysis. More importantly, we should continue to build and improve platforms and programs related to disease control, carry out epidemic-associated scientific research, enhance the managing efficiency of public health data, elevate the anti-risk capability of our medical system, and promote the steady progress of the health China strategy.

[Electroacupuncture Treatment Conduced Before and After Surgery Is Better in Promoting Reco-very of Gastrointestinal Function in Colorectal Cancer Patients Undergoing Radical Resection].

OBJECTIVE: To investigate the effect of electroacupuncture (EA) at different time-points on postoperative gastrointestinal function in patients undergoing colorectal cancer surgery. METHODS: Eighty patients with colorectal cancer undergoing laparotomy were randomly assigned to intravenous anesthesia, EA A, EA B, and EA C groups (n＝20 cases in each group). All the patients in the four groups received intravenous anesthesia with midazolam, sufentanil, cisatracurium besylate and Propofol, postoperative gastrointestinal decompression and drug analgesia. EA (2－3 mA, 2 Hz) was applied to Zhongwan (CV 12) and Tianshu (ST 25), Neiguan (PC 6), Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39) on the right side for 30 min, once (one day before surgery) in the EA A group, twice (one day and 30 min before surgery) in the EA B group, and 3 times (one day, 30 min before and one day after surgery) in the EA C group. The acupoints used after surgery were PC 6, ST 36, ST 37 and ST 39. The time of postoperative ventilation, defecation, food-intake and water drinking, stomach tube removal and abdominal drainage tube removal, the volumes of stomach tube drainage and abdominal drainage, and postoperative adverse reactions were recorded. RESULTS: The first ventilation time, after surgery in the EA C group was significantly earlier than those in the intravenous anesthesia, EA A and EA B groups (P<0.05); and the water intake and abdomicnal drainage tube removal time after surgery in the EA C group were significantly earlier than those in the intravenous anesthesia group (P<0.05). No significant differences were found among the 4 groups in the time of defecation, food intake, stomach tube removal, stomach tube drainage and abdominal drainage volumes, and numbers of patients with nausea, vomiting, fever and other adverse reactions (P>0.05)．. CONCLUSION: EA treatment combined with intravenous anesthesia conducted before and after surgery is effective in promoting the recovery of gastrointestinal function in patients undergoing colorectal cancer laparotomy, and is obviously better than simple pre-operative EA.

Tirucallane-type triterpenoids from the fruits of Phellodendron chinense Schneid and their cytotoxic activities.

Eleven triterpenoids were isolated from the fruits of Phellodendron chinense Schneid, and their structures were determined by spectroscopic analysis. The results show that four new tirucallane-type triterpenoids 1, 2, 5, and 6 and seven known compounds 3, 4, 7, 8, 9, 10, and 11 were isolated. Structurally, compound 6 was uncommon; it has a chlorine atom instead of a methyl group at the C-20 position. The cytotoxicities of the compounds was evaluated against the in vitro proliferation of four human tumor cell lines HEL, K562, MDA, and PC3 using adriamycin as the positive control. Compound 1 showed a similar cytotoxicity as the positive control; compounds 3 and 10 showed moderate cytotoxicities compared to the control (P<0.05). This indicates that these compounds have great potential for the development of new antitumor drugs.