Comparative effectiveness and safety of 32 pharmacological interventions recommended by guidelines for coronavirus disease 2019: a systematic review and network meta-analysis combining 66 trials / 中华医学杂志(英文版)

BACKGROUND@#The global pandemic coronavirus disease 2019 (COVID-19) has become a major public health problem and presents an unprecedented challenge. However, no specific drugs were currently proven. This study aimed to evaluate the comparative efficacy and safety of pharmacological interventions in patients with COVID-19.@*METHODS@#Medline, Embase, the Cochrane Library, and clinicaltrials.gov were searched for randomized controlled trials (RCTs) in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/SARS-CoV. Random-effects network meta-analysis within the Bayesian framework was performed, followed by the Grading of Recommendations Assessment, Development, and Evaluation system assessing the quality of evidence. The primary outcome of interest includes mortality, cure, viral negative conversion, and overall adverse events (OAEs). Odds ratio (OR) with 95% confidence interval (CI) was calculated as the measure of effect size.@*RESULTS@#Sixty-six RCTs with 19,095 patients were included, involving standard of care (SOC), eight different antiviral agents, six different antibiotics, high and low dose chloroquine (CQ_HD, CQ_LD), traditional Chinese medicine (TCM), corticosteroids (COR), and other treatments. Compared with SOC, a significant reduction of mortality was observed for TCM (OR = 0.34, 95% CI: 0.20-0.56, moderate quality) and COR (OR = 0.84, 95% CI: 0.75-0.96, low quality) with improved cure rate (OR = 2.16, 95% CI: 1.60-2.91, low quality for TCM; OR = 1.17, 95% CI: 1.05-1.30, low quality for COR). However, an increased risk of mortality was found for CQ_HD vs. SOC (OR = 3.20, 95% CI: 1.18-8.73, low quality). TCM was associated with decreased risk of OAE (OR = 0.52, 95% CI: 0.38-0.70, very low quality) but CQ_HD (OR = 2.51, 95% CI: 1.20-5.24) and interferons (IFN) (OR = 2.69, 95% CI: 1.02-7.08) vs. SOC with very low quality were associated with an increased risk.@*CONCLUSIONS@#COR and TCM may reduce mortality and increase cure rate with no increased risk of OAEs compared with standard care. CQ_HD might increase the risk of mortality. CQ, IFN, and other antiviral agents could increase the risk of OAEs. The current evidence is generally uncertain with low-quality and further high-quality trials are needed.

Study on effects of different habitat processing methods of Salviae Miltiorrhizae Radix et Rhizoma in rats with acute myocardial ischemia / 中国中药杂志

To investigate the effects of different habitat processing methods of Salviae Miltiorrhizae Radix et Rhizoma on acute myocardial ischemia induced by pituitrin in rats. In this experiment, the tail vein injection of pituitrin was used to induce acute myocardial ischemia in rats. Electrocardiograph(ECG) heart rate and ΔST changes were recorded, and the levels of creatine kinase isoenzyme(CK-MB), lactate dehydrogenase(LDH), superoxide dismutase(SOD) and malondialdehyde(MDA) in serum of rats were detected to comprehensively evaluate the effects of six processing methods of Salviae Miltiorrhizae Radix et Rhizoma on serum biochemical indexes of rats with acute myocardial injury. The ECG results showed that the Salviae Miltiorrhizae Radix et Rhizoma dried in a drying oven had a good effect on the improvement of heart rate and ΔST of electrocardiogram after ischemia, and all the other groups had some protective effects to different degrees. The results of biochemical indexes in serum of each group after ischemia showed that the activity of CK-MB decreased most significantly in Salviae Miltiorrhizae Radix et Rhizoma high-dose group with drying in a drying oven after sweating and losing weight in a drying oven, high-dose group with drying in the shade and low-dose group with drying in the shade. The activity of LDH decreased most significantly in Salviae Miltiorrhizae Radix et Rhizoma high-dose group with drying in the shade and low-dose group of drying in the shade. The activity of SOD increased most significantly in Salviae Miltiorrhizae Radix et Rhizoma low-dose group with drying in sun, low-dose group with drying in sun after sweating and losing weight in sun, and low-dose group with drying in a drying oven. The activity of MDA decreased most significantly in Salviae Miltiorrhizae Radix et Rhizoma low-dose group with drying in sun. The comprehensive scoring results showed that the highest score was obtained in Salviae Miltiorrhizae Radix et Rhizoma high-dose group with drying in the shade while the scores of other treatment groups were higher than that of the model group. It could be seen that the Salviae Miltiorrhizae Radix et Rhizoma dried in a drying oven had a good improvement effect on electrocardiograph indexes after acute myocardial injury, the Salviae Miltiorrhizae Radix et Rhizoma dried in the shade had a good improvement effect on serum myocardial enzymes after acute myocardial injury, and the other processing methods had a certain protective effect on myocardial injury. The six processing methods evaluated by pharmacodynamics showed that the Salviae Miltiorrhizae Radix et Rhizoma dried in the shade and dried in a drying oven had good efficacy.

Establishment of genetic transformation system for Sophra alopecuroides and deletion analysis of SaLDC promoter / 中国中药杂志

Establishing the genetic transformation system of medicinal plant is important to study their functional genes. Based on the established regeneration system of Sophra alopecuroides, 6 factors of genetic transformation were optimized, that was the concentration of Agrobacterium tumefaciens, the infection time, the co-cultivation time of agrobacterium tumefaciensand S.alopecuroides callus, the preculture time of S.alopecuroides callus, the adding method ofacetosyringone (AS) and the concentration of AS, respectively. The results showed that a maximum genetic transformation efficiency of 83.33% was achieved with 15d-precultured of S.alopecuroides callus, which was infected by A600=0.9 A. tumefaciens for 15 minutes and then co-cultivated for 48 hours with 200 μmol•L-1AS. The promoter sequence (1 260 bp) of upstream SaLDC was cloned from S.alopecuroides genomic DNA (gene bank accession number: KY038928). The deletion fragment of SaLDC promoter with different length (310,594,765,924,1 260 bp) were ligated with the GUS reporter gene to form five plant expression vectors named P310,P594,P765,P924,P1260, which were then transferred into S.alopecuroides callus. The GUS transient expression showed that all 5 different deletion fragment of SaLDC promoter can drive the GUS gene expression in S. alopecuroides callus. The SaLDC promoter we cloned has high promoter activity, and they may facilitate its function analysis in the future.

Study on response of resting-state functional magnetic resonance imaging induced by abdominal acupuncture with invigorating the kidney and nourishing marrow method / 中国针灸

<p><b>OBJECTIVE</b>To approach the central nervous mechanism of abdominal acupuncture by using resting-state functional magnetic resonance imaging (fMRI).</p><p><b>METHODS</b>Twelve old healthy volunteers were treated by standardized abdominal acupuncture with invigorating the kidney and nourishing marrow method and Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanyuan (CV 4), Qixue (KI 13), Shangqu (KI 17) and Huaroumen (ST 24) were selected. They were examined by using resting-state fMRI before and after treatment of abdominal acupuncture and the brain functional connectivities were analyzed based on bilateral hippocampus chosen as seed points.</p><p><b>RESULTS</b>(1) Before acupuncture, functional connectivities were found in the bilateral middle frontal gyrus, bilateral superior temporal gyrus, bilateral middle temporal gyrus, bilateral thalamus, bilateral subiculum hippocampi, bilateral insula, the cupula and declivis of right cerebellum, left superior frontal gyrus, left head of caudate nucleus, left posterior cingulate gyrus and left inferior parietal lobule (all P < 0.05). (2) After acupuncture, functional connectivities were found in the bilateral superior frontal gyrus, bilateral superior temporal gyrus, bilateral middle temporal gyrus, bilateral thalamus, bilateral insula, bilateral subiculum hippocampi, bilateral inferior parietal lobule, bilateral postcentral gyrus, bilateral cingulate gyrus, right head of caudate nucleus, right middle occipital gyrus and right posterior cingulate gyrus (all P < 0.05). (3) After acupuncture, there were intensity functional connectivities greater than before acupuncture in the bilateral superior frontal gyrus, bilateral middle frontal gyrus, bilateral superior temporal gyrus, bilateral superior parietal lobule, right inferior frontal gyrus, right anterior cingulate gyrus, right fusiform gyrus, right precuneus and right postcentral gyrus, while the intensity of functional connectivities of left middle temporal gyrus, right lingual gyrus, left cuneus/precuneus and left inferior parietal lobule were attenuated.</p><p><b>CONCLUSION</b>Abdominal acupuncture with invigorating the kidney and nourishing marrow method can improve the allomeric function of the brain cognition network of central nervous system.</p>

Acupuncture at the acupoints of different meridians at the same anatomy level: a study with functional magnetic resonance imaging / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the response of the specific brain functional areas of normal human to acupuncture at the acupoints of different Meridians at the same anatomy level.</p><p><b>METHODS</b>Twelve healthy young volunteers were enrolled in this research and functional magnetic resonance imaging (fMRI) scans were taken randomly in a block design. During the stimulation phase, an acupuncture needle inserted in right Shenmen (HT7) or Yanglao (SI6) was twirled at an angle of 180 degrees and a frequency of about 1.5 Hz. The collected images were analyzed using SPM2 for exploring the inter-group differences in blood oxygen level dependent (BOLD) responses. RESULTS Increases in BOLD signal (group analysis, corrected, 0.05, K>or=10) were found mainly in the right ostcentral gyrus of the frontal lobe (BA2, BA1, BA43) and left inferior frontal gyrus (BA47) by acupuncture at HT7, and chiefly in the left inferior parietal lobule (BA 40) and right inferior frontal gyrus (BA 45, BA 46) by acupuncture at SI6.</p><p><b>CONCLUSION</b>Acupuncture of HT7 and SI6 elicits different BOLD responses in some related cerebral regions correlative with cognition.</p>