I Single-Atom Doped P-Rich CoPn Nanocluster@CoP with Enhanced HER.

Constructing I single-atom (ISA) doped CoP electrocatalyst for HER is extremely challenging and has not been reported to date. Herein, an ISA doping-phosphatization strategy is proposed to prepare a novel I single-atom doped P-rich CoPn nanocluster@CoP electrocatalyst (ISA-CoPn/CoP) with enhanced HER performance first. ISA-CoPn/CoP shows a low overpotential of only 44 and 81 mV in 0.5 m H2SO4 solution, to drive a current density of 10 and 100 mA cm-2. ISA and P-rich CoPn nanocluster show unique synergies, which can optimize the H adsorption energy and accelerate the kinetics of HER in the CoP system. The intermediate I─H bond vibration peak is directly observed through in situ Raman testing, demonstrating that ISA doping helps accelerate the HER process. Additionally, the ΔGH of ISA-CoPn/CoP is only 0.05 eV by density functional theory (DFT) calculation, which is conducive to H2 evolution.

Hydroxyl and amino dual-functionalized core-shell molecular sieves featuring hydrogen bond donor groups for efficient CO2 cycloaddition.

In CO2 cycloaddition reactions, hydrogen bond donor (HBD) groups are considered environmentally friendly substitutes for metals to promote epoxide ring-opening through interactions with nucleophilic anions. A core-shell structured ILs-based catalyst (mSiO2@MCM-NH2-OH) with dual hydrogen bond donors (-OH and -NH2) was synthesized by copolymerization strategy. Through in-depth characterization, it has been demonstrated that the catalyst (mSiO2@MCM-NH2-OH) possesses multiple catalytic active sites including -OH, -NH2, Br- groups, and the synergistic effect of double HBD groups (-OH and -NH2) and Lewis base (Br-) significantly improved the catalytic activity. Meanwhile, the core-shell structure of the catalyst effectively prevents the loss of active components, which makes the yield remain at about 94 % after 10 cycles. Based on Density Functional Theory (DFT) calculations, a synergistic catalytic mechanism, which involves dual hydrogen-bond donors (-OH and -NH2) and Lewis bases (Br-) was proposed. The cooperative interaction between -OH/-NH2 and Br- reduced the ring-opening barrier of epoxide from 58.6 to 32.0 kcal mol-1 significantly, and thereby facilitated the CO2 cycloaddition reaction.

MnFe phosphides doped in hollow Prussian blue analogues with Ru modification as an efficient cathode for Li-O2 batteries.

A highly efficient catalyst for Li-O2 batteries based on Ru and MnFe phosphides nanoparticles entrapped in a MnFe Prussian blue analogue (PBA) substrate (Ru-MnFeP/PBA) was explored. Synergy between homogeneous Ru and MnFe phosphides nanoparticles improved the catalytic activity and alleviated side reactions. The Li-O2 battery based on Ru-MnFeP/PBA exhibited excellent performance.

Ternary alloy (FeCoNi) nanoparticles supported on hollow porous carbon with defects for enhanced oxygen evolution reaction.

Low-cost non-noble metal nanoparticles are promising electrocatalysts that can catalyze oxygen evolution reaction (OER). Various factors such as poor activity and stability hinder the practical applications of these materials. The electroactivity and durability of the electrocatalysts can be improved by optimizing the morphology and composition of the materials. Herein, we report the successful synthesis of hollow porous carbon (HPC) catalysts loaded with ternary alloy (FeCoNi) nanoparticles (HPC-FeCoNi) for efficient OER. HPC is firstly synthesized by a facile carbon deposition method using the hierarchical porous zeolite ZSM-5 as the hard template. Numerous defects are generated on the carbon shell during the removal of zeolite template. Subsequently, FeCoNi alloy nanoparticles are supported on HPC by a sequence of impregnation and H2 reduction processes. The synergistic effect between carbon defects and FeCoNi alloy nanoparticles endows the catalyst with an excellent OER performance (low overpotential of 219 mV; Tafel slope of 60.1 mV dec-1) in a solution of KOH (1 M). A stable potential is maintained during the continuous operation over 72 h. The designed HPC-FeCoNi presents a platform for the development of electrocatalysts that can be potentially applied for industrial OER.

Effects of Qishen Dihuang Granules on Intestinal Microbiota in Experimental Autoimmune Myasthenia Gravis Model Rats.

Objective: Effects of Qishen Dihuang (QSDH) granules on intestinal flora of an experimental autoimmune myasthenia gravis (EAMG) model rat were investigated (CNBI:PRJNA910532). Methods: Thirty-six female Lewis rats were assigned to Control, EAMG, QSDH-low-dose, QSDH-medium-dose, QSDH-high-dose, and Prednisone groups using the random number table method (6 rats/group). A rat EAMG model was established by injecting Rα97-116 peptide antigen. Each day for 30 days, gavages were administered to rats in the Chinese medicine group (QSDH granules in different concentrations), Prednisone group (prednisone), and Control and Model groups (0.5% CMC). After 30-day gavages, rat fecal samples were collected and the microbial community composition and diversity differences between intestinal microbiota of EAMG and QSDH granule-treated groups were analyzed using 16S amplicon sequencing to explore the effect underlying QSDH granules alleviation of EAMG. Results: The clinical symptoms of rats in each treatment group improved significantly after the intervention treatment with QSDH granules. Comparison of the relative abundance of microorganisms in the gut flora of different groups with that of the EAMG group rats revealed: significantly lower phylum-level Bacteroidetes abundance and significantly greater Actinobacteria abundance in the QSDH-high-dose group and a significantly greater Firmicutes/Bacteroidetes ratio in the QSDH-medium-dose group; significantly increased family-level QSDH-high-dose group abundances of Lachnospiraceae and Trichospiraceae (Firmicutes), significantly increased QSDH-medium-dose group Lactobacillaceae abundance, and significantly increased QSDH-low-dose group Bacteroidaceae abundance; genus-level, QSDH-high-dose group Prevotella and Coprococcus abundances were significantly increased and Turicibacter and Lactobacillus abundances were significantly decreased, while QSDH-medium-dose group Akkermansia and Lactobacillus abundances were significantly increased. Greater overall community richness, diversity, and genetic diversity were observed in QSDH granules-treated groups, but differences were insignificant (P > .05). The most significant inter-group genus-level community marker differences involved Prevotella, Ruminococcus, Coprococcus, and Turicibacter. Conclusion: QSDH granules may regulate EAMG rat intestinal flora by decreasing relative abundances of Turicibacter and Clostridium and increasing relative abundances of Bifidobacterium, Lachnospiraceae, and Prevotella.

Defect-Enriched Hollow Porous Carbon Nanocages Enable Highly Efficient Chlorine Evolution Reaction.

Metal-free carbon-based catalysts are crucial for the electrocatalytic chlorine evolution reaction (CER) to reduce the usage of noble metals and industrial cost. However, the corresponding catalytic activity of high overpotential and low durability hinders their wide application. Here, a hollow porous carbon (HPC) nanocage with a controlled oxygen electronic state around designed carbon defects for CER activity is reported. Alkali etching can bring defects in zeolite with a hollow structure. In a hard template strategy, the type of carbon defects is directly related to etching degree of the zeolite template. More importantly, the oxygen atoms can be "borrowed" from the zeolite framework by the defective carbon. The electron density around unsaturated O atoms can be decreased on the minor defects in carbon compared with that on large defects which is favorable for the adsorption of Cl- . Consequently, the as-synthesized HPC nanocages with minor defects show excellent electrocatalytic performance for CER with a low overpotential of 94 mV at current density of 10 mA cm-2 with good stability, which is superior to the commercial precious metal catalyst of dimensionally stable anode (DSA), and the best in the reported carbon materials. The designed carbon materials provide an option for metal-free industrial catalysts with significant CER activities.

Short-term outcome prediction for myasthenia gravis: an explainable machine learning model.

Background: Myasthenia gravis (MG) is an autoimmune disease characterized by muscle weakness and fatigability. The fluctuating nature of the disease course impedes the clinical management. Objective: The purpose of the study was to establish and validate a machine learning (ML)-based model for predicting the short-term clinical outcome in MG patients with different antibody types. Methods: We studied 890 MG patients who had regular follow-ups at 11 tertiary centers in China from 1 January 2015 to 31 July 2021 (653 patients for derivation and 237 for validation). The short-term outcome was the modified post-intervention status (PIS) at a 6-month visit. A two-step variable screening was used to determine the factors for model construction and 14 ML algorithms were used for model optimisation. Results: The derivation cohort included 653 patients from Huashan hospital [age 44.24 (17.22) years, female 57.6%, generalized MG 73.5%], and the validation cohort included 237 patients from 10 independent centers [age 44.24 (17.22) years, female 55.0%, generalized MG 81.2%]. The ML model identified patients who were improved with an area under the receiver operating characteristic curve (AUC) of 0.91 [0.89-0.93], 'Unchanged' 0.89 [0.87-0.91], and 'Worse' 0.89 [0.85-0.92] in the derivation cohort, whereas identified patients who were improved with an AUC of 0.84 [0.79-0.89], 'Unchanged' 0.74 [0.67-0.82], and 'Worse' 0.79 [0.70-0.88] in the validation cohort. Both datasets presented a good calibration ability by fitting the expectation slopes. The model is finally explained by 25 simple predictors and transferred to a feasible web tool for an initial assessment. Conclusion: The explainable, ML-based predictive model can aid in forecasting the short-term outcome for MG with good accuracy in clinical practice.

Dispersion Management Nonlinear Multimode Interference Mode-Locked Ytterbium Fiber Laser.

Dispersion management plays an important role in improving the output performance of a mode-locked fiber laser. Therefore, dispersion management is carried out by introducing the grating pair in our experiment. Through adjusting the distance between the grating pair, mode-locked pulses corresponding to different dispersion regimes can be realized, which typically range from soliton state in the anomalous dispersion regime to the dissipative soliton format in the normal dispersion regime. Furthermore, tunable spectrum distribution can be achieved by adjusting two intra-cavity polarization controllers. The proposed dispersion management method complements mode-locking techniques based on nonlinear multimode interference (NL-MMI). The laser can operate with self-start mode locking stably and is useful for practice applications.

Comparative the efficacy and acceptability of immunosuppressive agents for myasthenia gravis: A protocol for systematic review and network meta-analysis.

BACKGROUND: Immunosuppressive drugs are routinely used to treat myasthenia gravis (MG). However, current recommendations provide limited evidence to support treatment options, leading to considerable variation in practice among healthcare specialists. Hence, we present a protocol for a systematic review and network meta-analysis (NMA) to update the evidence by comparing the efficacy and acceptability of oral immunosuppressive drugs for the treatment of MG. METHODS: We will conduct a systematic review and NMA of all randomized controlled trials evaluating the following oral immunosuppressive drugs for the treatment of MG. Published studies will be searched using the following databases from inception to November 23, 2021: CENTRAL, the CINAHL, MEDLINE, Embase, PsycINFO, Web of Science, and 3 Chinese databases (Chinese Biomedical Literatures Database, CNKI, and Wan Fang database). Assessment of study eligibility and data extraction will be conducted independently by 2 reviewers. The main outcome will be a quantitative MG scoring system. We will conduct Bayesian NMA to synthesize all evidence for each outcome and obtain a comprehensive ranking of all treatments. The quality of the evidence will be evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations framework. RESULTS: The objective of this study was to assess the relative clinical efficacy and acceptability of first-line immunosuppressants for the treatment of MG, using a systematic review and NMA approach. CONCLUSION: In the absence of head-to-head trials comparing therapies, evidence from this NMA of available clinical trials will inform clinicians, patients, and families the risk-benefit profiles of different treatment options.

Invigorating spleen, replenishing qi and tonifying kidney method treatment of traditional Chinese medicine for myasthenia gravis: A protocol for systematic review and meta-analysis.

BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease related to the production of autoantibodies. It is mediated by antibodies against acetylcholine receptor (AChR), muscle specific kinase (MuSK) or other AChR related proteins in the postsynaptic muscle membrane, which interfere with the transmission of signals at the neuromuscular junction, resulting in clinical symptoms of skeletal muscle weakness and fatigue, leading to the occurrence and development of MG. At present, the incidence rate of Mg is increasing year by year. At present, the method of invigorating spleen, replenishing qi and tonifying kidney in traditional Chinese medicine has been widely used in the clinical treatment of MG, and the effect is good. The purpose of this study was to systematically evaluate the efficacy and safety of the method of invigorating the spleen, supplementing qi and tonifying the kidney in the treatment of MG. METHODS: We will search from the following eight databases: PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, Sinomed, Wanfang, and Vip. All randomized controlled trial (RCT) literature has been searched and classified since the establishment of the database to date. In this study, two researchers independently screened and evaluated the quality of the retrieved literature. Cochrane risk bias assessment tool was used to evaluate the risk of bias. The meta-analysis uses RevMan 5.3 software provided by Cochrane Collaboration Network for meta analysis. RESULTS: This study compared the main outcome indicators: clinical response rate, recurrence rate, incidence of adverse reactions, quantitative myasthenia gravis score (QMG). Secondary outcomes were clinical absolute score, quality of life score (QOL), levels of inflammatory factors such as IL-6, IL-10, and serum acetylcholine receptor antibody (AChR-Ab) levels. CONCLUSION: The purpose of this study was to evaluate the efficacy and safety of the method of invigorating the spleen, supplementing qi and tonifying the kidney in treating MG, and to provide evidence based medicine.

Full-Color and Switchable Circularly Polarized Light from a Macroscopic Chiral Dendritic Film through a Solid-State Supramolecular Assembly.

Chiral materials displaying chirality across multiple length scales have attracted increasing interest due to their potential applications in diverse fields. Herein, we report an efficient approach for the construction of macroscopic crystal dendrites with hierarchical chirality based on an in situ solid assembly in a block copolymer film. Chiral fluorescent crystals are formed by enantiopure d-/l-dibenzoyl tartaric acid and pyrenecarboxylic acid in a poly(1,4-butadiene)-b-poly(ethylene oxide) film. The chiro-optical activity of the crystalline dendrites can be greatly amplified in the absorption and scattering regions and goes along with the dimension of dendrites. Notably, the chiral dendrites exhibited strong circularly polarized luminescence emission with a high dissymmetric factor (0.03). The enhancement of the quantum yield of the chiral film was up to 28%, which was 14 times higher that of the corresponding fluorescent molecules. The circularly polarized emission bands of the films can be fine-tuned by contriving the emissive bands of fluorescent molecules. More importantly, the chiral signals are able to be wiped when the fluorescent group photodimerizes under UV irradiation. This work provides an efficient way to develop functional materials through solid self-assembly.

Exploring the Potential Mechanism of Qi-Shen-Di-Huang Drug Formulary for Myasthenia Gravis (MG) based on UHPLC-QE-MS Network Pharmacology and Molecular Docking Techniques.

Myasthenia gravis (MG) is a rare and refractory autoimmune disease, and Qi Shen Di Huang (QSDH) drug formulary is an in-hospital herbal decoction with proven clinical efficacy in treating MG. Currently, most of the research on the QSDH drug formulary has concentrated on its clinical efficacy, and there is a lack of systematic study on the material basis. The active compounds and their mechanism of action have not been entirely determined. Therefore, this study sought to identify the active compounds in the QSDH drug formulary and analyze the key targets and potential mechanisms. We used ultra-performance liquid chromatography Q Exactive-mass spectrometry (UHPLC-QE-MS) and Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database to identify and screen 85 active ingredients corresponding to 59 potential targets (17 herbs) associated with myasthenia gravis, and further identified AKT1 as the primary core target and the PI3K/AKT signaling pathway as the most substantial enriched pathway. Molecular docking and UPLC-MS analysis identified quercetin, luteolin, wogonin, kaempferol, laccasein, and epigallocatechin gallate are the core compounds of the QSDH drug formulary. In vivo rat studies showed that the QSDH drug formulary reduced Lennon's clinical score and decreased acetylcholine receptor antibody levels in peripheral blood rats with experimental autoimmune myasthenia gravis. In addition, the QSDH drug formulary downregulated P-PI3K/PI3K and P-Akt/Akt protein expression. Collectively, these findings describe the role and potential mechanism of the QSDH drug formulary in the treatment of MG, which exerts potential value by acting on AKT targets and regulating the PI3K/AKT signaling pathway and providing a theoretical reference for QSDH drug formulary application in the clinical treatment of MG.

The route to a 200 MHz, all-PM femtosecond Yb-doped fiber laser with a high output coupling ratio.

Based on the time-independent rate equations and nonlinear Schrödinger equation, we simulate a 200 MHz all-polarization-maintaining (PM) mode-locked Yb-doped fiber laser. The cavity round trip evolution toward stable mode locking is present. Additionally, the gain coefficients along the gain fiber as well as the pulses, chirp, and spectra at different locations in the cavity are examined. The effects of chirped fiber Bragg grating parameters on the pulse shape and spectrum profile are also investigated. According to the calculations, we experimentally realize a 200 MHz femtosecond fiber laser with 115 mW output power. The timing jitter and integrated relative intensity noise are measured as 158 fs (1 kHz to 10 MHz) and 0.0513% (1 Hz to 300 kHz), respectively. Eventually, an amplified average power of 610 mW and 79 fs compressed pulses with a peak power of approximately 28 kW are obtained. The exhibited all-PM femtosecond fiber laser system can be adopted as the foundation for an optical frequency comb.

The prevention of stroke by statins: A meta-analysis.

PURPOSE: The objectives of this study were to determine the preventive effects of statins on stroke. METHODS: The published randomized controlled trials of statins for stroke prevention were searched from PubMed, EMBASE, Cochrane Library, and China Journal databases. We performed the meta-analysis via calculating the odds ratio (OR) and 95% confidence interval (CI) to study the mortality rate, incidence, and recurrence rate of patients with stroke in the prevention group and the control group. Chi-square-based Q test and I2 statistics were performed to test the potential heterogeneity; we conducted the sensitivity analysis to assess the stability of our analysis. Moreover, we performed the Begg and Egger tests to assess the publication bias. RESULTS: Nine studies were included to perform meta-analysis, which included 15,497 patients (prevention group [n = 4114]; control group [n = 11383]). We found that the statins were not associated with the patients with stroke in mortality rate (OR = 1.00, 95% CI [0.82, 1.23]) and incidence (OR = 0.94, 95% CI [0.46, 1.92]) between the 2 groups. However, there was a significant differences in recurrence rate between the 2 groups (OR = 0.31, 95% CI [0.19, 0.51]). CONCLUSIONS: Our findings indicated that the statins were associated with the patients with stroke in recurrence rate, but there was no significant correlation with the mortality and morbidity of patients with stroke.

Plasma exchange versus intravenous immunoglobulin in AChR subtype myasthenic crisis: A prospective cohort study.

Myasthenic crisis (MC) is a life-threatening state with respiratory failure in patients with myasthenia gravis (MG). The fast-acting immunomodulatory therapies for treating MC included plasma exchange (PE) and intravenous immunoglobulin (IVIG). However, the efficacy and the impact on antibody changes remained unknown. We prospectively followed 40 anti-acetylcholine receptors (AChR) antibody-positive MC patients who received either PE (n = 12) or IVIG (n = 28) at crisis. PE was associated with a reduced ICU stay length (p = 0.018) and an early response by the average changes in MGFA-QMG (p = 0.003), MMT (p = 0.020), and ADL (p = 0.011) at one-week off-ventilation. However, the clinical efficacy was equally comparable in both groups after 1 month. Post-treatment hemoglobin drop was significant in both groups, while IVIG was associated with a significant reduction in anti-AChR antibody titers (p < 0.001). This analysis provides real-world evidence in supporting the use of PE as a fast-acting therapy for shortening the ICU stay in AChR-associated MC.

Electrocatalytic HER Enhancement of C3 N4 in NiCo2 O4.

Generally, C3 N4 was widely used in the field of photocatalytic hydrogen production, but only few studies focused on electrocatalytic hydrogen production field in Ni/Co based systems. Herein, to investigate the enhanced HER property of C3 N4 , NiCo2 O4 @C3 N4 were fabricated successfully via a simple mixture method. With the introduction of C3 N4 , NiCo2 O4 @C3 N4 showed better HER property with small overpotential (89 mV, η10  mA cm-2 ), low Tafel slope (146 mV dec-1 ) and superior long-term stability, thereby indicating the excellent synergistic effect between NiCo2 O4 and C3 N4 . Besides, compared with NiCo2 O4 , the large electrochemically active surface areas of NiCo2 O4 @C3 N4 (ca. 126 cm2 ) indicated the abundant active sites, directly proofing the HER enhancement of C3 N4 . According to Density Functional Theory (DFT) calculation results, when NiCo2 O4 combined with C3 N4 , the EH2O* of NiCo2 O4 @C3 N4 decreased from 3.80 to 2.76 eV and, accordingly, the heterostructure possessed an appropriate ΔGH* (0.19 eV, close to Pt), suggesting the unique synergistic effect between NiCo2 O4 and C3 N4 . Meanwhile, H2 O interacted with the d orbital of the Co atom and induced more electrons to transfer from NiCo2 O4 to C3 N4 and H2 O sequentially, thereby accumulating plenty of electrons on H2 O molecule and further activating H2 O molecule. Accordingly, the H-O-H bond angle of H2 O was narrowed from 104.3° to 103.2°, meanwhile, the O-H bond length was extended from 0.975 to 0.989 Å, demonstrating the HER enhancement of C3 N4 .

Pneumonia and systemic inflammatory response syndrome as predictors for difficult-/prolonged-weaning after invasive ventilation in myasthenic crisis: A retrospective analysis of a Chinese cohort.

Weaning from invasive mechanical ventilation (MV) represents a pivotal step for myasthenic crisis (MC) patients. The aim was to evaluate the association between the weaning process and clinical outcomes, as well as to determine the independent predictors for difficult-/prolonged-weaning in MC. MC patients requiring invasive MV were recruited from Jan 2014 through Sep 2020. Among 124 consecutive MC patients, we finally included 66 patients (age 48.4 ±â€¯18.7 years, female 45.5%). According to the WIND (Weaning according to a New Definition) classification, these patients were classified into no-weaning (n = 5, 7.6%), short-weaning (n = 13, 19.7%), difficult-weaning (n = 26, 39.4%), and prolonged-weaning group (n = 22, 33.3%). Four-week functional assessment in short-weaning group was more favorable than that in difficult-/prolonged-weaning group (p<0.001). Length of hospital stay (23.0 (15.0-28.0) vs. 37.5 (27.0-54.8), p<0.001), length of ICU stay (17.0 (8.5-22.5) vs. 34.0 (20.3-45.0), p<0.001), duration on ventilation (6.0 (6.0-8.5) vs. 18.0 (13.3-30.0), p<0.001), and time interval from MV to first weaning (6.0 (6.0-8.0) vs. 11.0 (8.0-20.8), p<0.001) in short-weaning group were significantly shorter than those in difficult-/prolonged-weaning group. Short-weaning group had a lower prevalence of pneumonia (23.1% vs. 75.0%) and systemic inflammatory response syndrome (SIRS) (38.5% vs. 85.4%), and a higher value in the lowest hemoglobin level (123.0 ±â€¯12.9 g/L vs. 108.3 ±â€¯18.1 g/L) and the lowest serum albumin level (33.2 ±â€¯3.4 g/L vs. 29.9 ±â€¯4.2 g/L) than difficult-/prolonged-weaning group. Multivariate logistic regression analysis identified pneumonia and the presence of SIRS within one week of MC as independent predictors for difficult-/prolonged-weaning. The weaning process is associated with clinical outcomes in MC patients requiring ventilation. Pneumonia concurrence and the presence of SIRS within one week of MC were identified as independent predictors for difficult-/prolonged-weaning after invasive MV.

Factors related to the risk of stroke in the population with type 2 diabetes: A protocol for systematic review and meta-analysis.

BACKGROUND: Type 2 diabetes is an independent risk factor for stroke. The main role of the current study is to study the mechanism of stroke induced by diabetes, but there is no systematic summary of daily management and stroke prevention for patients with type 2 diabetes. In order to provide a more detailed stroke prevention program for patients with type 2 diabetes, we included in the study and looked forward to analyzing the risk factors that were more in line with the clinical characteristics of type 2 diabetes. METHODS: We will search the following Chinese and English databases: PubMed, Web of science, Cochrane Library, Medline, and China National Knowledge Infrastructure database. All of the above electronic databases will be searched from inception to June 30, 2021. In addition, we will manually search for conference papers, ongoing experiments, and internal reports to supplement the studies retrieved via electronic search. We will use the STATA 16.0 provided by Cochrane Collaboration Network for statistical analysis. RESULTS: The study will prove a collective view on the relationship between related factors and stroke in the type 2 diabetes population. CONCLUSION: We plan to submit this systematic review to a peer-reviewed journal.INPLASY registration number: INPLASY2021100046.

Optimal intervention time and risk of the activating blood and removing stasis method in acute cerebral hemorrhage patients: A randomized placebo-controlled trial.

INTRODUCTION: Stroke is the leading cause of disability-adjusted life years in neurological diseases and has become one of the top 3 fatal diseases in the world. Cerebral hemorrhage accounts for approximately 18% to 24% of all strokes in Asian countries. Cerebral hemorrhage is one of the most destructive subtypes of stroke and has high morbidity and mortality. Based on the current research, it has been confirmed that neither surgical treatment nor current drug treatment is the most preferred treatment. Traditional Chinese medicine (TCM) is increasingly being used to treat cerebral hemorrhage, and the activating blood and removing stasis (ABRS) method has received more attention. At present, there is still a lack of high-quality clinical research on the treatment of acute cerebral hemorrhage. METHOD: We designed a multicenter, prospective, randomized, double-blind, placebo-controlled clinical trial. We aim to recruit 312 cerebral hemorrhage patients aged 18 to 80 years within 24 to 72 hours after onset. In addition to routine treatment, participants will randomly receive ABRS granules or placebo for 14 days. Those enrolled within 24 to 48 hours after onset will enter strata A, and those enrolled within 49 to 72 hours (including 48-49 hours) after onset will enter strata B. The strata sample size ratio will be 1:1. The primary outcome is the disability degree (modified Rankin Scale score, mRS) at 6 months after onset. The secondary outcomes include the percentage of hematoma enlargement after treatment, Barthel index (BI), National Institutes of Health stroke scale (NIHSS) score, mortality rate, all-cause mortality rate, TCM stroke syndrome evaluation scale score, and adverse events. DISCUSSION: The study is expected to confirm the safety and effect of acute cerebral hemorrhage within 24 to 72 hours treated with the ABRS method and to determine the optimal time for intervention in this period. TRIAL REGISTRATION NUMBER: ChiCTR1900022627.

Profiles of COVID-19 clinical trials in the Chinese Clinical Trial Registry.

The COVID-19 pandemic has caused a global public health crisis. There is a pressing need for evidence-based interventions to address the devastating clinical and public health effects of the COVID-19 pandemic. The Chinese scientists supported by private and government resources have adopted extensive efforts to identify effective drugs against the virus. To date, a large number of clinical trials addressing various aspects of COVID19 have been registered in the Chinese Clinical Trial Registry (ChiCTR), including more than 200 interventional studies. Under such an urgent circumstance, the scope and quality of these clinical studies vary significantly. Hence, this review aims to make a comprehensive analysis on the profiles of COVID-19 clinical trials registered in the ChiCTR, including a wide range of characteristics. Our findings will provide a useful summary on these clinical studies since most of these studies will encounter major challenges from the design to completion. It will be a long road for the outcomes of these studies to be published and international collaboration will help the ultimate goals of developing new vaccines and anti-viral drugs.