RESUMEN
This study aims to analyze the outcome indicators of randomized controlled trial(RCT) on traditional Chinese medicine(TCM) intervention of sepsis-induced myocardial injury(SIMI) in recent five years, which is expected to lay a basis for the construction of core outcome set(COS) for this disease treated by TCM. To be specific, RCT on the treatment of SIMI with TCM was retrieved from 4 Chinese databases, 3 English databases, and 2 clinical trial protocol registries. The quality of the included studies was evaluated with Cochrane risk-of-bias(ROB) tool, and the outcome indicators were analyzed. Finally, 42 RCTs were included, of which 2 were clinical trial registration schemes. The study found that 42 RCTs had a high risk of bias, and reported a total of 86 indicators in "clinical effective rate, disease severity, TCM syndrome score, inflammation, myocardium, cardiac structure and hemodynamics, electrocardiogram, immunology, metabolism and liver and kidney function, and safety". Outcome indicators on myocardium had the highest emergence frequency, followed by indicators on the cardiac structure and hemodynamics. A total of 8 RCTs reported TCM syndrome scores. Further analysis suggested the following problems in the selection of outcome indicators in the RCTs on TCM intervention of SIMI: no classification of primary and secondary indicators, disregard of endpoint indicators, irrational selection of alternative indicators, neglection of TCM characteristics, no assessment of patients' immune status, and no emphasis on economic indicators and safety indicators. Therefore, according to the recommendations of the core outcome measures in effectiveness trials(COMET) working group, a COS for TCM intervention of TCM for SIMI should be developed, so as to facilitate clinical researchers to select appropriate outcome indicators, the combination of conclusions of similar clinical studies, and the promotion of TCM interventions.
Asunto(s)
Medicamentos Herbarios Chinos , Sepsis , Medicamentos Herbarios Chinos/uso terapéutico , Humanos , Medicina Tradicional China , Ensayos Clínicos Controlados Aleatorios como Asunto , Sepsis/complicaciones , Sepsis/tratamiento farmacológico , Resultado del TratamientoRESUMEN
We report a comprehensive understanding of the stereoselective interaction between two opposite enantiomeric polyesters prepared from the regioselective copolymerization of chiral terminal epoxides and cyclic anhydrides. For many of the resultant polyesters, the interactions between polymer chains of opposite chirality are stronger than those of polymer chains with the same chirality, resulting in the formation of a stereocomplex with an enhanced melting point (Tm) and crystallinity. The backbone, tacticity, steric hindrance of the pendant group, and molecular weight of the polyesters have significant effects on stereocomplex formation. Bulky substituent groups favor stereocomplexation, resulting in a greater rise in Tm in comparison to the component enantiomeric polymers. The stereocomplex assembly of discrete (R)- and (S)-poly(phenyl glycidyl ether-alt-phthalic anhydride)s oligomers revealed that the minimum degree of polymerization required for stereocomplex formation is five. Raman spectroscopy and solid-state NMR studies indicate that stereocomplex formation significantly restricts the local mobilities of CâO and C-H groups along the backbone of chains. The reduced mobility results in the enhanced spin-lattice relaxation time and both 1H and 13C downfield shifts due to the strong intermolecular interactions between R- and S-chains.
RESUMEN
OBJECTIVE: To investigate changes of endocrine hormones during 7 d head down bed rest (HDBR). METHOD: Six healthy male volunteers served as the subjects and experienced 7 d -6 degrees HDBR. Urine was collected from 6:00-22:00 and from 22:00-6:00. Serum was collected 48 h before HDBR, 48 h and 120 h during HDBR. Then the endocrine indices in urine and serum were determined. RESULT: 1) The levels of serum CORT and ALD increased at 48 h during HDBR, while serum T3, T4, TP, UN decreased but they all recovered to normal at 120 h during HDBR. 2) The level of urine CORT, ALD and NE reached its peak in 24-48 h, and then gradually decreased to normal level. CONCLUSION: The endocrine indices in serum and urine changed in the early period but returned to normal level gradually with the proceeding of HDBR.