Reporting quality of acupuncture overviews: A methodological investigation based on the PRIOR statement.

OBJECTIVE: Acupuncture overviews are increasing rapidly; however, their reporting quality is yet unclear. We aimed to investigate the reporting quality of relevant overviews according to the preferred reporting items for overviews of reviews (PRIOR) statement. METHODS: We systematically searched PubMed from inception to August 16, 2022 for overviews on acupuncture therapies. Reporting quality of included overviews was evaluated using the PRIOR statement, and the results were cross-checked. Multiple linear regression analysis was used to assess the predictors of the reporting completeness. GraphPad 9.4 was utilized to generate an evidence map, Excel 2019 was used to extract and manage data, and R 4.2.3 was used for data analysis. RESULTS: A total of 49 overviews published from 2006 to 2022 were included, of which China ranked first with 38 overviews. The most frequently searched database was PubMed/ Medline (n = 48, 98%), and commonly used methodological quality assessment tool was AMSTAR-2 (n = 14, 29%). The overarching themes centered on acupuncture for obstetrics, gynecology, reproductive diseases, as well as depression, anxiety, and insomnia. Reporting quality needs to be improved involving the definition of systematic reviews (SRs), overlap of primary studies and SRs, methods for managing discrepant data across SRs, risk of bias in primary studies, heterogeneity, and sensitivity analysis of synthesized results, reporting bias assessment, and registration and protocol. Moreover, publication in recent years and receiving funding support were significantly associated with higher overall reporting quality score (P < 0.05). CONCLUSION: Based on the PRIOR statement, this methodological study indicates that the reporting quality of the included acupuncture overviews is poor. In the future, authors of overviews are encouraged to use the PRIOR statement for standardized reporting. Furthermore, it is recommended that journal editors mandate the inclusion of this statement in authors' reports and require a complete PRIOR checklist.

Effects of roasting on the chemical compositions, color, aroma, microstructure, and the kinetics of changes in coffee pulp.

Roasting is a critical process that affects the quality attributes of coffee beans; however, how roasting conditions affect the physical, chemical, biological, and organoleptic changes of coffee pulp needs more research. In the present study, we investigated the effects of roasting temperatures and times on chemical compositions and quality attributes of coffee pulp. The results showed that the contents of total soluble sugar (TSS) and free amino acid (FAA) followed a temporal pattern of first increasing and then decreasing under the roasting temperatures between 100 and 160°C. Total phenolic content (TPC) and antioxidant activity of coffee pulp significantly (p < 0.05) increased after roasting, reaching the maximum values of 83.09 mg gallic acid equivalent (GAE) /g and 360.45 µM 6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid (Trolox) /g, respectively, when coffee pulp was roasted at 160°C for 18 min. Drying rates of coffee pulp fitted the Logarithmic kinetic model, while color (L*, a*, and b*) changes and 5-caffeoylquinic acid degradation followed the first-order kinetic model. Electronic nose analysis showed that the main aroma compounds of the coffee pulp are sulfur-containing organics that were reduced with the extended roasting time. Scanning electronic microscopy analysis presented the loosened, shrunk, and cracked microstructure on the surface of the roasted coffee pulp, which might contribute to the increased TSS, FAA, TPC, and antioxidant activity of coffee pulp roasted under specific conditions. In conclusion, our research provides valuable information for preparing high-quality coffee pulp tea. PRACTICAL APPLICATION: This article investigates the effects of roasting on the chemical composition, color, flavor, microstructure, and the kinetics of changes in the moisture, color, and 5-caffeoylquinic acid (5-CQA) of the coffee pulp. We have found that high-temperature and short-time roasting helps retain the total phenolic contents, antioxidant activity, and aroma. The drying kinetic fits the Logarithmic model, and the changes in color and 5-CQA fit the first-order kinetic model. This study provides meaningful information for preparing coffee pulp tea with high-quality attributes and antioxidant activity.

The Consistency between Registered Acupuncture-Moxibustion Clinical Studies and Their Published Studies and Update Status of Registered Information.

BACKGROUND: Few studies have analyzed the consistency between registered acupuncture-moxibustion clinical studies and their published research results as well as their update status of registered information. METHODS: We searched for acupuncture-moxibustion clinical studies that were registered at the World Health Organization International Clinical Trials Registry Platform between 2013 and 2015 and collected data regarding their characteristics and update status. Published results of these registered studies were identified and compared with registered information. RESULTS: A total of 425 registered acupuncture-moxibustion clinical studies were included; 379 (89.2%) of them were interventional studies, and the remaining 46 (10.8%) were observational studies. Forty-six studies (10.8%) were found to have published results, and 51 published articles were identified. Overall, 73.2% (311) of registered studies did not update the research status in time; 46.6% (198) stopped updating before recruiting; 21.6% (92) stopped updating after recruiting; and 4.9% (21) stopped updating after completion. Regarding the 46 studies with published results, 29 (63.0%) were considered to be affected by reporting bias. These reporting biases predominantly involved the omission of some predefined outcomes or endpoints (16 studies), contradictions regarding descriptions of sample sizes (9 studies), discrepancies in treatment measurements or group distribution (7 studies), and inconsistent treatment durations (4 studies). When compared with other studies, significant and various reporting biases could also be commonly found in fields other than acupuncture-moxibustion. CONCLUSIONS: There were many discrepancies between registered information and published reports on acupuncture-moxibustion, which could also be commonly observed in other fields. Moreover, a large proportion of registered studies did not update their research status in time. Efforts should be made to improve the reporting quality and timely updates.Es gibt nur wenige Studien, in denen die Übereinstimmung zwischen den registrierten klinischen Studien zur Akupunktur und Moxibustion mit den veröffentlichten Studienergebnissen und dem Aktualisierungsstand der Informationen im Register untersucht wurde.Wir suchten nach klinischen Studien zur Akupunktur und Moxibustion, die zwischen 2013 und 2015 auf der International Clinical Trials Registry Platform der Weltgesundheitsorganisation registriert wurden, und erhoben Daten zu ihren Merkmalen und ihrem Aktualisierungsstand. Die veröffentlichten Ergebnisse der registrierten Studien wurden identifiziert und mit den Informationen im Register verglichen.Insgesamt wurden 425 registrierte klinische Studien zur Akupunktur und Moxibustion eingeschlossen, davon waren 379 (89,2 %) Interventionsstudien und die restlichen 46 (10,8 %) waren Beobachtungsstudien. Es wurden 46 Studien (10,8 %) mit veröffentlichten Ergebnissen gefunden und 51 veröffentlichte Artikel identifiziert. Insgesamt wurde bei 73,2 % (311) der registrierten Studien der Forschungsstand nicht zeitnah aktualisiert; bei 46,6 % (198) wurde die Aktualisierung vor der Rekrutierung eingestellt; bei 21,6 % (92) wurde die Aktualisierung nach der Rekrutierung eingestellt und bei 4,9 % (21) wurde die Aktualisierung nach Abschluss der Studie eingestellt. Von den 46 Studien mit veröffentlichten Ergebnissen wurden 29 (63,0 %) als von Publikationsverzerrung betroffen angesehen. Diese Publikationsverzerrung betraf vor allem die Auslassung einiger vordefinierter Zielkriterien oder Endpunkte (16 Studien), Widersprüche bei der Beschreibung des Stichprobenumfangs (9 Studien), Diskrepanzen bei den Behandlungsmessungen oder der Gruppenverteilung (7 Studien) und Inkonsistenzen bei der Behandlungsdauer (4 Studien). Beim Vergleich mit anderen Studien wurden auch in anderen Bereichen als Akupunktur und Moxibustion häufig signifikante und unterschiedliche Publikationsverzerrungen festgestellt.Es bestanden zahlreiche Diskrepanzen zwischen den Informationen im Register und den veröffentlichten Berichten über Akupunktur und Moxibustion, die auch in anderen Bereichen häufig zu beobachten waren. Darüber hinaus wurde bei einem Großteil der registrierten Studien der Forschungsstand nicht zeitnah aktualisiert. Es sollten Anstrengungen unternommen werden, um die Qualität der Berichterstattung und die zeitnahe Aktualisierung zu verbessern.

Effects of hot-air drying on the bioactive compounds, quality attributes, and drying and color change kinetics of coffee leaves.

Drying is a key step that affects the chemical composition and quality of tea. In the present study, we reported the impacts of drying temperature and time on drying and color change kinetics, phytochemical composition, antioxidant activity, and surface microstructure of coffee leaves during hot-air drying. The results showed that drying temperature was positively (p < 0.05) correlated with the drying rate (DR), color index a* and total color change ΔE, and total soluble sugar (TSS), while negatively correlated with color indexes b* and L*, soluble protein content, and the DPPH scavenging capacity. Drying time has similar impacts on the color indexes and soluble protein as drying temperature. The content of total free amino acid and TSS increased by 62.5% and 47.4%, respectively, when coffee leaves were dried at 160°C for 24 min, under which the total phenolic content and DPPH and ABTS scavenging capacities reached the maximum of 108.04 mg GAE/g, 515.07 µmol Trolox/g, and 606.70 µmol Trolox/g, respectively. Drying significantly decreased the contents of chlorogenic acids and mangiferin and antioxidant activity, while high-temperature short-time drying helped retain phenolic compounds in coffee leaves. The DR fitted Page kinetic model. The color changes fitted the first-order kinetic models and the activation energies ranged from 16.00 to 31.06 kJ·mol-1 . Prolonged drying time caused serious wrinkles on the surface of coffee leaves and the stomata closed. PRACTICAL APPLICATION: Drying decreased soluble protein while increasing free amino acid and soluble sugar. High-temperature short-time drying helps retain phenolics in the coffee leaves. The color change of coffee leaves during drying follows first-order kinetic. Prolonged drying time resulted in loosened texture of coffee leaves. Our study suggested that drying coffee leaves at 160°C for 24 min results in the coffee leaf tea being of better quality.

Efficacy of Vitamin C Supplementation on Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review and Meta-Analysis.

Background: In recent years, the pleiotropic roles of antioxidants have drawn extensive attention in various diseases. Vitamin C is a well-known antioxidant, and it has been used to treat patients with chronic obstructive pulmonary disease (COPD). This systematic review and meta-analysis aim to demonstrate the impact of vitamin C supplementation in patients with COPD. Methods: We searched PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), SinoMed, Wanfang, and China Science and Technology Journal Database (cqvip.com) for eligible randomized controlled trials (RCTs) from their respective inception to May 18th, 2021, by using the searching terms of COPD, vitamin C, and RCTs. A meta-analysis was performed to evaluate the effects of vitamin C on lung function, antioxidant levels, and nutritional conditions in COPD patients by using Review Manager (Version 5.4). Results: Ten RCTs including 487 participants were eligible for our study. Meta-analysis results showed that vitamin C supplementation (≥400 mg/day) can significantly improve the forced expiratory volume in one second as a percentage (FEV1%) in COPD (SMD:1.08, 95% CI:0.03, 2.12, P=0.04). Moreover, vitamin C supplementation significantly improved the ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC) (WMD:0.66, 95% CI: 0.26, 1.06, P=0.001), vitamin C level in serum (SMD:0.63, 95% CI: 0.02, 1.24, P=0.04) and glutathione (GSH) level in serum (SMD:2.47, 95% CI: 1.06, 3.89, P=0.0006). While no statistically significant difference was observed in body mass index (BMI), fat-free mass index (FFMI), vitamin E level and superoxide dismutase (SOD) level in serum. Conclusion: Vitamin C supplementation could increase the levels of antioxidation in serum (vitamin C and GSH) and improve lung function (FEV1% and FEV1/FVC), especially in patients treated with vitamin C supplementation greater than 400 mg/day. However, further prospective studies are needed to explore the role of vitamin C in improving nutritional status.

Ginsenoside Rg3 and sorafenib combination therapy relieves the hepatocellular carcinomaprogression through regulating the HK2-mediated glycolysis and PI3K/Akt signaling pathway.

Hepatocellular carcinoma (HCC) is the most common pathological type of primary hepatic carcinoma. This study investigated the effects of ginsenoside Rg3 (Rg3) and sorafenib (SFN) combination therapy on HCC progression. The HCC-related data were obtained from TCGA database, and the data of HK2 mRNA, clinicopathological features, and survival outcomes were extracted using R Programming 4.0. The human hepatoma cell lines HepG2 and Bel7404 were used. Cell viability was tested using the MTT assay. Glucose consumption and lactate levels of HCC cells were detected using the corresponding kits. Western blotting was used to determine the protein expression of HK2, PI3K, and Akt. HK2 was overexpressed in patients with HCC. Compared with patients with overexpressed HK2, those with low levels of HK2 achieved a longer survival time. In addition, the Rg3 and SFN combination therapy significantly reduced cell viability, glucose consumption, lactate levels, and protein expression of HK2, PI3K, and Akt in HCC cells. Additionally, the Rg3 and SFN combination therapy exhibited a better effect than the single drug group. Inhibition of the PI3K/Akt signaling pathway or exogenous lactate intervention reversed the effects of Rg3 and SFN combination therapy in HCC cells. In conclusion, Rg3 has a synergistic effect on the sensitivity of HepG2 and Bel7404 hepatoma cells to SFN, which is related to HK2-mediated glycolysis and the PI3K/Akt signaling pathway.

Reporting and methodological quality of meta-analyses of acupuncture for patients with migraine: A methodological investigation with evidence map.

BACKGROUND: Acupuncture has been widely used to relieve migraine-related symptoms. However, the findings of previous systematic reviews (SRs) and meta-analyses (MAs) are still not completely consistent. Their quality is also unknown, so a comprehensive study is needed. OBJECTIVE: To evaluate the reporting and methodological quality of these MAs concerning acupuncture for migraine, and summarize evidence about the efficacy and safety of acupuncture for migraine. SEARCH STRATEGY: PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Databases, Wanfang Data, and VIP databases were searched from inception to September 2020, with a comprehensive search strategy. INCLUSION CRITERIA: The pairwise MAs of randomized controlled trials (RCTs) concerning migraine treated by acupuncture or acupuncture-based therapies, with a control group that received sham acupuncture, medication, no treatment, or acupuncture at different acupoints were included. DATA EXTRACTION AND ANALYSIS: Two independent investigators screened studies, extracted relevant data, and assessed reporting and methodological quality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), then all results were cross-checked. Spearman correlation test was used to evaluate the correlation between reporting and methodological quality scores. RESULTS: A total of 20 MAs were included in this study. The included MAs indicated that acupuncture was efficacious and safe in preventing and treating migraine when compared with control intervention. There was a high correlation between reporting and methodological quality scores (rs = 0.87, P < 0.001). The quality of the included SRs needs to be improved mainly with regard to protocol and prospective registration, using a comprehensive search strategy, summarizing the strength of evidence body for key outcomes, a full list of excluded studies with reasons for exclusion, reporting of RCTs' funding sources, and assessing the potential impact of risk of bias in RCTs on MA results. CONCLUSION: Acupuncture is an effective and safe intervention for preventing and treating migraine, and could be considered as a good option for patients with migraine. However, the reporting and methodological quality of MAs included in this overview is suboptimal. In the future, AMSTAR 2 and PRISMA tools should be followed when making and reporting an SR with MA.

The effects of ultrasonication on the phytochemicals, antioxidant, and polyphenol oxidase and peroxidase activities in coffee leaves.

In the present study, we investigated the impacts of ultrasonic conditions on the phytochemical profiles, antioxidant activity, and polyphenol oxidase (PPO) and peroxidase (POD) activities in coffee leaves. Ultrasonic frequency, power, and time, pH, and incubation time affected PPO and POD differently, thus resulting in different ABTS scavenging capacity and phenolic content in coffee leaves. Triple-frequency (20/35/50 kHz) ultrasound significantly (P < 0.05) inhibited trigonelline, caffeine, mangiferin, rutin, chlorogenic acids, antioxidant activity, and PPO activity, while the single frequency of 35 kHz increased the phenolics compounds, which was associated with the lowest POD activity. Increasing the incubation time after ultrasonication gradually decreased phenolic compounds and antioxidant activities, however, POD activity followed a temporal pattern of first increase and then decrease. Our results showed that PPO and POD were temporally inactivated after ultrasonication, which leading to the continuous decrease of phenolics in coffee leaves.

The efficacy and safety of 5-fluorouracil based adjuvant therapy in resected biliary tract cancer: A systematic review and meta-analysis.

OBJECTIVES: The adjuvant therapy (AT) for biliary tract cancer (BTC) patients after surgery has always been controversial. More therapeutic regimens and high-quality evidence were needed to evaluate AT's survival benefit further. Thus, this study was performed to investigate the efficacy and safety of the 5-fluorouracil (5-FU) regimen in resected BTC patients. METHODS: PubMed, Cochrane Library, Web of Science, and the Embase were systematically searched from inception to Feb.3, 2021, for eligible studies. The pooled analyses were performed using Review Manager, Stata, and SPSS software. RESULTS: A total of 9 trials involving 1339 participants were included in the meta-analysis. Resected BTC patients could significantly benefit from a 5-FU regimen (HR:0.51, 95%CI, 0.38-0.69, P<0.0001), regardless of gallbladder carcinoma (GBC) or cholangiocarcinoma (CCA). Moreover, both adjuvant chemotherapy (HR:0.61, 95%CI, 0.47-0.79, P=0.0003) and chemoradiotherapy (HR:0.35, 95%CI, 0.14-0.83, P=0.02) could significantly improve clinical survival of resected BTC patients than the surgery alone group. In the subgroup analyses, patients with node-positive (P=0.02) or vascular invasion disease (P=0.002) could better benefit from postoperative AT. CONCLUSION: This study provides the latest evidence to support the 5-FU regimen in resected BTC patients regardless of GBC or CCA. Furthermore, high-risk patients are more likely to benefit from it, such as node-positive or vascular invasion disease.

Saffron (Crocus sativus L.) and health outcomes: a meta-research review of meta-analyses and an evidence mapping study.

BACKGROUND: Although a number of systematic reviews and meta-analyses of saffron (Crocus sativus L.) have been published, no study has comprehensively summarized the clinical evidence from meta-analyses, or assessed the reporting or methodological quality of these reviews. PURPOSE: The present meta-research study was designed to fill the gaps in knowledge to inform future studies and allow enhanced clinical decision-making on saffron. METHODS: The PubMed, Cochrane Library, Embase, and CNKI databases were systematically searched from inception to April 3 rd, 2021, for meta-analyses of clinical trials that assessed the efficacy and safety of saffron. PRISMA 2009 and AMSTAR-2 were employed to assess the reporting and methodological quality of meta-analyses identified in the search, respectively. The present study was registered on PROSPERO with registration number CRD42020220274. RESULTS: Nineteen eligible systematic reviews with meta-analyses published in English were identified from 235 records. These meta-analyses were published in 12 peer-reviewed journals from 2013 to 2021. The heterogeneous results indicated that saffron significantly reduced fasting blood glucose, waist circumference, diastolic blood pressure, concentrations of total cholesterol and low-density lipoprotein cholesterol, and improved symptoms of depression, cognitive function and sexual dysfunction compared with controls (mainly placebos). Common side effects of saffron consumption included nausea, dry mouth, poor appetite, and headache, but no serious adverse reactions were reported. Primary analysis and sensitivity analysis confirmed that the reporting and methodological quality of reviews included in the study were highly correlated (p < 0.001). The quality of meta-analyses of saffron requires improvement by including a structured abstract, a prospective protocol and registration, explanation of the study designs within each study that is reviewed, the searches, risk of bias assessment, literature selection, and reporting of funding sources. CONCLUSION: The available evidence indicates that saffron is a safe plant for administration as a medicine and can improve diverse clinical outcomes, but the scientific quality of the published systematic reviews needs to be improved. Moreover, the clinical effects of saffron need to be confirmed through high-quality randomized trials in multiple countries with large sample sizes.

Improvement of Acupuncture Based on Smart Medical Care for Post-Stroke Hemiplegic Shoulder Pain and Upper Limb Motor Function.

As a new stage in the development of medicine and health, smart medicine has attracted attention from all parties in recent years. Especially, under the impetus of the Internet, due to the development of new technologies, smart medical care has made considerable progress, and it has also brought us new challenges. The concept, hypothesis, and design of intelligent medical care are analyzed, and the design objects and design principles of intelligent medical care are highlighted. In Africa, 79 patients with shoulder pain after stroke and hemiplegia in the recession period were disintegrated and divided into observation group (40 people) and control group (39 people). The observation group and the control group used two different treatment methods, acupuncture treatment and traditional western medicine treatment. Finally, the situation of the two groups is checked. From the results, the treatment effect of the control group was not as good as that of the observation group (P < 0.05). After treatment, the effects of capillary disease and patients' living conditions in the observation group were better than those in the control group (P < 0.05). It is concluded that the therapeutic effect of wisdom acupuncture treatment has a certain effect and can be used in medical treatment.

Gut microbiota from patients with arteriosclerotic CSVD induces higher IL-17A production in neutrophils via activating RORγt.

The intestinal microbiota shape the host immune system and influence the outcomes of various neurological disorders. Arteriosclerotic cerebral small vessel disease (aCSVD) is highly prevalent among the elderly with its pathological mechanisms yet is incompletely understood. The current study investigated the ecology of gut microbiota in patients with aCSVD, particularly its impact on the host immune system. We reported that the altered composition of gut microbiota was associated with undesirable disease outcomes and exacerbated inflammaging status. When exposed to the fecal bacterial extracts from a patient with aCSVD, human and mouse neutrophils were activated, and capacity of interleukin-17A (IL-17A) production was increased. Mechanistically, RORγt signaling in neutrophils was activated by aCSVD-associated gut bacterial extracts to up-regulate IL-17A production. Our findings revealed a previously unrecognized implication of the gut-immune-brain axis in aCSVD pathophysiology, with therapeutic implications.

The reporting quality and risk of bias of randomized controlled trials of acupuncture for migraine: Methodological study based on STRICTA and RoB 2.0.

OBJECTIVES: To investigate the reporting quality and risk of bias of randomized controlled trials (RCTs) of acupuncture for migraine, to facilitate and improve the quality of RCTs of acupuncture for migraine. METHODS: The Cochrane Library, PubMed and EMBASE were searched from inception to June 11, 2019 using a comprehensive search strategy. The reporting quality and risk of bias of included RCTs were independently evaluated by two investigators using STRICTA and RoB 2.0. Any disagreement was resolved by a third investigator. RESULTS: A total of 28 eligible RCTs were published in 24 academic journals from 1994 to 2018. Based on STRICTA, four sub-items including "details of other interventions'' (1/28, 4 %), "setting and context of treatment" (9/28, 32 %), "the extent to which treatment was varied" (11/28, 39 %), and "number of needle insertions per subject per session" (13/28, 46 %), showed low reporting quality. A total of 32 different outcomes were reported in 28 RCTs, and based on RoB 2.0, nine (9/28, 32 %) RCTs were judged to be high RoB, three of which were owing to deviations from intended interventions; 11(11/28, 39 %) RCTs elicited some concerns; and eight (8/28, 29 %) RCTs were low RoB for their outcomes. CONCLUSIONS: The reporting quality and risk of bias of RCTs of acupuncture for migraine remain suboptimal. Therefore, all stakeholders should make a contribution to improve the quality of RCTs of acupuncture for migraine using STRICTA and RoB 2.0, while not limiting this approach solely to studies on migraine, using STRICTA and RoB 2.0 tools.

Anti-inflammatory effect of Ganluyin, a Chinese classic prescription, in chronic pharyngitis rat model.

BACKGROUND: Ganluyin (GLY) is a famous classical prescription with a long history of use as a treatment for inflammatory conditions such as chronic pharyngitis (CP) in many parts of China. However, it has not been developed as a modern pharmaceutic and its anti-inflammatory mechanisms remain unclear. The aim of this study was to assess the anti-inflammatory efficacy of GLY and potential mechanisms in a rat model of CP. METHODS: The chemical profile of GLY was analyzed by HPLC-UV. We used a mouse model of ear edema and a rat model of paw edema. Specifically, xylene was used to induce edema on the surface of one ear in mice, and carrageenan was injected subcutaneously into the right hind paws of rats to induce paw edema. The paw thickness, ear weight, and ear perfusion were measured and recorded. The CP model in rats was induced by irritating the throat with 5% ammonia and was used to evaluate the therapeutic efficacy of GLY. Levels of interleukin-6 (IL-6), interleukin-1ß (IL-1ß), tumor necrosis factor (TNF-α), and prostaglandin E2 (PGE2) were measured by ELISA in serum, and protein expression of cyclooxygenase-2 (COX-2) and nuclear factor kappa-B p65 (NF-κB p65) in the throat were detected by immunohistochemistry and Western blot to evaluate the anti-inflammatory mechanism of GLY. Hematological assays were also conducted. RESULTS: There were four flavonoids identified in GLY: naringin, neohesperidin, baicalin, and wogonoside. The oral administration of GLY showed a significant inhibitory effect on xylene-induced ear swelling and ear blood flow in mice and significantly ameliorated rat right hind paw edema at doses of 6.2 and 12.4 g/kg. Mechanistic studies found that the anti-inflammatory activity of GLY was related to the inhibition of pro-inflammatory cytokines such as IL-1ß, IL-6, TNF-α, and PGE2 and that GLY reduced the expression of COX-2 and NF-κB p65 proteins in the throat, attenuated throat injury, and reduced inflammatory exudates. Hematological analysis showed that treatment with GLY prevented increases in white blood cell (WBC), neutrophil (NEUT), lymphocyte (LYMPH) and monocyte (MONO) levels. CONCLUSIONS: These studies indicated that GLY has beneficial anti-inflammatory effects on CP and that it acts through reducing pro-inflammatory factors such as IL-1ß, IL-6, TNF-α, and PGE2, as well as decreasing WBC, NEUT, LYMPH and MONO levels and decreasing the expression of COX-2 and NF-κB p65 proteins. These findings may lay the groundwork for further studies of GLY as a suitable candidate for the treatment of inflammatory diseases such as CP.

Use of AMSTAR-2 in the methodological assessment of systematic reviews: protocol for a methodological study.

BACKGROUND: Systematic reviews (SRs) with or without meta-analyses (MAs) are widely used in resolving questions in various healthcare areas (such as, traditional Chinese medicine, public health and surgery), and they are the cornerstone of evidence-based healthcare. However, the reliability of SRs is typically influenced by their methodological quality. AMSTAR (A Measurement Tool to Assess Systematic Reviews) and AMSTAR-2 tools can assess the methodological quality of SRs, and the use of AMSTAR has been investigated. However, AMSTAR-2 is now widely used to evaluate the methodological quality of SRs, but the use of AMSTAR-2 for determining the methodological quality of SRs has not yet been investigated and assessed thoroughly. Thus, we designed the present study to investigate the use of AMSTAR-2 in studies that assessed the methodological quality of a sample of SRs with the AMSTAR-2 and provide references to potential users of AMSTAR-2 tool. METHODS: Four commonly used electronic databases including PubMed, EmBase, the Cochrane Library, and Web of Science will be searched following a comprehensive search strategy to identify and retrieve studies that have used AMSTAR-2 tool for evaluating the methodological quality of SRs. Two independent authors will retrieve bibliometric information and methodological data, including all author names, time of publication, and journal names, whether a specific score value was given for each item, and whether overall quality assessment was performed. Descriptive statistical analyses will be used to present the study results, e.g., frequencies and percentages, mean and standard deviation (SD) or median and interquartile range (IQR). In addition, subgroup analyses will be performed to identify the methodological differences (e.g., the reporting of study designs included in SRs) between overviews and methodological studies. The risk ratio (RR) with 95% confidence interval (95% CI) will be calculated to measure the methodological differences. Cytoscape 3.7.1 software tool will be used to construct collaboration network maps. Further, Microsoft Office Excel 2016 and Stata 12.0 will be used to manage and analyze data. DISCUSSION: The results of this study will identify any gaps in the use of AMSTAR-2 and important bibliometric features, such as active researchers and journals, provide guidance to researchers in various healthcare areas (such as, traditional Chinese medicine and public health) for using AMSTAR-2 tool and help them in developing cooperation and submitting their manuscripts.

Comparative Effectiveness of Different Combinations of Treatment Interventions in Patients with Stroke at the Convalescence Stage Based on the Markov Decision Process.

OBJECTIVE: The objective of this study was to compare the effectiveness of different combinations of interventions in patients with stroke at the convalescence stage based on the electronic health records (EHRs) by using the Markov decision process (MDP) theory and explore the feasibility of the Markov model in the real-world study (RWS). METHODS: Screening was conducted for patients with stroke at the convalescence stage who were admitted to the Third Affiliated Hospital of Zhejiang Chinese Medical University from January 2012 to January 2017 based on the EHRs. The relevant clinical data were extracted, and the appropriate conversion was made (state-action-reward) according to the Markov model. The transformed data were analysed and solved by the MDP to obtain the best interventions for patients with various stroke recovery periods. RESULTS: 926 patients with stroke at the convalescence stage were initially selected. And according to the inclusion exclusion criteria, 854 patients were screened. Through the MDP, we obtained the following results: (1)when the patients with stroke at the convalescence stage have a medical history, but no complications, and mild neurological impairment, ≥66-year- and 18-45-year-old patients are advised to choose acupuncture treatment. 46-65-year-old patients are advised to choose rehabilitation treatment. When patients with moderate to severe neurological impairment, patients are advised to choose rehabilitation, Chinese herbal decoction, and acupuncture combined therapy. (2) Without complications or medical history, patients who are ≥ 66 years old are recommended to choose rehabilitation treatment when the nerve function impairment is mild; rehabilitation and acupuncture treatment are recommended when moderate and severe injuries are caused. (3) The combination of rehabilitation, Chinese herbal decoction, and acupuncture treatment is recommended for patients with phlegm and blood stasis. Acupuncture treatment is recommended for patients with mild impairment of nerve function in qi deficiency and blood stasis type. Rehabilitation, Chinese herbal decoction, and acupuncture treatment are recommended for moderate-severe injuries. CONCLUSIONS: The MDP makes it possible to study the effectiveness of various treatment methods in stroke patients who are at the convalescence stage. Further exploratory studies using MDP theory in other areas in which complex interventions are common would be worthwhile.

Beneficial Effects of Macroporous Resin Extract of Dendrobium candidum Leaves in Rats with Hyperuricemia Induced by a High-Purine Diet.

Objectives. The incidence of hyperuricemia (HUA) is increasing year by year, and there are no ideal drugs for the treatment; the existing ones can cause serious liver and kidney damage. We have confirmed that the water extract of Dendrobium candidum leaves could reduce the level of uric acid in rats, but the active ingredients remain unknown, and the mechanism is not well understood. This research investigated the therapeutic effect of the macroporous resin extract of the Dendrobium candidum leaf (DLE) on hyperuricemia. In this study, hyperuricemia was induced in rats by a 5-week high-purine diet. After that, DLE was administered continuously for 9 weeks. The result showed that biochemical parameters of liver and kidney function, especially serum uric acid (UA) levels, were significantly improved with DLE, which may relate to the reduction of xanthine oxidase (XOD) and adenosine deaminase (ADA) in the liver. Moreover, DLE could significantly prevent kidney and liver from damage, and intestinal injury and reduce inflammation in hyperuricemic rats by inhibiting the expression of both NF-κB and TLR4 proteins. These results showed that the macroporous resin extract of the Dendrobium candidum leaves may be effective for the treatment of hyperuricemia in rats by inhibiting uric acid production and decreasing inflammation.

Physicochemical characterization of polysaccharide from the leaf of Dendrobium officinale and effect on LPS induced damage in GES-1 cell.

The polysaccharide was first successfully isolated from the leaf of Dendrobium officinale by hot water extraction and alcohol precipitation and further purified using DEAE-52 and Sephadex G-100 chromatography. The structure of LDOP-1 was characterized by HPLC, GPC, and FT-IR and NMR spectroscopy, and its protective effect on LPS-induced GES-1 cell injury was analyzed. Results showed that LDOP was a homogeneous polysaccharide with average molecular weight of 91.8 kDa and consisted of Man, Gla, Glc, Glc acid, and Ara at a molar ratio of 2.0:1.3:1.6:1.7:0.7. LDOP had two types of residues, including 1,6-linked α-d-Glup and 1,4-linked α-d-Manp. Activity studies indicated that LDOP-1 can significantly suppress the release of tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), and IL-6 from LPS-induced GES-1 cell injury, decreased the protein expressions of TLR4, phospho-NF-κB, ASC, NLRP3, cleaved-IL-1ß, IL-6, and Bax, increased the protein expression of Bcl-2, and downregulated the ratios of cleaved caspase-1 to pro-caspase-1, phospho-IκBα to IκBα, and phospho-NF-кB to NF-κB. These findings strongly suggested that LDOP can prevent LPS-induced GES-1 cell injury by inhibiting the release of inflammatory cytokines regulated via the TLR4/NF-κB signal pathways.

Top-100 Most Cited Publications Concerning Network Pharmacology: A Bibliometric Analysis.

BACKGROUND: Network pharmacology (NP) has become an increasingly important focus in the drug research field over the past decade. However, no study to date has mapped the current status of NP. Therefore, we performed a bibliometric study to evaluate the top 100 cited papers on NP. METHODS: We searched the Web of Science Core Collection from its inception to February 25, 2019, using the terms "network pharmacology" and "systems pharmacology." Key data, including title, publication year, number of citations, authors, countries/regions, organizations, and journals, were retrieved and analyzed using Excel 2016 and VOSviewer 1.6.10. RESULTS: The total number of citations for the 100 cited papers ranged from 21 to 1,238, published in 53 journals, from 2005 to 2017. The top three journals with the most publications on NP were Clinical Pharmacology & Therapeutics (n = 8, IF2017 = 6.544), Journal of Ethnopharmacology (n = 8, IF2017 = 3.115), and PLoS One (n = 7, IF2017 = 2.766). Most published articles were from the USA (n = 41) and China (n = 35). The most active author was Wang Yonghua from the Northwest A&F University, and of the 100 publications, 14 listing his name. The most frequently used substantive terms included "drug discovery," "traditional Chinese medicine (TCM)," "in-vitro," "cancer," and "cardiovascular disease." Conclusions. The USA and China made the greatest contribution to NP research. The current NP research mainly focused on NP methods (including experimental validation) and using them to explore the molecular mechanisms of TCM for some critical diseases such as cardiovascular diseases and cancers. Furthermore, we believe some guidelines should be developed to regulate NP studies.

[Dry eye syndrome of deficient lacrima production treated with the acupoint thread-embedding therapy: a randomized controlled trial].

OBJECTIVE: To compare the therapeutic effects on the relevant symtoms in the patients with dry eye syndrome treated with the acupoint thread-embedding therapy versus topical artificial tears eye drops. METHODS: A total of 88 patients with dry eye syndrome of deficiency lacrima production were randomized into an acupoint thread-embedding therapy group (thread-embedding group) and a control group with topical artificial tears eye drops (medication group), 44 cases in each one. In the thread-embedding group, 3 cases were dropped out. In the thread-embedding group, Ganshu (BL 18), Pishu (BL 20) and Shenshu (BL 23) etc. were selected and the acupoint thread-embedding therapy was operated once every 30 days, totally for two treatments. In the medication group, the topical artificial tears eye drops was used, 4 to 6 times a day, one drop each time, for 8 weeks totally. Separately, before treatment, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears were determined and the scores of the relevant symptoms of ocular surface such as eye dryness, foreign body sensation in the eyes and eye fatigue were evaluated. RESULTS: In the thread-embedding group, after 4-week and 8-week of treatment as well as in 8-week and 12-week follow-up, the scores of eye dryness, foreign body sensation, burning sensation of eye, phengophobia and eye fatigue were reduced significantly as compared with those before treatment (all P<0.05). In the medication group, the relevant symptoms of ocular surface were reduced after 4-week and 8-week treatment as compared with those before treatment (all P<0.05). In the follow-up, the scores of the relevant symptoms of ocular surface in the thread-embedding group were significantly lower than the medication group (all P<0.05). Separately, after 4-week treatment and 8-week treatment as well as in 8 weeks and 12 weeks of the follow-up, the levels of lactoferrin in tears in the thread-embedding group were significantly increased as compared with those before treatment (all P<0.05). The change was not obvious as compared with that before treatment in the medication group (P>0.05). The levels of lactoferrin in tears at each time point after treatment in the thread-embedding group were higher than the medication group (P<0.05). CONCLUSION: The acupoint thread-embedding therapy effectively improves in the relevant symptoms of ocular surface, such as eye dryness, foreign body sensation, burning sensation of eye, phengophobia and eye fatigue, and increases the level of lactoferrin in tears in the patients with dry eye syndrome of deficiency aqueous production. In the follow-up, the therapeutic effects of the acupoint thread-embedding therapy are significantly better than artificial tears eye drops.