[Network Meta-analysis of Chinese medicine injections in treatment of rheumatoid arthritis].

This study aims to systematically evaluate the efficacy and safety of Chinese medicine injections in the treatment of rheumatoid arthritis. Specifically, randomized controlled trial(RCT) in the treatment of rheumatoid arthritis with Chinese medicine injections was retrieved from PubMed, EMbase, Cochrane Library, Web of Science, Wanfang, CNKI, VIP, and SinoMed(from inception to February 16, 2022). RevMan 5.3 and Stata 15.0 were employed for data analysis. Finally, 53 RCTs, involving 4 280 patients were included. The experimental groups involved the following injections: including Danshen Chuanxiongqin Injection, Tanshinone Ⅱ_A Sodium Sulfonate Injection, Danhong Injection, Dengzhan Xixin Injection, Gugua Extract Injection, Honghua Injection, Lugua Polypeptide Injection, Lugua Polypeptide Injection + Tanshinone Ⅱ_A Sodium Sulfonate Injection, Shuxuetong Injection, Zhengqing Fengtongning Injection, Compound Danshen Injection, and Xuebijing Injection. The network Meta-analysis showcased the following trends.(1) As for improving total clinical effective rate, the surface under the cumulative ranking curve(SUCRA) followed the order of conventional treatment of western medicine combined with Xuebijing Injection > combined with Gugua Extract Injection > combined with Compound Danshen Injection > combined with Danshen Chuanxiongqin Injection > combined with Honghua Injection > combined with Zhengqing Fengtongning Injection > combined with Danhong Injection > combined with Lugua Polypeptide Injection > combined with Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Dengzhan Xixin Injection.(2) As for improving erythrocyte sedimentation rate(ESR), SUCRA followed the order of conventional treatment of western medicine combined with Xuebijing Injection > combined with Shuxuetong Injection > combined with Honghua Injection > combined with Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Gugua Extract Injection > combined with Danhong Injection > combined with Lugua Polypeptide Injection > combined with Dengzhan Xixin Injection > combined with Lugua Polypeptide Injection + Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Danshen Chuanxiongqin Injection > combined with Zhengqing Fengtongning Injection.(3) As for improving rheumatoid factor(RF), SUCRA followed the order of conventional treatment of western medicine combined with Lugua Polypeptide Injection > combined with Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Lugua Polypeptide Injection + Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Gugua Extract Injection > combined with Danshen Chuanxiongqin Injection > combined with Zhengqing Fengtongning Injection > combined with Danhong Injection > combined with Dengzhan Xixin Injection.(4) As for improving C-reactive protein(CRP), SUCRA followed the order of conventional treatment of western medicine combined with Xuebijing Injection > combined with Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Lugua Polypeptide Injection + Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Honghua Injection > combined with Danshen Chuanxiongqin Injection > combined with Dengzhan Xixin Injection > combined with Gugua Extract Injection > combined with Lugua Polypeptide Injection > combined with Zhengqing Fengtongning Injection > combined with Danhong Injection.(5) As for alleviating morning stiffness, SUCRA followed the order of conventional treatment of western medicine combined with Shuxuetong Injection > combined with Lugua Polypeptide Injection > combined with Dengzhan Xixin Injection > combined with Xuebijing Injection > combined with Gugua Extract Injection > combined with Zhengqing Fengtongning Injection > combined with Danhong Injection > combined with Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Honghua Injection.(6) As for improving disease activity score(DAS28), SUCRA followed the order of conventional treatment of western medicine combined with Lugua Polypeptide Injection + Tanshinone Ⅱ_A Sodium Sulfonate Injection > combined with Lugua Polypeptide Injection > combined with Zhengqing Fengtongning Injection > combined with Honghua Injection > combined with Gugua Extract Injection > combined with Dengzhan Xixin Injection. The experimental groups had lower incidence of adverse reactions than the control group. The results of network Meta-analysis suggest that on the combination of conventional treatment of western medicine with Chinese medicine injections can improve the efficacy on rheumatoid arthritis. However, in view of the great differences in the quality and number of studies included for different therapies, the SUCRA of Chinese medicine injections need to be further verified with high-quality multi-center, large-sample, randomized double-blind trials.

Use self-gravitation traction to treat lumbar disc herniation: Study protocol for a double-center, single-blind randomized controlled trial.

BACKGROUND: Self-gravitation traction is 1 of the most popular treatments for lumbar disc herniation (LDH). This study aims to evaluate the effectiveness and safety of the self-gravitation traction device in the treatment of LDH and to confirm its positive treatment effect. METHODOLOGY: This trial is designed as a pragmatic double-center, single-blind, and 3-arm (1:1:1 ratio) randomized controlled trial. The recruited patients with LDH will be randomly allocated to the intervention (traction weight is 40% or 60% of its body weight) or control (traction weight is 20% of its body weight) group. Traction will be completed within 6 consecutive weeks (3 times a week), with 10 minutes of traction for the first 3 weeks, 20 minutes of traction for the next 3 weeks. After the experiment is completed, we will establish an experiment-related database. The software of SPSS, version 21 (SPSS Inc. Chicago, IL) will be used for statistical analysis, and measurement data will be expressed via mean and standard deviation (mean ±â€…SD). DISCUSSION: Once the trial is completed, we will publish the study in journals in both Chinese and English to promote the dissemination and use of the results. In addition, we also plan to promote the research results at various academic conferences both domestically and internationally.

Efficacy and safety of percutaneous endoscopic decompression via transforaminal and interlaminar approaches for lumbar spine stenosis: Protocol for a systematic review and meta-analysis.

BACKGROUND: Lumbar spinal stenosis (LSS) is a common and frequently-occurring disease in the elderly. Percutaneous endoscopic decompression (PED) has become the first choice for the treatment of LSS because of its small wound, mild pain and rapid recovery. The surgical approaches are mainly divided into percutaneous interlaminar approach and transforaminal approach. However, these two surgical approaches have their own advantages, disadvantages and indications. Hence, the present study aims to synthesize the available direct and indirect evidence of transforaminal approach and interlaminar approach to prove their respective advantages and disadvantages. METHODS: The following databases will be searched: Cochrane Library, PubMed, Web of Science, Embase, CNKI, Wanfang data, and China Biomedical Literature Database (CBM). The search dates will be set from the inception to November 2019. Two researchers independently screened the literature, extracted the data and assessed the risk of bias in the included studies. The efficacy outcomes including: Back and Leg Visual Analog Scale (VAS) score, the MacNab criteria, the Oswestry Disability Index (ODI) and Japanese Orthopedic Association (JOA) score. The safety outcomes including: incidence of complications (dura tear, incomplete decompression, reoperation, etc.). The meta-analysis will be conducted using Stata 12.0 software. Grading of Recommendations Assessment, Development and Evaluation (GRADE) will be used to assess evidence quality. RESULTS: The results of this meta-analysis will be published in a peer-reviewed journal. CONCLUSION: The meta-analysis will provide a comprehensive summary of the evidence for 2 approaches to PED in patients with LSS. PROTOCOL REGISTRATION NUMBER: CRD42019128080.