Effectiveness and Safety of Chinese Medicine at Shenque (CV 8) for Primary Dysmenorrhea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Primary dysmenorrhea (PD) is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life. In Chinese medicine, navel therapy, treatment provided at Shenque (CV 8), is used as a treatment option for PD. OBJECTIVE: To evaluate the effect of navel therapy on pain relief and quality of life in women with PD, compared with Western medicine (WM). METHODS: China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), SinoMed and Wanfang Database, MEDLINE, the Cochrane Library, Embase, Web of Science, and the International Clinical Trial Registry of the U.S. National Institutes of Health were searched from their inceptions to April 1, 2021. Randomized controlled trials (RCTs) assessing therapeutic effects of navel therapy on PD were eligible for inclusion. RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool. RESULTS: Totally 24 RCTs involving 2,614 participants were identified. Interventions applied to acupuncture point CV 8 included: herbal patching, moxibustion or combined navel therapy (using at least 2 types of stimulation). Compared to placebo, there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment [mean difference: -0.82, 95% confidence interval (CI): -1.00 to -0.64, n=90; 1 RCT]. As compared with Western medicine, navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment [standardized mean difference (SMD): -0.64, 95% CI: -1.22 to -0.06, I2=80%, n=262; 3 RCTs]; on symptom resolution rate at 3-month follow-up (risk ratio: 1.94, 95% CI: 1.47 to 2.56, n=1527, I2=38%; 13 RCTs); and on global menstrual symptoms score at the end of treatment (SMD: -0.67, 95% CI: -0.90 to -0.45, I2=63%, n=990; 12 RCTs). Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine. No major adverse events were reported. The methodological quality of included trials was poor overall. CONCLUSIONS: Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD. However, these findings need to be confirmed by well-designed clinical trials with adequate sample size (Systematic review registration at PROSPERO, No. CRD42021240350).

Development of patient versions of guidelines in Chinese mainland: A systematic survey of current practices and methods.

OBJECTIVES: To review current practices and methods underlying the development of patient versions of guidelines (PVGs) in Chinese mainland. METHODS: We systematically searched for PVGs created or published between January 2010 and February 2022. We conducted a framework analysis for the development process and assessed the compliance of PVGs using the Reporting Checklist for Public Versions of Guidelines (RIGHT-PVG). RESULTS: We identified 26 PVGs developed by 16 PVG-working teams. In accordance with the Guidelines International Network (GIN), only two PVGs were translated using one clinical practice guideline (CPG) provided by the CPG-working group source. Several CPGs and other information sources were integrated and translated into a single PVG by other PVG teams. Moreover, we identified various practices described by different PVG teams that could be structured into six steps. Out of the 17 RIGHT-PVG items, five items were fully reported in all PVGs, while two items ("Provide a summary of the PVG" and "Provide a list of terms and abbreviations") were not reported in any of the PVGs. CONCLUSIONS AND PRACTICAL IMPLICATIONS: A relatively small number of PVGs were developed in Chinese mainland. The development of a PVG requires comprehensive methodological guidance based on several CPGs and other sources of information as opposed to only using one.

Compound glycyrrhizin injection for improving liver function in children with acute icteric hepatitis: A systematic review and meta-analysis.

BACKGROUND: Compound glycyrrhizin injection (CGI) is a preparation with glycyrrhizin as the main active ingredient extracted from licorice. As clinical trials suggest that CGI is effective in improving liver function for acute icteric hepatitis in children (AIHC), this systematic review aimed to evaluate and verify its therapeutic effects and safety. METHODS: Six electronic databases were searched from their inception to 15 May 2021. Randomized controlled trials (RCTs) assessing therapeutic effects and safety of CGI for AIHC were included. The risk of bias for each trial was assessed using the Cochrane Risk of Bias Tool 2.0. Primary outcomes were indexes related to liver function, including total bilirubin (TBiL), alanine aminotransferase (ALT) and aspartate transaminase (AST). RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool. RESULTS: Six RCTs involving 608 children were included. The overall bias was assessed as having "high risk of bias" in all trials. All trials compared the combination of CGI and conventional western medicine (CWM) with CWM alone. Regarding the effects of CGI for AIHC, results showed that CGI plus CWM was superior to CWM alone in reducing the levels of TBiL (mean difference (MD) = -8.19 mmol/L, 95% CI -9.86 to -6.53), ALT (MD = -24.09 U/L, 95% CI -30.83 to -17.34) and AST (MD = -18.67 U/L, 95% CI -21.88 to -15.45). No trial reported adverse events. The certainty of the evidence for outcomes were all evaluated as low or very low. CONCLUSION: CGI may have adjuvant therapeutic effects on improving the liver function of children with AIHC. There is no evidence to determine the safety of CGI for AIHC. As current evidence is weak, further well-designed RCTs are required for verification of the therapeutic effects of CGI.

Cardiovascular safety of celecoxib in rheumatoid arthritis and osteoarthritis patients: A systematic review and meta-analysis.

OBJECTIVE: To assess the cardiovascular safety of celecoxib compared to non-selective non-steroid anti-inflammatory drugs or placebo. METHODS: We included randomized controlled trials of oral celecoxib compared with a non-selective NSAID or placebo in rheumatoid arthritis and osteoarthritis patients. We conducted searches in EMBASE, Cochrane CENTRAL, MEDLINE, China National Knowledge Infrastructure, VIP, Wanfang, and Chinese Biomedical Literature Database. Study selection and data extraction were done by two authors independently. The risk of bias was assessed using Cochrane's risk-of-bias Tool for Randomized Trials. The effect size was presented as a risk ratio with their 95% confidence interval. RESULTS: Until July 22nd, 2021, our search identified 6279 records from which, after exclusions, 21 trials were included in the meta-analysis. The overall pooled risk ratio for Antiplatelet Trialists Collaboration cardiovascular events for celecoxib compared with any non-selective non-steroid anti-inflammatory drugs was 0.89 (95% confidence interval: 0.80-1.00). The pooled risk ratio for all-cause mortality for celecoxib compared with non-selective non-steroid anti-inflammatory drugs was 0.81 (95% confidence interval: 0.66-0.98). The cardiovascular mortality rate of celecoxib was lower than non-selective non-steroid anti-inflammatory drugs (risk ratio: 0.75, 95% confidence interval: 0.57-0.99). There was no significant difference between celecoxib and non-selective non-steroid anti-inflammatory drugs or placebo in the risk of other cardiovascular events. CONCLUSION: Celecoxib is relatively safe in rheumatoid arthritis and osteoarthritis patients, independent of dose or duration. But it remains uncertain whether this would remain the same in patients treated with aspirin and patients with established cardiovascular diseases.

Therapeutic effects and safety of oral Chinese patent medicine for COVID-19: A rapid systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: Chinese patent medicine (CPM) is an indispensable part of traditional Chinese medicine. Coronavirus Disease 2019 (COVID-19) manifests is an acute respiratory infectious disease. This systematic review aimed to evaluate the therapeutic effects and safety of oral CPM for COVID-19. METHODS: We included randomized controlled trials (RCTs) that tested oral CPM for the treatment of COVID-19 identified from publications in CNKI, Wanfang, VIP, Web of Science, SinoMed, PubMed, Embase, BioRxiv, MedRxiv and arXiv before November 2nd, 2020. The risk of bias for each trial was assessed using the Cochrane Risk of Bias Tool 2.0. RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool. RESULTS: Seven RCTs including 1079 participants were identified. The overall bias was assessed as "-high risk of bias" for all included trials. Oral CPM investigated were: Lianhua Qingwen capsule/granules (LHQW), Jinhua Qinggan granules (JHQG), Huoxiang Zhengqi dripping pills (HXZQ), Toujie Quwen granules (TJQW) and Lianhua Qingke granules (LHQK). Compared with conventional western therapy alone for people with COVID-19: regarding the main outcomes, the results showed that oral CPM combined with conventional western therapy improved cure rate (RR = 1.20, 95 % CI 1.04-1.38, involving LHQW and TJQW), reduced aggravation rate (RR = 0.50, 95 % CI 0.29 - 0.85, involving LHQW, JHQG, LHQK and TJQW); with regard to additional outcomes, the results showed that add-on oral CPM shortened the duration of fever, cough and fatigue, improved the recovery rate of cough and fatigue, and increased the improvement and recovery rate of chest CT manifestations. There were some differences in therapeutic effects among various CPMs for the same COVID-19 outcome. The use of TJQW and LHQG appeared not to increase the risk of adverse events, but JHQG may cause mild diarrhea. CONCLUSION: Low-certainty or very low-certainty evidence demonstrated that oral CPM may have add-on potential therapeutic effects for patients with non-serious COVID-19. These findings need to be further confirmed by well-designed clinical trials with adequate sample sizes.

Bupleuri radix for Acute Uncomplicated Respiratory Tract Infection: A Systematic Review of Randomized Controlled Trials.

Objective: To evaluate the efficacy, clinical effectiveness, and safety of the Chinese herb Bupleuri radix for the treatment of acute uncomplicated respiratory tract infections (ARTIs). Methods: Four English and four Chinese databases were searched from their inception to June 2021. Randomized controlled trials (RCTs) assessing therapeutic effects of Bupleuri radix on ARTI were eligible for inclusion. The risk of bias for each trial was assessed using the Cochrane Risk of Bias Tool 2.0. RevMan 5.4 software was used for data analyses with effects estimated as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). The certainty of the evidence was assessed using the online GRADEpro tool. Results: Seven randomized trials involving 910 patients with acute upper respiratory tract infection (AURTI) were included. The review identified Bupleuri radix agents with four administration routes (oral, acupoint injection, intramuscular injection, nebulized inhalation). Bupleuri radix acupoint injection compared with placebo showed statistically significant effects in reducing fever resolution time (MD: -33.32 h, 95%CI: -35.71, -30.93), and in increasing the proportion of participants with fever resolved within 48 h from treatment onset (RR: 14, 95%CI: 1.96, 99.94). Bupleuri radix acupoint injection combined with usual care is more effective in reducing the temperature at day 1 from treatment onset (MD: -1.00°C, 95%CI: -1.19, -0.81) compared with usual care alone. Bupleuri radix pills showed similar antipyretic effects to acetaminophen. However, Bupleuri radix intramuscular injection plus vitamins failed to demonstrate an effect in reducing fever, when compared with ribavirin plus vitamins. It suggested that oral administration of Bupleuri radix solution for injections, pills, and Bupleuri radix decoction have a similar effect on improving global AURTI symptoms including two key symptoms (nasal discharge and cough), when compared with usual care alone. Only two trials reported whether or not there were any AEs and found no occurrence of adverse events in the herbal group. Conclusion: Low-certainty or very low-certainty evidence demonstrated that Bupleuri radix (solution for injections and pills) has an antipyretic effect on febrile patients with AURTI, but it has no effect on other AURTI symptoms. However, these findings need to be further confirmed by well-designed clinical trials with adequate sample sizes. Systematic review registration: (https://www.crd.york.ac.uk/prospero/#recordDetails), PROSPERO registration number: CRD42021234066.

[Evaluation of ecosystem services of the Thousand-Island Lake, Zhejiang, China.] / 千岛湖生态系统服务价值评估.

We quantitatively evaluated Thousand-Island Lake's aquatic ecosystem service value and analyzed its developing trend at the whole lake scale. We built an index system to evaluate the ecosystem service of Thousand-Island Lake, which included 16 indicators of 10 categories. The results showed that the total value of ecosystem services of Thousand-Island Lake was 49.3 billion and 57.2 billion yuan in 2007 and 2017, respectively. The highest value of Thousand-Island Lake's ecosystem service was its regulating function, which played an absolutely dominant role. Ranked according to their values, different functions of the final ecosystem services were in a descending order of floodwater regulation, surface water regulation, carbon sequestration (reduction), oxygen generation, tourism, water purification, fishing, energy saving through water source heat pump, water for hydropower, agriculture, forestry and animal husbandry uses of water resources, ecological and public use of water resources, water source for industrial use, volume of freight transportation, water source for city resident use, water circulation cooling, and passenger transportation. Thousand-Island Lake provided a total ecosystem services value of 86.0 million and 99.8 million yuan·km-2, which was 47.6 and 17.3 times as the GDP per area in Chun'an County in 2007 and 2017.

[Impacts of land use change on ecosystem services in the agricultural area of North China Plain: A case study of Shangqiu City, Henan Province, China.] / 华北平原农区土地利用变化对生态系统服务的影响­­ä»¥æ²³å—省商丘市为例.

Under the rapid urbanization, quantitatively assessing the impacts of land use and cover change (LUCC) on ecosystem service is of great significance for regional ecological environment construction. Based on the land use maps of Shangqiu City (as the typical agricultural area of North China Plain) in the year of 1990, 2005 and 2015, the spatio-temporal dynamics of land use and ecosystem service were analyzed, and the impacts of LUCC on ecosystem services was quantified with the impact assessment model. The results showed that, from 1990 to 2015, farmland and construction land area, which covered more than 95% of the total area of the research area, changed the most in quantity as -104.38 and 201.59 km2 respectively, while forestland, grassland and water area changed the most by 79.3%, -73.7% and -24.2%, respectively. The total value of ecosystem service continuously decreased by 1.005 billion yuan, among which the value of hydrolo-gical regulation service suffered the most. The value of ecosystem service (ESV) presented an increasing trend in the west and a decreasing trend in the east. Extending from the center of the city to the outside, the value of ecosystem services was "high-low-high" in the east to west direction. The rate of farmland and water area contributed more than 95% to the total ecosystem service value, which had the greatest impact. The main drivers for the changes of land use and ESV in Shangqiu were population pressure, economic growth, regional policy, and urban planning. In the urban and rural development planning of Shangqiu City, more attention should be paid to the protection of na-tural resources and rational adjustment of the land use structure to realize sustainable development based on the harmony of economy, society and environment.

Support vector machine-based open crop model (SBOCM): Case of rice production in China.

Existing crop models produce unsatisfactory simulation results and are operationally complicated. The present study, however, demonstrated the unique advantages of statistical crop models for large-scale simulation. Using rice as the research crop, a support vector machine-based open crop model (SBOCM) was developed by integrating developmental stage and yield prediction models. Basic geographical information obtained by surface weather observation stations in China and the 1:1000000 soil database published by the Chinese Academy of Sciences were used. Based on the principle of scale compatibility of modeling data, an open reading frame was designed for the dynamic daily input of meteorological data and output of rice development and yield records. This was used to generate rice developmental stage and yield prediction models, which were integrated into the SBOCM system. The parameters, methods, error resources, and other factors were analyzed. Although not a crop physiology simulation model, the proposed SBOCM can be used for perennial simulation and one-year rice predictions within certain scale ranges. It is convenient for data acquisition, regionally applicable, parametrically simple, and effective for multi-scale factor integration. It has the potential for future integration with extensive social and economic factors to improve the prediction accuracy and practicability.

[Landscape pattern change of ethnic townships under the background of urbanization: Case of Aerla Town in Molidawa Daur Autonomous Banner, Inner Mongolia, China.] / åŸŽå¸‚åŒ–ä¸‹çš„æ°‘æ—ä¹¡é•‡æ™¯è§‚æ ¼å±€å˜åŒ–­­ä»¥å† 蒙古莫力达瓦达斡尔自治旗阿尔拉镇为例.

With the stable development of new countryside construction and new-type urbanization, the changing of the landscape pattern in countryside attracts more attention, especially in the ethnic townships which are hardly accessible. To explore the development of these areas, it is crucial to understand the spatial and temporal variation of the landscape pattern. In this paper, the landscape pattern change was analyzed at both patch type level and landscape level based on the landscape ecology theory. The land use data (format: vector) got from Aerla Town (a typical Daur ethnic township in Inner Mongolia) for the duration from 2008 to 2013 was studied by ArcGIS platform and Fragstats. For the type level, the grassland, farmland, and forest turned into building land gra-dually. Regarding the landscape level, the landscape diversity index and landscape connectivity index were relatively low, the heterogeneity index and the landscape fragmentation were relatively high. With considering the correlation analysis and grey correlation of the above indexes as well as the social and economic development in Aerla Town, the results indicated that population change and GDP growth were the main driving forces of landscape pattern change. Finally, the driving forces which resulted in the variation of landscape pattern with the incorporation of the economic, cultural, policy, and natural effects were discussed. The research could provide basic information and theoretical foundation for the development of minority areas in Northeast China.

[Sustainable development of the three economic patterns in China: The application of genuine progress indicator in the sustainability assessment of six typical cities.] / 中国"三大经济模式"的可持续发展­­ä»¥çœŸå®žå‘å±•æŒ‡æ ‡å¯¹6ä¸ªå ¸åž‹åŸŽå¸‚çš„å¯æŒç»­æ€§è¯„ä¼°ä¸ºä¾‹.

Three economic patterns, i.e., Zhujiang Model, Wenzhou Model and Sunan Model, were all generated in the developed areas of China. Sustainability assessment of those areas plays an important role in guiding future development of the economy of China. Genuine progress indicator (GPI) was adopted in this study to evaluate the sustainability of 6 typical cities (Guangzhou, Shenzhen, Wenzhou, Suzhou, Wuxi, and Changzhou) of the three economic patterns from 1995 to 2012. During the study period, the values of GDP for the six cities had experienced exponential growth, while the values of GPI started to increase since 2005 after a relatively constant period between 1995 and 2005. The gap between GPI and GDP had been widening from a historical perspective. Zhujiang Model made great progress in economic growth, however, the economic, social, and environmental costs were evident. It should tackle income inequality, traffic jam, and environmental pollution to reach sustainability. The development of Wenzhou Model slowed down in the late pe-riod, with inadequate potential to develop. Its income inequality was tough, social and economic development was slow, and the economic development pattern needed to be urgently changed. Sunan Model had a higher value of GPI and the potential to reach sustainability, with remarkable growth of economy, median level of the GPI costs, and steady improvement of social development, although its natural resources were depleted. Three economic patterns should focus on the three dimensions of sustainability (economy, environment, and society), and Zhujiang Model and Wenzhou Model needed to be more active to search for transition of their development.

[Environmental efficiency evaluation under carbon emission constraint in Western China].

This research used the SBM model based on undesirable outputs to measure the static environmental efficiency of Western China under carbon emission constraint from 2000 to 2012. The researchers also utilized the Malmquist index to further analyze the change tendency of environmental efficiency. Additionally, Tobit regression analysis was used to study the factors relevant to environmental efficiency. Practical solutions to improve environmental quality in Western China were put forward. The study showed that in Western China, environmental efficiency with carbon emission constraint was significantly lower than that without carbon emission constraint, and the difference could be described as an inverse U-shaped curve which increased at first and then decreased. Guang-xi and Inner Mongolia, the two provinces met the effective environmental efficiency levels all the time under carbon emission constraint. However, the five provinces of Guizhou, Gansu, Qinghai, Ningxia and Xinjiang did not. Furthermore, Ningxia had the lowest level of environmental efficiency, with a score between 0.281-0.386. Although the environmental efficiency of most provinces was currently at an ineffective level, the environmental efficiency quality was gradually improving at an average speed of 6.6%. Excessive CO2 emission and a large amount of energy consumption were the primary factors causing environmental inefficiency in Western China, and energy intensity had the most negative impact on the environmental efficiency. The increase of import and export trade reduced the environmental efficiency significantly in Western China, while the increase of foreign direct investment had a positive effect on its environmental efficiency.

Prediction and setup of phytoplankton statistical model of Qiandaohu Lake.

This research considers the mathematical relationship between concentration of Chla and seven environmental factors, i.e. Lake water temperature (T), Secci-depth (SD), pH, DO, CODMn, Total Nitrogen (TN), Total Phosphorus (TP). Stepwise linear regression of 1997 to 1999 monitoring data at each sampling point of Qiandaohu Lake yielded the multivariate regression models presented in this paper. The concentration of Chla as simulation for the year 2000 by the regression model was similar to the observed value. The suggested mathematical relationship could be used to predict changes in the lakewater environment at any point in time. The results showed that SD, TP and pH were the most significant factors affecting Chla concentration.