Quenching Detrimental Reactions and Boosting Hole Extraction via Multifunctional NiOx /Perovskite Interface Passivation for Efficient and Stable Inverted Solar Cells.

Nickel oxide (NiOx ) is one of the most promising hole transport materials for inverted perovskite solar cells (PSCs). However, its application is severely restrained due to unfavorable interfacial reactions and insufficient charge carrier extraction. Herein, a multifunctional modification at the NiOx /perovskite interface is developed via introducing fluorinated ammonium salt ligand to synthetically solve the obstacles. Specifically, the interface modification can chemically convert detrimental Ni≥3+ to lower oxidation state, resulting in the elimination of interfacial redox reactions. Meanwhile, interfacial dipole is incorporated simultaneously to tune the work function of NiOx and optimize energy level alignment, which effectively promotes the charge carrier extraction. Therefore, the modified NiOx -based inverted PSCs achieve a remarkable power conversion efficiency (PCE) of 22.93%. Moreover, the unencapsulated devices obtain a significantly enhanced long-term stability, maintaining over 85% and 80% of the initial PCEs after storage in ambient air with a high relative humidity of 50-60% for 1000 h and continuous operation at maximum power point under one-sun illumination for 700 h, respectively.

Efficient and stable organic solar cells enabled by multicomponent photoactive layer based on one-pot polymerization.

Degradation of the kinetically trapped bulk heterojunction film morphology in organic solar cells (OSCs) remains a grand challenge for their practical application. Herein, we demonstrate highly thermally stable OSCs using multicomponent photoactive layer synthesized via a facile one-pot polymerization, which show the advantages of low synthetic cost and simplified device fabrication. The OSCs based on multicomponent photoactive layer deliver a high power conversion efficiency of 11.8% and exhibit excellent device stability for over 1000 h (>80% of their initial efficiency retention), realizing a balance between device efficiency and operational lifetime for OSCs. In-depth opto-electrical and morphological properties characterizations revealed that the dominant PM6-b-L15 block polymers with backbone entanglement and the small fraction of PM6 and L15 polymers synergistically contribute to the frozen fine-tuned film morphology and maintain well-balanced charge transport under long-time operation. These findings pave the way towards the development of low-cost and long-term stable OSCs.

Dual Optimization of Bulk and Interface via the Synergistic Effect of Ligand Anchoring and Hole Transport Dopant Enables 23.28% Efficiency Inverted Perovskite Solar Cells.

The crystalline morphology of perovskite film plays a key role in determining the stability and performance of perovskite solar cells (PSCs). In addition, the work function and conductivity of hole transport layer (HTL) have a great influence on the effciency of PSCs. Here, we develop a synergistic doping strategy to fabricate high-performance inverted PSCs, doping a functional nanographene (C78-AHM) into the poly[bis(4-phenyl)(2,4,6-trimethylphenyl)amine (PTAA) HTL, thus forming an HTL with higher conductivity, lower roughness, and frontier energy levels matching the perovskite absorber work function. On this basis, thiosemicarbazide (TSC) was doped into the precursor solution of perovskite as the grain and interface modifier to further improve the crystalline morphology of perovskite film. Compared with the current single passivation method, this codoping strategy can simultaneously reduce the surface and bulk defects of perovskite film and reduce the interface energy barrier. Eventually, high-quality TSC-doped perovskite films based on C78-AHM-doped PTAA HTL are obtained with over 2 µm sized grains, pinhole-free, and improved crystallinity. As a result, this synergistic doping strategy increases the efficiency of the device from 20.27% to 23.28%. Furthermore, the environmental and thermal stabilities of the devices are significantly improved. Therefore, this work provides a simple way for the preparation of other efficient optoelectronic devices.

Tuning Perovskite Surface Polarity via Dipole Moment Engineering for Efficient Hole-Transport-Layer-Free Sn-Pb Mixed-Perovskite Solar Cells.

Post-treatment has been recognized as one of the effective methods for passivating the underlying defects in perovskite solar cells (PSCs), but little attention has been paid to how to pick suitable passivation agents with diverse isomers for efficient PSCs, particularly for the tin-lead (Sn-Pb) mixed PSCs. Here, we introduce the dependence of the power conversion efficiency (PCE) on a dipole moment for surface passivator screening, in which we chose three trifluoromethyl-phenylethylamine hydroiodide (CF3-PEAI) isomers as surface-treatment materials for hole-transport-layer-free (HTL-free) Sn-Pb mixed PSCs. The different positions of the -CF3 group for the CF3-PEAI isomer result in different dipole moments, which influences the interaction between CF3-PEAI and lead iodide. The para position CF3 with the highest dipole moment exhibits a higher PCE than the ortho-position with a lower dipole moment, which is attributed to the large dipole moment on the surface that could tune the surface polarity from p-type to n-type, facilitating electron charge transport in the HTL-free Sn-Pb mixed PSCs. An ultrathin 2D layer is formed on the perovskite surface to passivate the surface defects, which is responsible for the enhancement of the PCE and stability of the PSCs. As a result, the open-circuit voltage (VOC) of the device is improved from 0.775 to 0.824 V, yielding a champion PCE of 20.17%, which is one of the highest PCEs among the reported HTL-free Sn-Pb mixed PSCs. The device also shows improved stability with remaining 75% of its initial PCEs after storage in N2 for 700 h.

Deciphering the Morphology Change and Performance Enhancement for Perovskite Solar Cells Induced by Surface Modification.

Organic-inorganic perovskite solar cells (PSCs) have achieved great attention due to their expressive power conversion efficiency (PCE) up to 25.7%. To improve the photovoltaic performance of PSCs, interface engineering between the perovskite and hole transport layer (HTL) is a widely used strategy. Following this concept, benzyl trimethyl ammonium chlorides (BTACls) are used to modify the wet chemical processed perovskite film in this work. The BTACl-induced low dimensional perovskite is found to have a bilayer structure, which efficiently decreases the trap density and improves the energy level alignment at the perovskite/HTL interface. As a result, the BTACl-modified PSCs show an improved PCE compared to the control devices. From device modeling, the reduced charge carrier recombination and promoted charge carrier transfer at the perovskite/HTL interface are the cause of the open-circuit (Voc ) and fill factor (FF) improvement, respectively. This study gives a deep understanding for surface modification of perovskite films from a perspective of the morphology and the function of enhancing photovoltaic performance.

Dually Modified Wide-Bandgap Perovskites by Phenylethylammonium Acetate toward Highly Efficient Solar Cells with Low Photovoltage Loss.

Wide-bandgap perovskites as a class of promising top-cell materials have shown great promise in constructing efficient perovskite-based tandem solar cells, but their intrinsic relatively low radiative efficiency results in a large open-circuit voltage (VOC) deficit and thereby limits the whole device performance. Reducing film flaws or optimizing interfacial energy level alignments in wide-bandgap perovskite devices can efficiently inhibit nonradiative recombination to boost device VOC and efficiency. However, the simultaneous regulation on both sides and their underlying mechanism are less explored. Herein, a bifunctional modification approach is proposed to optimize the wide-bandgap perovskite surface with an ultrathin layer of phenylethylammonium acetate (PEAAc) to synchronously decrease the surface imperfection and mitigate the interfacial energy barrier. This treatment effectively heals under-coordinated surface defects through the formation of chemical interaction between the perovskite and PEAAc, bringing about a much slower charge trapping process and dramatically decreasing nonradiative recombination losses. Meanwhile, the passivation-induced upshifted Fermi level of the perovskite contributes to accelerated electron extraction and larger Fermi-level splitting under illumination. Consequently, the PEAAc-modified wide-bandgap (1.68 eV) device achieves an optimal efficiency of 20.66% with a high VOC of 1.25 V, among the highest reported VOC values for wide-bandgap perovskite devices, enormously outperforming that (18.86% and 1.18 V) of the device without passivation. In addition, the radiative limit of VOC for both cells is determined to be 1.42 V, delivering nonradiative recombination losses of 0.24 and 0.17 V for the control and PEAAc-modified devices, respectively. These results highlight the significance of the bifunctional modification strategy in achieving high-performance wide-bandgap perovskite devices.

Prognostic Analysis of Liver Cirrhosis Patients with Cerebral Infarction and/or Gastrointestinal Hemorrhage: A Retrospective Cohort Study.

Background: To explore the risk factors of gastrointestinal hemorrhage and/or cerebral infarction complications in liver cirrhosis and provide evidence for early prevention, clinical diagnosis, and treatment of liver cirrhosis. Methods: 200 liver cirrhosis patients were analyzed: liver cirrhosis (n = 78), liver cirrhosis complicated with cerebral infarction (n = 43), liver cirrhosis complicated with gastrointestinal hemorrhage (n = 57), and liver cirrhosis complicated with gastrointestinal hemorrhage and cerebral infarction (n = 22). The incidence of disease in each group of patients at different times was calculated. Multivariate logistic regression was used to analyze the risk factors of liver cirrhosis patients with gastrointestinal hemorrhage and cerebral infarction. After 12 months of follow-up, the mortality rate of each group was calculated. Results: The incidences of gastrointestinal hemorrhage, cerebral infarction, and gastrointestinal hemorrhage combined with cerebral infarction in patients with liver cirrhosis were 21.5%, 28.5%, and 11%, respectively. The width of the portal vein, D-2 polymer, albumin (ALB), and hemoglobin (Hb) were predictors of gastrointestinal hemorrhage and cerebral infarction in patients with liver cirrhosis. Age, hypertension, bleeding history, infection, portal vein width, and D-2 polymer were confirmed as risk factors for gastrointestinal hemorrhage and cerebral infarction in patients with liver cirrhosis. ALB and Hb were independent protective factors. Patients with liver cirrhosis and gastrointestinal hemorrhage with cerebral infarction had the worst survival. Conclusion: Age, hypertension, bleeding history, infection, portal vein width, and D-2 polymer are all independent risk factors for gastrointestinal bleeding and cerebral infarction, while ALB and Hb are independent protective factors.

Simultaneous Tuning of Alkyl Chains and End Groups in Non-fused Ring Electron Acceptors for Efficient and Stable Organic Solar Cells.

Fine-tuning the alkyl chains and end groups of non-fused ring electron acceptors (NFREAs) plays vital roles in the promotion of charge transfer (CT) and power conversion efficiency (PCE). In this work, we developed a series of A-D-A'-D-A-type NFREAs, which possess the same terminals (A), the cyclopentadithiophene unit (D), and the thieno[3,4-c]pyrrole-4,6-dione (A'). Despite the subtle difference in side chains and halogenated end groups, the six acceptors exhibit a considerable difference in the efficiency and device stability of the organic solar cells (OSCs). Among the molecules, chlorinated NFREAs show a broader light absorption than the fluorinated ones do. Compared with C8C8-4F (1-octylnonyl and fluorination) and C6C4-4Cl (2-butyloctyl and chlorination), C8C8-4Cl (1-octylnonyl and chlorination) exhibits a lower highest occupied molecular orbital level, higher electron mobility, and denser molecular packing. The OSCs based on PM6:C8C8-4Cl yield the best PCE of 14.11%, which is attributed to the faster charge transport, high miscibility, and preferable morphology. Moreover, the PM6:C8C8-4Cl devices retain 91.1% of the initial PCE after being placed in air with 67% relative humidity for 50 days. This work shows that the simultaneous optimization of side chains and end groups facilitates the CT and improves the stability in the OSCs, offering a novel view into the molecular design of A-D-A'-D-A-type NFREAs.

Highly Orientational Order Perovskite Induced by In situ-generated 1D Perovskitoid for Efficient and Stable Printable Photovoltaics.

Employing low-dimensional perovskite has been proven to be a promising approach to enhance the efficiency and stability of perovskite solar cells. Here, thiopheniformamidine hydrochloride is introduced into CH3 NH3 PbI3 -based printable mesoscopic perovskite solar cells, to form 1D iodide lead thiophenamidine (TFPbI3 ) in situ. This judiciously designed low-dimensional perovskite can effectively passivate the defect of perovskite and induce the perovskite crystals to grow in a direction perpendicular to the substrate. Thus, the obtained 1D@3D perovskite could suppress the charge recombination and promote the charge transfer significantly. Benefiting from its dual effect and robustness, a significantly improved power conversion efficiency of 17.42% is yielded. The authors also develop high-performance printable mesoscopic perovskite solar cells with a champion efficiency approaching 13% for aperture area about 11.8 cm2 , as well as outstanding operational stability, retaining 90% of the original power conversion efficiency after 1000 hours of continuous illumination at the maximum power point in air.

Assessing the post-treatment therapeutic effect of tongxie in irritable bowel syndrome: A randomized controlled trial.

Diarrhea predominant irritable bowel syndrome (IBS) is a highly relapsing gastrointestinal disorder decreasing the quality of life. Existing studies indicated that the therapeutic effects maintained for a period of time after the treatments were discontinued (post-treatment therapeutic effects or PTTE). In this study, we aim to assess the PTTE of tongxie. We performed a multiple center, controlled, double blind study of patients with IBS randomized to tongxie (n = 120) or placebo (n = 120) for 4 weeks and followed up for 57 weeks. The primary outcomes were abdominal pains and stool consistency. The secondary outcomes were pain frequency and stool frequency. Tertiary outcomes were adverse effects and global overall symptom. The outcome data were collected at days 1, 2, 3, weeks 1 and 4 during the treatment and at days 1, 2, 3, until week 57 during the post-treatment. Significantly more patients receiving tongxie were clinical responders to the primary and secondary endpoints from day 1 until the end of the treatment. The positive effects of tongxie were maintained until 17-25 weeks after tongxie was discontinued. The relapse-free probabilities in the tongxie group were significantly higher than those in the placebo group (P < .001). Twenty-five weeks after the therapies were discontinued could be considered as IBS natural history. During this period, an average of 53.8-56.3% of patients (pool tongxie and placebo data together) had IBS symptoms (pain scale ≥ 3, stool consistency ≥ 5). In particular, at the end of this study (week 61), 145 (54.2%) patients had IBS symptoms. Our results provide clinical insights into efficient and cost-effective management of refractory IBS, and lend support to the IBS management that the selection of a therapy should consider both its effectiveness during treatment and its PTTE after the treatment.

Realizing White Emission of Single-Layer Dual-Color Perovskite Light-Emitting Devices by Modulating the Electroluminescence Emission Spectra.

Dual-color emission in a single perovskite layer would make perovskite light-emitting devices (PLEDs) more competitive compared with other display technologies. However, due to the carrier dynamics in a blended perovskite film and the low reaction activation energy of the halide exchange reaction, it is very difficult to achieve the dual-color emission in a perovskite layer. Here, dual-color electroluminescence (EL) emission in a single perovskite layer has been realized by slowing the energy transfer from wide-bandgap energy levels to narrow-bandgap energy levels. Moreover, the EL spectra can be controlled by modulating the composition of the perovskite layer. When the amount of CH3NH3I(MAI) in the precursor was varied, white emission with CIE coordinates of (0.33, 0.34) could be achieved. Our work proposes a new strategy for white emission from PLEDs. Also, the analysis and discussion of carrier dynamics in this work may help to enhance our understanding of the working mechanism of PLEDs.

Water-Soluble Conjugated Polyelectrolyte Hole Transporting Layer for Efficient Sky-Blue Perovskite Light-Emitting Diodes.

An optimized charge transporting layer (CTL) under perovskite film is crucial for efficient photoelectric devices. Here, a new water-soluble conjugated polyeletrolyte (CPE) with CH3 NH3 + (MA+ ) counterion termed as TB(MA) is used as the hole transporting layer (HTL) instead of the acidic poly(3,4-ethylenedioxythiophene):poly-styrene sulfonate (PEDOT:PSS) in sky-blue perovskite light-emitting diodes (PeLEDs). The inherent hydrophilicity of CPE enables a well-growth of quasi-2D perovskite layer with uniform and compact morphology, enhanced crystallinity with rare defect density and excellent energy transfer, resulting in a high photoluminescence quantum yield (PLQY) up to 62.0%. Especially, the MA+ counterion is able to passivate the interfacial defects in the perovskite, which optimize the interfacial compatibility between HTL and perovskite film. Finally, efficient sky-blue PeLEDs, emitting at 488 nm, are fabricated with high external quantum efficiency (EQE) up to 13.5% by using CPE as HTL. In addition, due to the low-temperature processability of water-soluble CPE, an efficient flexible sky-blue PeLEDs based on PEN/ITO substrate is also obtained with high EQE of 8.3%. Using CPE as HTL is an effective strategy toward fabricating efficient blue PeLEDs.

Assessing the post-treatment therapeutic effect of pinaverium in irritable bowel syndrome: a randomized controlled trial.

Irritable bowel syndrome (IBS) is the most common gastrointestinal disorder significantly decreasing patients' lives of quality and placing huge economic burden on our society. Existing studies indicated that the therapeutic effects maintained for a period of time after the treatments were discontinued. It is clinically important to assess these post-treatment therapeutic effects (PTTE), which prevent IBS from relapsing. To assess the PTTE in pinaverium treatment and obtain high-quality evidence to justify the use of PTTE for long-term IBS management, we performed this controlled, double blind study on patients with IBS who were randomized to pinaverium 50 mg (n = 132) or placebo (n = 132), three times daily, for 4 weeks, and were followed up for 57 weeks after the treatments. The primary endpoints were abdominal pain and stool consistency. The secondary endpoints were pain frequency and stool frequency. The tertiary endpoints were global overall symptom and adverse events. Three days after pinaverium was discontinued, endpoints rebounded only 23.2-42.8% (P < 0.015 cf. placebo). The PTTE (P < 0.05 cf. placebo) lasted 9-17 weeks, which is similar to other antispasmodics with a 15-week treatment in striking contrast to ≥ 1 year PTTE in cognitive behavior therapy and < 1 week PTTE in serotonin antagonist treatment indicating that PTTE length markedly depends on the medication class used for the treatment and less depends on treatment length. After 17 weeks, the stage could be considered as an IBS natural history [no significant differences between pinaverium and placebo (all endpoints' P's > 0.05)], during which an average of 51.5-56.4% of patients (pool pinaverium and placebo data together) had IBS symptoms. These results provide clinical insights into efficient and cost-effective management of refractory IBS, and lend support to the IBS management that the selection of a therapy should consider both its effectiveness during treatment and its PTTE after the treatment.Trial registration number: NCT02330029 (16/08/2016).

Synthesis, structure and photocatalytic property of a novel Zn(II) coordination polymer based on in situ synthetized pyridine-3,4-dicarboxylhydrazidate ligand.

One new pyridine-3,4-dicarboxylhydrazidate-coordinated compound [Zn(pdh)] 1 (pdh = pyridine-3,4-dicarboxylhydrazidate) was obtained under the hydrothermal conditions. Noteworthily, the pdh molecules in the title compound originated from the ligand in situ reaction between organic pyridine-3,4-dicarboxylic acid (pdca) and N2H4·H2O. X-ray single-crystal diffraction analysis revealed that the pdh ligands exhibit a special µ4-bridging mode in compound 1, which link Zn(II) centers into a 2D layered structure. The photocatalysis analysis indicates that it is a potential visible light catalyst. In addition, the solid photoluminescence property of compound 1 was also investigated.

The exploration of mechanisms of comorbidity between migraine and depression.

Migraine comorbid with depression is common and is often encountered in clinical practice. The comorbidity may lead to more serious conditions with other symptoms and a longer duration of treatment and it may impose heavy economic and social burdens, directly or indirectly, on patients and their families. Numerous studies have been published on the association of migraine with depression. Numerous literature have showed that the comorbidity may have a common complicated pathogenic mechanism involving biopsychosocial characteristics, including abnormal brain development and shared genetic basis, as well as neurotransmitters, sex hormones and stress. In addition, some studies have identified the multiple, bidirectional relationship between migraine and depressive disorder. We searched the literature for the possible common mechanisms between migraine and depression and classified the research results.

Application of Hierarchical CuO Bowl-like Array Film to Amperometric Detection of l-Ascorbic Acid.

A hierarchical CuO array film was fabricated by electrochemical deposition with the aid of a colloidal monolayer as a template, followed by oxidation at high temperature. The prepared CuO film with a granular structure was arranged with ordered, hexagonal close-packed, and bowl-like pores. Combined with a gold layer sputtered on a glass substrate, this CuO array film was used as an electrochemical electrode in the amperometric detection of l-ascorbic acid. The array film exhibited a high sensitivity of 3484 µA mM-1 cm-2, a wide linear range from 1 µM to 7 mM, and a detection limit of 0.2 µM. Excellent stability was also achieved. The results demonstrate that the hierarchical CuO bowl-like array film is a promising new platform for the construction of non-enzymatic ascorbic acid sensors.

Are personalized tongxie formula based on diagnostic analyses more effective in reducing IBS symptoms?-A randomized controlled trial.

OBJECTIVES: To examine the efficacy and safety ofpersonalized tongxie formulas; to decrease type II errors to minimum. METHODS: Patients were randomized (1:1:1) into three groups given tongxie, placebo, or pinaverium 3 times daily for 4 weeks. Patients in the tongxie group were treated with personalized formulas based on TCM differential diagnosis, i.e., basic type of IBS, IBS due to liver depression and qi stagnation, excess heat in the liver, deficient spleen function, deficient kidney function, and others (groups 1-6). Primary endpoints were significantly greater reductions in abdominal pain and Bristol stool score. Secondary endpoints were reductions in pain and stool frequencies and abdominal discomfort and its frequency. RESULTS: There were significantly more patients whose stool consistencies were improved than pains were relieved in the entire population (p < 0.001), but there was no significantly difference in subpopulation group 3 (p > 0.05). There were significantly more patients whose stool frequencies were reduced than pain frequencies were reduced in the entire population (p < 0.001), but there were no significantly difference in the subpopulation Groups 1, 3, 4, and 6 (p > 0.05). Multiple active ingredients and their mechanisms of actions to relieve IBS symptoms were identified. CONCLUSION: The outcomes in subpopulations may be different from those of the entire population, indicating that personalized formulas are important to achieve optimal outcomes; the active ingredients and innovative mechanisms identified in this study can be the candidates for developing new IBS drugs, and used to manage IBS, respectively. TRIAL REGISTRATION: NCT01641224 (www.ClinicalTrials.gov).

Donor Engineering for NIR-II Molecular Fluorophores with Enhanced Fluorescent Performance.

Organic fluorophores have been widely used for biological imaging in the visible and the first near-infrared windows. However, their application in the second near-infrared window (NIR-II, 1000-1700 nm) is still limited mainly due to low fluorescence quantum yields (QYs). Here, we explore molecular engineering on the donor unit to develop high performance NIR-II fluorophores. The fluorophores are constructed by a shielding unit-donor(s)-acceptor-donor(s)-shielding unit structure. Thiophene is introduced as the second donor connected to the shielding unit, which can increase the conjugation length and red-shift the fluorescence emission. Alkyl thiophene is employed as the first donor connected to the acceptor unit. The bulky and hydrophobic alkyl thiophene donor affords larger distortion of the conjugated backbone and fewer interactions with water molecules compared to other donor units studied before. The molecular fluorophore IR-FTAP with octyl thiophene as the first donor and thiophene as the second donor exhibits fluorescence emission peaked at 1048 nm with a QY of 5.3% in aqueous solutions, one of the highest for molecular NIR-II fluorophore reported so far. Superior temporal and spatial resolutions have been demonstrated with IR-FTAP fluorophore for NIR-II imaging of the blood vessels of a mouse hindlimb.

Tongxie Formula Reduces Symptoms of Irritable Bowel Syndrome.

BACKGROUND & AIMS: Irritable bowel syndrome (IBS) is the most common chronic gastrointestinal disorder, yet few drugs are effective in reducing symptoms. Approximately 50% of patients with IBS attempt herbal therapy at least once. We performed a randomized controlled trial to compare the efficacy of the herb formulation tongxie vs placebo or pinaverium (an antispasmodic agent) in reducing symptoms of IBS. METHODS: We performed a trial of 1044 adult patients with IBS (based on Rome III criteria) at 5 hospitals in China, from August 2012 through January 2015. Subjects were randomly assigned (1:1:1) to groups given tongxie (a combination of A macrocephalae, P lactiflora, C reticulata, S divaricata, C pilosula, C wenyujin, C medica, and P cocos, along with other herbs, based on patient features), placebo, or pinaverium (50 mg tablets) 3 times daily for 4 weeks. Primary end points were significantly greater reductions in abdominal pain and Bristol stool score (before vs after the 4-week study period) in patients given tongxie compared with patients given placebo or pinaverium. Secondary end points were reductions in pain and stool frequencies and abdominal discomfort and its frequency. RESULTS: Subjects given tongxie had significant reductions, before vs after the study period, in all 6 symptoms assessed, compared to patients given placebo (P < .001). A significantly higher proportion of patients given tongxie had increased stool consistency (75.6%) than patients given pinaverium (50.6%), and a significantly higher proportion of patients given tongxie had fewer daily stools (72.7%) than subjects given pinaverium (58.3%) (P < .001 for both). However, significantly higher proportions of patients given pinaverium had reduced pain (63.5%) and pain frequency (69.5%) than patients given tongxie (51.4% and 58.6%, respectively; P < .005 for both). CONCLUSIONS: In a randomized controlled trial of patients with IBS in China, we found 4 weeks of tongxie to produce significantly greater reduction in symptoms than placebo, and greater increases in stool consistency and reductions in stool frequency, than patients given pinaverium. Tongxie can therefore be considered an effective alternative therapy for patients with IBS who do not respond well to conventional therapies. Clinicaltrials.gov no: NCT01641224.

Pinaverium Reduces Symptoms of Irritable Bowel Syndrome in a Multicenter, Randomized, Controlled Trial.

BACKGROUND & AIMS: Pinaverium bromide (pinaverium) is an antispasmodic commonly used to treat irritable bowel syndrome (IBS), but there has been no convincing evidence for its effectiveness and safety. We evaluated these in a prospective, double-blind, placebo-controlled trial. METHODS: Patients with IBS, based on Rome III criteria, were assigned randomly to groups given pinaverium (50 mg, 3 times/day; n = 218) or placebo (3 times/day; n = 209) at 4 hospitals in China, from August 2012 through December 2013. The primary end points were reductions in abdominal pain and Bristol stool score. Secondary end points were reductions in pain and stool frequencies and abdominal discomfort and its frequency. We also evaluated changes in IBS global symptom scores and the number of adverse effects. RESULTS: Based on an intention-to-treat analysis, a significantly larger proportion of patients receiving pinaverium met either of the primary end points (50.0% met an end point at week 2, and 77.5% met an end point at week 4), compared with placebo (P < .001). Pinaverium reduced at least 1 secondary end point in significantly more patients receiving pinaverium (76.1% had a reduction at week 2, and 91.7% had a reduction at week 4) than placebo (P < .001). Based on symptom scores, significantly higher percentages of patients receiving pinaverium believed that their IBS symptoms improved (60%) than in the placebo group (34%; P < .001); 29% of patients in the pinaverium group believed that their IBS symptoms stayed the same (29%) and 11% said they worsened. Pinaverium was not associated with severe adverse effects; common side effects included nausea (3.7%), dizziness (3.2%), increased blood pressure (2.3%), and abdominal discomfort (2.3%). CONCLUSIONS: Based on a controlled trial, pinaverium reduces symptoms of IBS. It can be considered a first-line treatment for IBS. TRIAL REGISTRATION: NCT01641224 (www.ClinicalTrials.gov).