[Formulation of expert consensus on clinical application of external ethnic medicine: taking Baimai Ointment as an example].

The concept of ethnic medicine is divided into a broad sense and a narrow sense. The broad concept refers to the traditional medicine of the Chinese nation, and the narrow concept refers to the traditional medicine of Chinese ethnic minorities. The external medicine is one of the main forms of ethnic medicine, and it is also the important content of ethnic medicine for external use, which is widely used in clinical practice. As the theory of ethnic medicine is unique, the application methods have certain characteristics, which are the key technical parts of clinical practice. However, the existing traditional Chinese medicine consensus formulation me-thods cannot meet the needs of the consensus formulation of the external ethnic medicine. Therefore, the methods suitable for expert consensus on external ethnic medicine are required. This article took Expert opinion on clinical application of Baimai Ointment as an exa-mple, and explorde a reasonable, effective, multi-dimensional, and multi-stage method to formulate expert consensus on the external ethnic medicine. In this research, three-dimensional sources of information, including ancient classics, clinical research evidence, and expert application experiences, were systematically and scientifically collected. After organization and analysis, the information was formed into comprehensive evidence. In a formal consensus meeting, part of the recommendations reached consensus. As to the issues that did not reach agreement, in-depth interviews were used to explore the reasons for the differences and resolve the disagreements. Finally, unanimous recommendations were reached. There are common problems during the formulation process of Expert opinion on clinical application of Baimai Ointment. This study is expected to provide references for the formulation of expert consensus on other external ethnic medicine.

Reynoutria japonica Houtt for Acute Respiratory Tract Infections in Adults and Children: A Systematic Review.

Introduction: Respiratory tract infections (RTIs) are a major cause of morbidity and mortality in some high-risk groups including children and older adults. There is evidence that Chinese herbal medicine has an effect on RTIs. Reynoutria japonica Houtt (better known under its synonym Fallopia japonica (Houtt.) Ronse Decr.) (F. japonica), a commonly used Chinese herbal medicine, has a high content of resveratrol and glycosides. In traditional Chinese medicine theory, F. japonica has the effect of clearing heat in the body, improving blood and qi circulation, eliminating phlegm, and relieving cough, so it may have an effect on RTIs. Methods: This systematic review was registered under PROSPERO CRD42020188604. Databases were searched for randomized controlled trials of F. japonica as a single herb, or as a component of a complex herbal formula for RTIs. Quality of methodology was assessed by two reviewers independently using the Cochrane Risk of Bias Tool. The primary outcome was symptom improvement rate. The secondary outcome measures were fever clearance time, Murray lung injury score and incidence of adverse effects. The extracted data were pooled and meta-analysed by RevMan 5.3 software. Results: Eight RCTs with 1,123 participants with acute RTIs were included in this systematic review, and all the RCTs used F. japonica as part of a herbal mixture. Only one included trial used F. japonica in a herbal mixture without antibiotics in the treatment group. The findings showed that herbal remedies that included F. japonica could increase the symptom improvement rate (risk ratio 1.14, 95% confidence intervals [1.09, 1.20], I2 = 0%, p < 0.00001, n = 7 trials, 1,013 participants), shorten fever duration, reduce Murray lung injury score and did not increase adverse events (RR 0.33, 95% CI [0.11, 1.00], I2 = 0%, p = 0.05, n = 5 trials, 676 participants). Conclusion: There is limited but some evidence that F. japonica as part of a herbal mixture may be an effective and safe intervention for acute RTIs in clinical practice. In future studies it would be preferable to evaluate the effectiveness and safety of using F. japonica without antibiotics for acute RTIs.

[Systematic review of efficacy and safety of Ginkgo biloba extract 50 in treatment of ischemic stroke].

The present study aimed to systematically evaluate the efficacy and safety of Ginkgo biloba extract 50(GBE50) in the treatment of ischemic stroke. The databases including CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library were searched for randomized controlled trial(RCT) of GBE50 for the treatment of ischemic stroke reported between database inception and May 2020. The methodological quality of the included RCTs was evaluated via the Cochrane risk of bias tool. The RevMan 5.4 was used for Meta-analysis. Sixteen RCTs were included, involving 1 615 patients with acute ischemic stroke. Most of the included RCTs reported the methods of random sequence generation, but only two performed the concealment of random sequence. All RCTs failed in blinding. Two RCTs reported the information of cases lost to follow-up and drop-outs. Since the number was small, the baselines of groups remained balanced. All RCTs reported key outcomes of ischemic stroke, which made selective reporting bias in a low risk. Meta-analysis results revealed that GBE50 combined with routine therapies could effectively lower the score of the National Institutes of Health stroke scale(NIHSS) and restore cognitive function and daily activity in ischemic stroke patients. Compared with routine therapies, the combination is advantageous in treating patients with ischemic stroke. However, high-quality multicenter RCTs with large sample sizes are still required for verification.

[Heavy metal pollution and comprehensive ecological risk assessment of surface soil in diffe-rent functional areas of Shenzhen, China]. / æ·±åœ³å¸‚ä¸åŒåŠŸèƒ½åŒºåœŸå£¤è¡¨å±‚é‡é‡‘å±žæ±¡æŸ“åŠå ¶ç»¼åˆç”Ÿæ€é£Žé™©è¯„ä»·.

To explore the impact of urban functional zones on surface soil metal pollution, we analyzed the concentrations and pollution status of eight heavy metals (i.e., Mn, Ni, Cr, Pb, Cd, Zn, Cu, and As) in surface soils from various urban functional zones of Shenzhen City. Nemero index and potential ecological hazard indices were used to quantify the ecological risk levels of different heavy metals in different urban functional zones. Moreover, we spatially classified ecological risk zones for soil heavy metal pollution. Results showed that: 1) concentrations of Cd, Zn, Cu, and As in the surface soil were heavily impacted by human activities, while those of Mn, Ni, Cr, and Pb were not. High-intensity urbanization and industrialization with the constraints of physical environment were identified as the determining factors for regional and functional variation of heavy metal pollution. 2) Pb, Cd, Zn, and Cu had high pollution risks in the surface soils, with Pb having the highest risk, which necessitated further management and control of heavy metals. The overall level of heavy metal pollution risk in the surface soils of Shenzhen was higher than that of other cities in China. 3) Nemero index and potential ecological hazard indices had different emphases in terms of assessing the risk level of heavy metals. Those indices showed different performances in the risk assessment of single heavy metal, overall ecological risks in the different urban functional zones, and ecological risk classification of heavy metal pollution in the urban surface soils. We suggest that those indices should be combined to provide more holistic information about urban heavy metal pollution.