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1.
Phytother Res ; 2020 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-32939932

RESUMO

This study aims to evaluate the efficacy and safety of Qiming granule (QG) on diabetic macular edema (DME). PubMed, Embase, the Cochrane Library, CNKI, Wanfang, qvip and China Biology Medicine Disc were searched. Randomized controlled trials (RCTs) about participants with a diagnosis of DME were included. Risk of bias assessment was conducted by Cochrane risk-of-bias tool for RCT. Random-effects model was implemented to pool results. Among 16 included studies, QG combined with conventional treatment was administered 13.5 g daily for a period ranging from 2 to 6 months. Results showed combination therapy was more effective than conventional treatment alone in central macular thickness (weighted mean difference (WMD) = -29.43, 95% confidence interval (CI) (-39.56 to -19.29), p = .0001), optimum corrected vision (pooled standardized mean difference (SMD) = -0.962, 95%CI (-1.35 to -0.57), p = .0001) and overall effective rate (RR = 1.25, 95%CI = [1.13 to 1.35], p < .0001). Only three studies reported adverse effects. The quality of evidence is low. Due to a lack of placebo control, the net efficacy of QG is still uncertain. More high-quality RCTs are needed to confirm the efficacy and safety of QG in DME.

2.
Biomed Res Int ; 2020: 3860213, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32964029

RESUMO

This study was aimed at elucidating the potential mechanisms of quercetin in the treatment of gastric cancer (GC). A network pharmacology approach was used to analyze the targets and pathways of quercetin in treating GC. The predicted targets of quercetin against GC were obtained through database mining, and the correlation of these targets with GC was analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. Next, the protein-protein interaction (PPI) network was constructed, and overall survival (OS) analysis of hub targets was performed using the Kaplan-Meier Plotter online tool. Finally, the mechanism was further analyzed via molecular docking of quercetin with the hub targets. Thirty-six quercetin-related genes were identified, 15 of which overlapped with GC-related targets. These targets were further mapped to 319 GO biological process terms and 10 remarkable pathways. In the PPI network analysis, six hub targets were identified, including AKT1, EGFR, SRC, IGF1R, PTK2, and KDR. The high expression of these targets was related to poor OS in GC patients. Molecular docking analysis confirmed that quercetin can bind to these hub targets. In conclusion, this study provided a novel approach to reveal the therapeutic mechanisms of quercetin on GC, which will ease the future clinical application of quercetin in the treatment of GC.

3.
Medicine (Baltimore) ; 99(39): e22224, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991416

RESUMO

BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by erosion of joints and surrounding tissues. RA not only causes the decline of patients' physical function and quality of life, but also brings huge economic burden to patients' families and society. Total glucosides of paeony (TGP) is commonly used in treating RA in China. At present, there are many clinical reports about this medicine, but these reports have their own flaws. Therefore, there is an urgent need for systematic review and meta-analysis of the existing clinical evidence. METHODS AND ANALYSIS: Literature search will be carried out in 6 databases, and the literatures will be screened according to the inclusion and exclusion criteria. The clinical effective rate will be taken as primary outcome. Serum rheumatoid factor, C-reactive protein, erythrocyte sedimentation rate, Western Ontario and McMaster before and after treatment and adverse effects will be secondary outcomes. The heterogeneity of the study will be examined by χ and I test. To identify the source of heterogeneity, subgroup analysis will be carried out. The sensitivity test will be conducted investigate the stability of results. Funnel plot and Egger test will be used to evaluate publication bias. Finally, the quality of evidence will be summarized. RESULTS: The results will be published in peer-reviewed journals. CONCLUSIONS: This study will systematically evaluate the efficacy of TGP in the treatment of RA. The results of this study can better guide clinical practice. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/85QVF.


Assuntos
Artrite Reumatoide/terapia , Medicamentos de Ervas Chinesas/uso terapêutico , Glucosídeos/uso terapêutico , Paeonia , Humanos , Metanálise como Assunto , Revisões Sistemáticas como Assunto
4.
Medicine (Baltimore) ; 99(34): e21904, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846855

RESUMO

BACKGROUND: As one of the major chronic diseases that seriously threaten human health, type 2 diabetes mellitus (T2DM) has become a global public health problem. Blood glucose fluctuation is a risk factor independent of hyperglycemia. At present, the measures to treat blood glucose fluctuations in patients with T2DM are insufficient in effectiveness and safety. Medical practice and clinical studies have proved that Chinese herbal medicine has obvious advantages in reducing blood glucose fluctuations. In this systematic review, we will assess the efficacy and safety of Chinese herbal medicine in the treatment of blood glucose fluctuations in patients with T2DM. METHODS: We will search related literature of PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database, and will manually search grey documents such as literature such as conference articles and references articles. Eligible randomized controlled trials will be screened based on inclusion criteria, and data extraction, risk of bias assessment, publication bias assessment, subgroup analysis, and quality assessment will be performed. Review Manager version 5.3 software and stata version 13 software will be used for data analysis. Each process is independently conducted by 2 researchers, and if there is any objection, it will be submitted to the third researcher for resolution. RESULTS: This study will provide evidence for the efficacy and safety of Chinese herbal medicine in the treatment of blood glucose fluctuations in patients with T2DM. Outcome measures include mean amplitude of glycemic excursions, 24 hours mean blood glucose, standard deviations of blood glucose, mean of daily differences, coefficient of variation, glucose time in range, fasting blood glucose, 2 hours postprandial blood glucose, glycated hemoglobin, HOMA-ß, HOMA-IR, quality of life questionnaire, traditional Chinese medicine syndrome score, and adverse event.


Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , China/epidemiologia , Hemoglobina A Glicada/efeitos dos fármacos , Humanos , Avaliação de Resultados em Cuidados de Saúde , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Resultado do Tratamento
5.
Medicine (Baltimore) ; 99(27): e20736, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629649

RESUMO

BACKGROUND: Diabetes is a chronic disease characterized by chronic hyperglycemia, absolute or relative deficiency of insulin secretion, and chronic inflammation. Shenqi compound (SC) is a traditional Chinese medicine formula widely used in the treatment of diabetes and diabetic complications. Although many randomized clinical trials have proved that SC can benefit a lot from diabetes and its complications, the systematic evaluation of the effect of SC on diabetic blood glucose control and inflammatory markers has not yet appeared. The purpose of this study is to provide evidence that the therapeutic effect of SC on diabetes and its multiple system complications is related to its control of blood glucose and inflammatory mediators. METHODS: Three English database and 4 Chinese medical databases will be searched from its inception to May 2020. Then 2 methodological trained researchers will screen the qualified articles by reading the title, abstract, and full texts according to an established inclusion and exclusion criteria. The assessment of risk of bias will be conducted by using the Cochrane collaboration's tool. We will conduct meta-analyses for fasting blood glucose, postprandial blood glucose, glycated hemoglobin, tumor necrosis factor, C-reactive protein or high-sensitivity C-reactive protein, and other outcomes. The heterogeneity of data will be evaluated by Cochrane X and I tests. Subgroup analysis will also be carried out. We will conduct sensitivity analysis to evaluate the stability of the results, funnel plot analysis, and Egger test to evaluate the publication bias, and assessment for the quality of evidence by the grading of recommendations assessment, development, and evaluate system. RESULTS: The results of our research will be published in a peer-reviewed journal. CONCLUSION: In this study, we will systematically evaluate the influences of SC on glycemic measures and inflammatory markers of diabetes mellitus. Our research is supposed to provide evidence-based support for clinical practice. REGISTRATION NUMBER: INPLASY202040179.


Assuntos
Glicemia/análise , Diabetes Mellitus/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Biomarcadores/sangue , Diabetes Mellitus/sangue , Humanos , Inflamação/sangue , Medicina Tradicional Chinesa/métodos
6.
Medicine (Baltimore) ; 99(23): e20203, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: covidwho-526042

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Since the outbreak, the disease has caused more than 60,502 deaths worldwide. Lian-Hua Qing-Wen Granule (LHQWG) is widely used in treating COVID-19 in China. However, there is no evidence that LHQWG is effective for COVID-19. METHODS AND ANALYSIS: A comprehensive literature search will be conducted. Two methodological trained researchers will read the title, abstract and full texts and independently select the qualified literature according to inclusion and exclusion criteria. After assessment of the risk of bias and data extraction, we will conduct meta-analyses for outcomes related to COVID-19. The heterogeneity of data will be investigated by Cochrane X and I tests. Publication bias assessment will be conducted by funnel plot analysis and Egger test. RESULTS: The results of our research will be published in a peer-reviewed journal. CONCLUSION: Our study aims to systematically present the clinical evidence of LHQWG in treating COVID-19, which will be of significant meaning for further research and clinical practice. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/27SBU.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Ensaios Clínicos como Assunto , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Pandemias , Projetos de Pesquisa , Resultado do Tratamento
7.
Medicine (Baltimore) ; 99(22): e20157, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: covidwho-494601

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). There is no specific cure for this disease, and the clinical management mainly depends on supportive treatment. Traditional Chinese medicines (CHM) is widely used in treating COVID-19 in China. METHODS: A comprehensive literature search will be conducted. Two methodological trained researchers will read the title, abstract, and full texts and independently select the qualified literature according to inclusion and exclusion criteria. After assessment of the risk of bias and data extraction, we will conduct meta-analyses for outcomes related to COVID-19. The heterogeneity of data will be investigated by Cochrane χ and I tests. Then publication bias assessment will be conducted by funnel plot analysis and Egger test. RESULTS: The results of our research will be published in a peer-reviewed journal. CONCLUSION: Our study aims to systematically present the clinical evidence of CHM in the treatment of COVID-19, which will be of guiding significance for further research and clinical practice. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/H7GMU.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Metanálise como Assunto , Fitoterapia , Pneumonia Viral/tratamento farmacológico , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Pandemias , Resultado do Tratamento
8.
Medicine (Baltimore) ; 99(22): e20157, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481380

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). There is no specific cure for this disease, and the clinical management mainly depends on supportive treatment. Traditional Chinese medicines (CHM) is widely used in treating COVID-19 in China. METHODS: A comprehensive literature search will be conducted. Two methodological trained researchers will read the title, abstract, and full texts and independently select the qualified literature according to inclusion and exclusion criteria. After assessment of the risk of bias and data extraction, we will conduct meta-analyses for outcomes related to COVID-19. The heterogeneity of data will be investigated by Cochrane χ and I tests. Then publication bias assessment will be conducted by funnel plot analysis and Egger test. RESULTS: The results of our research will be published in a peer-reviewed journal. CONCLUSION: Our study aims to systematically present the clinical evidence of CHM in the treatment of COVID-19, which will be of guiding significance for further research and clinical practice. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/H7GMU.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Metanálise como Assunto , Fitoterapia , Pneumonia Viral/tratamento farmacológico , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Pandemias , Resultado do Tratamento
9.
Medicine (Baltimore) ; 99(23): e20203, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32501972

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Since the outbreak, the disease has caused more than 60,502 deaths worldwide. Lian-Hua Qing-Wen Granule (LHQWG) is widely used in treating COVID-19 in China. However, there is no evidence that LHQWG is effective for COVID-19. METHODS AND ANALYSIS: A comprehensive literature search will be conducted. Two methodological trained researchers will read the title, abstract and full texts and independently select the qualified literature according to inclusion and exclusion criteria. After assessment of the risk of bias and data extraction, we will conduct meta-analyses for outcomes related to COVID-19. The heterogeneity of data will be investigated by Cochrane X and I tests. Publication bias assessment will be conducted by funnel plot analysis and Egger test. RESULTS: The results of our research will be published in a peer-reviewed journal. CONCLUSION: Our study aims to systematically present the clinical evidence of LHQWG in treating COVID-19, which will be of significant meaning for further research and clinical practice. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/27SBU.


Assuntos
Infecções por Coronavirus/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Pneumonia Viral/tratamento farmacológico , Ensaios Clínicos como Assunto , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Pandemias , Projetos de Pesquisa , Resultado do Tratamento
10.
Medicine (Baltimore) ; 99(25): e20620, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32569191

RESUMO

BACKGROUND: Chronic atrophic gastritis (CAG) is defined as an important precancerous disease with high risk of gastric cancer. Rebamipide is a mucosal protective agent widely used in the treatment of chronic gastritis. The aim of this systematic review is to assess the efficacy and safety of rebamipide for the treatment of patients with CAG. METHODS AND ANALYSIS: We will perform a comprehensive retrieval in the following electronic databases: PubMed, Embase, MEDLINE, Cochrane Library Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI) database, Wanfang Data Knowledge Service Platform, Chinese Scientific Journals Database (VIP), Chinese Biomedical Literature Service System (SinoMed) and other sources. Two trained researchers will select the qualified studies for data extraction and assess the quality and risk of bias, independently. Then the meta-analyses will be conducted by using the RevMan 5.2 and stata 14.0. The heterogeneity of data will be investigated by Cochrane X and I tests. Sensitivity analysis will be conducted to evaluate the stability of the results. Funnel plot analysis and Egger test will be used to assess the publication bias. Finally, the quality of evidence will be assessed by the GRADE system. RESULTS: The results of our research will be published in a peer-reviewed journal. CONCLUSION: The conclusion of our systematic review will provide evidence to judge whether rebamipide is an effective intervention for patient with CAG. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/BKC3E.


Assuntos
Alanina/análogos & derivados , Antiulcerosos/uso terapêutico , Gastrite Atrófica/tratamento farmacológico , Quinolonas/uso terapêutico , Alanina/uso terapêutico , Humanos , Metanálise como Assunto , Revisões Sistemáticas como Assunto
11.
Medicine (Baltimore) ; 99(22): e20374, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481421

RESUMO

BACKGROUND: Chronic atrophic gastritis (CAG) is defined as an important precancerous disease in the development of gastric cancer. Early intervention of CAG is of great significance in reducing symptoms and blocking its progression to gastric cancer. Weifuchun (WFC) tablet is a classic Chinese patent medicine used to treat CAG. However, there is no systematic review related to WFC for atrophic gastritis published in English. we will conduct systematic review and meta-analysis to provide more evidence on the effectiveness and safety for clinical use of WFC. METHODS AND ANALYSIS: Three English database and 4 Chinese databases will be searched from its inception to April 2020. Two trained researchers will independently select the qualified studies for data extraction and assess the quality and risk of bias. Then the meta-analyses will be performed by using the RevMan 5.2 and stata 14.0. The heterogeneity of data will be investigated by Cochrane X and I tests. Sensitivity analysis will be conducted to evaluate the stability of the results. A funnel plot analysis and Egger's test will be drawn to assess the publication bias. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluate system to evaluate the methodological quality. RESULTS: The results of our research will be published in a peer-reviewed journal. CONCLUSION: The conclusion of our systematic review will provide evidence to judge whether WFC is an effective intervention for patient with CAG. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/2UTMB.


Assuntos
Medicamentos de Ervas Chinesas/administração & dosagem , Gastrite Atrófica/tratamento farmacológico , Doença Crônica , Medicamentos de Ervas Chinesas/uso terapêutico , Humanos , Comprimidos , Resultado do Tratamento
12.
J Heart Lung Transplant ; 39(5): 412-417, 2020 05.
Artigo em Inglês | MEDLINE | ID: covidwho-180903

RESUMO

BACKGROUND: The epidemiologic and clinical characteristics of heart transplant (HTx) recipients during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic remains unclear. We studied the characteristics of HTx recipients from December 20, 2019, to February 25, 2020, in an effort to understand their risk and outcomes. METHODS: All accessible HTx recipients were included in this single-center retrospective study. We collected information on the recipients using a web-based questionnaire as well as the hospital database. RESULTS: We followed 87 HTx recipients (72.4% were men, and the average age was 51 years). A total of 79 recipients resided in Hubei, and 57 recipients had a Wuhan-related history of travel or contact. Most took precautionary measures while in contact with suspicious crowds, and 96.6% of the families and communities undertook prevention and quarantine procedures. Four upper airway infections were reported, and 3 of them tested negative for SARS-CoV-2 (the fourth recovered and was not tested). All cases were mild and successfully recovered after proper treatment. Laboratory results of 47 HTx cases within the last 2 months were extracted. Of these, 21.3% of recipients had pre-existing lymphopenia, and 87.2% of recipients had a therapeutic concentration of tacrolimus (5-12 ng/ml). Liver and kidney insufficiency was seen in 5 and 6 recipients, respectively. CONCLUSION: HTx recipients who practiced appropriate prevention measures had a low rate of infection with SARS-CoV-2 and transition to the associated disease COVID-19. These early data will require confirmation as the pandemic establishes around the world.


Assuntos
Infecções por Coronavirus/epidemiologia , Coronavirus , Surtos de Doenças/prevenção & controle , Transplante de Coração , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , China/epidemiologia , Coronavirus/genética , Coronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Imunossupressão , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Peptidil Dipeptidase A/uso terapêutico , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/prevenção & controle , Quarentena , Estudos Retrospectivos , Inquéritos e Questionários
13.
J Heart Lung Transplant ; 39(5): 412-417, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32362392

RESUMO

BACKGROUND: The epidemiologic and clinical characteristics of heart transplant (HTx) recipients during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic remains unclear. We studied the characteristics of HTx recipients from December 20, 2019, to February 25, 2020, in an effort to understand their risk and outcomes. METHODS: All accessible HTx recipients were included in this single-center retrospective study. We collected information on the recipients using a web-based questionnaire as well as the hospital database. RESULTS: We followed 87 HTx recipients (72.4% were men, and the average age was 51 years). A total of 79 recipients resided in Hubei, and 57 recipients had a Wuhan-related history of travel or contact. Most took precautionary measures while in contact with suspicious crowds, and 96.6% of the families and communities undertook prevention and quarantine procedures. Four upper airway infections were reported, and 3 of them tested negative for SARS-CoV-2 (the fourth recovered and was not tested). All cases were mild and successfully recovered after proper treatment. Laboratory results of 47 HTx cases within the last 2 months were extracted. Of these, 21.3% of recipients had pre-existing lymphopenia, and 87.2% of recipients had a therapeutic concentration of tacrolimus (5-12 ng/ml). Liver and kidney insufficiency was seen in 5 and 6 recipients, respectively. CONCLUSION: HTx recipients who practiced appropriate prevention measures had a low rate of infection with SARS-CoV-2 and transition to the associated disease COVID-19. These early data will require confirmation as the pandemic establishes around the world.


Assuntos
Infecções por Coronavirus/epidemiologia , Coronavirus , Surtos de Doenças/prevenção & controle , Transplante de Coração , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , China/epidemiologia , Coronavirus/genética , Coronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Imunossupressão , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Peptidil Dipeptidase A/uso terapêutico , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/prevenção & controle , Quarentena , Estudos Retrospectivos , Inquéritos e Questionários
14.
Medicine (Baltimore) ; 99(15): e19682, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282722

RESUMO

BACKGROUND: Diabetic macroangiopathy is a further complication of diabetes mellitus and is the leading cause of death for diabetic patients. Shenqi compound (SC) is a traditional Chinese medicine formula widely used in the treatment of diabetes and diabetic macroangiopathy. At present, there is only 1 systematic review on SC in the treatment of diabetes. However, no meta-analysis has evaluated the efficacy and safety of SC on diabetic macroangiopathy. METHODS AND ANALYSIS: Three English database and four Chinese medical databases will be searched from its inception to February 2020. Then 2 methodological trained researchers will screen the qualified articles by reading the title, abstract, and full texts according to an established inclusion and exclusion criteria. The assessment of risk of bias will be conducted by using the Cochrane collaboration's tool. We will conduct meta-analyses for fasting blood glucose (FBG), postprandial blood glucose (PBG), glycated hemoglobin (HbA1c), and other outcomes. The heterogeneity of data will be evaluated by Cochrane χ and I tests. We establish 3 hypotheses before the subgroup analysis actually starts: disease status at baseline, duration of intervention, type of concomitant medication. We will conduct sensitivity analysis to evaluate the stability of the results, funnel plot analysis, and Egger test to evaluate the publication bias, and assessment for the quality of evidence by the Grading of Recommendations Assessment, Development, and Evaluate system (GRADE). RESULTS: The results will be published at a peer-reviewed journal. CONCLUSION: In this study, we will systematically evaluate the evidence of SC in the treatment of diabetic macroangiopathy. Our research is supposed to provide evidence-based support for clinical practice.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Angiopatias Diabéticas/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/patologia , Medicamentos de Ervas Chinesas/administração & dosagem , Jejum/sangue , Feminino , Hemoglobina A Glicada/efeitos dos fármacos , Humanos , Masculino , Medicina Tradicional Chinesa , Período Pós-Prandial/efeitos dos fármacos , Estudos Prospectivos , Projetos de Pesquisa , Sensibilidade e Especificidade , Doenças Vasculares/etiologia , Doenças Vasculares/patologia
15.
Medicine (Baltimore) ; 99(16): e19770, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311982

RESUMO

BACKGROUND: Type 2 diabetes mellitus is a common health problem in the world. The overall goal of diabetes management is to control blood glucose and lipids, so as to reduce the incidence of complications. Pueraria, scutellaria, and coptis decoction (PSCD) is 1 of the representative Traditional Chinese medicine formula in the treatment of diabetes, which is widely used in clinical practice in China. At present, there are many clinical reports about this formula, but these reports have their own defects.Therefore, there is an urgent need for a systematic review and meta-analysis to synthesize the current clinical evidence. METHODS AND ANALYSIS: A comprehensive literature search will be conducted and randomized controlled trials will be selected according to inclusion and exclusion criteria. Fasting blood glucose and 2 hours postprandial blood glucose will be selected as the main outcomes. The secondary outcomes are glycated hemoglobin, fasting insulin, total cholesterol, glycerol, low-density cholesterol, high-density cholesterol and adverse effects. Chi-square and I test will be used to test the heterogeneity of the study. Subgroup analysis will be conducted to explore the source of heterogeneity and sensitivity will be conducted to test the stability of the results. Funnel plot will be used to evaluate publication bias. Finally, the Grading of Recommendations Assessment, Development and Evaluate system will be used to summarize the quality of evidence. RESULTS: The results will be published in peer-reviewed journals. CONCLUSION: This research will evaluate the efficacy of Pueraria, scutellaria, and coptis decoction in the treatment of type 2 diabetes mellitus patients. It will provide strong evidence-based support for clinical practice. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/WVDE5.


Assuntos
Coptis , Diabetes Mellitus Tipo 2/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Pueraria , Scutellaria , Humanos , Metanálise como Assunto , Fitoterapia , Revisões Sistemáticas como Assunto
16.
Mol Med Rep ; 22(1): 387-397, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32319652

RESUMO

The sympathetic system is involved in the arterial diseases, but its mechanism remains poorly understood. The present study aimed to explore the impact of the sympathetic neurotransmitter norepinephrine (NE) on transforming growth factor (TGF) ß signaling and the role of NE in aortic remodeling. Guanethidine was used to induce a regional chemical sympathetic denervation (CSD) in angiotensin II (AngII) and ß­aminopropionitrile (BAPN)­induced aortic aneurysm models. The diameter of the aorta was measured, and elastic fiber staining was performed. TGFß type I receptor kinase (ALK5) expression in rat aortic NE­treated vascular smooth muscle cells (VSMCs) was detected by reverse transcription­quantitative PCR and western blotting. The effects of NE and ALK5 overexpression on migration, proliferation, apoptosis and TGFß signaling were also evaluated. Furthermore, adrenergic receptor blockers were used to determine which receptor was involved in the modulation on TGFß signaling by NE. The results of the present study demonstrated that CSD protected rats from AngII+BAPN­induced aortic remodeling and aneurysm formation. Compared with the control group, NE inhibited VSMC proliferation and migration, but promoted apoptosis by suppressing ALK5 expression, reversing the effects of TGFß signaling through the suppression of the SMAD­dependent canonical pathway and promotion of the non­canonical pathway. These effects were prevented by ALK5 overexpression. The inhibition of α­ or ß­adrenergic receptors alleviated the NE­mediated suppression of ALK5 expression. In conclusion, regional CSD protected rats from aortic aneurysm. NE inhibited SMAD2/3­dependent TGFß signaling by suppressing ALK5 expression, which may serve an important role in VSMC biological functions. Both α­ and ß­adrenergic receptors were involved in the regulation of ALK5 expression by NE. Abnormal sympathetic innervation of the aorta may be used as a therapeutic target in aortic diseases.

17.
Medicine (Baltimore) ; 99(16): e19729, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311964

RESUMO

BACKGROUND: Ulcerative colitis (UC) is a chronic non-specific intestinal inflammatory disease characterized by continuous and diffuse inflammatory response of colonic mucosa. Steroid-dependent UC is an important type of UC. Chinese herbal medicine is widely used in treating steroid-dependent UC in China. However, there is no systematic review and meta-analysis to collate and evaluate the evidence of these studies. The purpose of this research is to provide evidence of the efficacy and safety of Chinese herbal medicine in treating steroid-dependent UC. METHODS AND ANALYSIS: Six databases, including 3 English databases and 3 Chinese databases will be searched. In addition, other grey literatures and ongoing studies will also be searched. Two researchers will independently select eligible studies by reading titles, abstracts and full texts according to the inclusion and exclusion criteria. Risk of bias assessment will be conducted by 2 independent reviewers using Cochrane risk-of-bias tool. The outcomes include steroid-free remission rate, Total clinical effective rate, Incidence of adverse events, Disease activity index (modified Mayo score), Results of enteroscopy (Baron score) and mucosa (geboes index score). Heterogeneity between studies will be assessed by Cochrane X and I tests. We will conduct subgroup analysis and meta-regression to explore the source of heterogeneity. We will also evaluate the stability of the results through sensitivity analysis and publication bias through funnel plot and Egger test. RESULTS: The results will be published in peer-reviewed journals. CONCLUSION: Our meta-analysis and systematic evaluation results will confirm whether Chinese herbal medicine is effective in the treatment of steroid-dependent UC. It will provide more ideas for future research. OSF REGISTRATION NUMBER: DOI: 10.17605/OSF.IO/YP79Z.


Assuntos
Colite Ulcerativa/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Humanos , Metanálise como Assunto , Revisões Sistemáticas como Assunto
18.
Medicine (Baltimore) ; 99(16): e19768, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311981

RESUMO

BACKGROUND: Ulcerative colitis (UC), an important type of inflammatory bowel disease, is mainly characterized by persistent and diffuse inflammatory response of colonic mucosa. Many studies have explored the effects and mechanisms of Chinese herbal medicine (CHM) in UC animal models. However, there is no systematic review and meta-analysis to evaluate and summarize these studies. The purpose of this study is to provide precise evidence of the effects and mechanisms of CHM in treating UC. METHODS: Six databases, including 3 English databases and 3 Chinese databases will be searched. Two researchers will independently select eligible studies by reading titles, abstracts, and full texts according to the inclusion and exclusion criteria. Risk of bias assessment will be conducted by 2 independent reviewers using SYRCLE's risk of bias tool. The outcomes include total clinical effective rate, adverse events, disease activity index, interleukin-1ß (IL-1ß), IL-4, IL-6, IL-17; colombosa damage index, colonic mucosa damage index; myeloperoxidase; epidermal growth factor; transforming growth factor-ß1; and histopathological score. Heterogeneity between studies will be assessed by Cochrane X and I tests. We will conduct subgroup analysis to explore the subgroup effects. We will also evaluate the stability of the results through sensitivity analysis and publication bias through funnel plot and Egger test. RESULTS: The results will be published in peer-reviewed journals. CONCLUSION: This study can help us to understand the effects and possible mechanisms of CHM for UC. For further clinical researches, this study can help us to better look for possible effective medicines for clinical use. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/YU5FN.


Assuntos
Colite Ulcerativa/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Medicamentos de Ervas Chinesas/farmacologia , Humanos , Metanálise como Assunto , Fitoterapia , Revisões Sistemáticas como Assunto
19.
Medicine (Baltimore) ; 99(11): e19186, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176045

RESUMO

Obese individuals are apt to develop Stanford A acute aortic dissection (AAD) complicated with acute lung injury (ALI), but the mechanism is still not well defined. We aim to investigate whether oxidative stress and inflammatory are involved in the aortic dissection lung injury caused by obesity.Seventy-nine patients were categorized into AAD with obesity group (n = 17) and AAD without obesity group (n = 62) according to body mass index (BMI). Inflammatory reactions including interleukin 1ß (IL-1ß), tumor necrosis factor-α (TNF-α), IL-6, C-reactive protein (CRP) and white blood cell (WBC) count, and oxidative stress including malondialdehyde (MDA), superoxide dismutase were determined using enzyme-linked immunosorbent assays and chemiluminescence. All the patients received ascending aorta replacement combined with total arch replacement and stented elephant trunk. The postoperative complications were recorded.The incidence of preoperative hypoxemia (94.1% vs 35.5%, P < .01) and postoperative ALI (88.2% vs 40.3%, P < .01) in obese patients was significantly higher than that in non-obese patients. Besides, the ICU stay (119.2 ±â€Š59.2 vs 87.8 ±â€Š31.2 h, P < .01) and hospitalization duration (18.8 ±â€Š8.5 vs 14.3 ±â€Š8.1d, P = .048) were increased in the obese patients with AAD. The expression of IL-1ß, TNF-α, IL-6, CRP, and WBC was remarkably increased (P < .01) in obese group compared with non-obese group.Oxidative stress and inflammatory response may be involved in the process of ALI of aortic dissection caused by obesity, which provides new ideas for the treatment of ALI of the aortic dissection.


Assuntos
Lesão Pulmonar Aguda/cirurgia , Aneurisma Dissecante/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/efeitos adversos , Hipóxia/etiologia , Obesidade/complicações , Lesão Pulmonar Aguda/diagnóstico por imagem , Adulto , Idoso , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma da Aorta Torácica/diagnóstico por imagem , Implante de Prótese Vascular/métodos , Índice de Massa Corporal , Estudos de Coortes , Feminino , Hospitais Universitários , Humanos , Hipóxia/fisiopatologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/fisiopatologia , Cuidados Pré-Operatórios , Prognóstico , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Análise de Sobrevida , Resultado do Tratamento
20.
Medicine (Baltimore) ; 99(3): e18713, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32011447

RESUMO

BACKGROUND: Lower extremity artery disease (LEAD) is greatly harmful to Type 2 Diabetes Mellitus patients. Traditional Chinese Medicine (TCM) is an alternative therapy to delay the development of macrovascular diseases, but the existing evidence of its efficacy, safety and mechanism of action is insufficient. We report a study protocol of a multi-center, randomized, double-blind, placebo-controlled trial that aims to use well-designed clinical trial to evaluate the efficacy and safety of Chinese herbal medicine (CHM) Shen-Qi Hua-Yu formula, and to explore efficacy mechanism of the TCM granules and the biomarkers of TCM syndrome. METHODS: This is a multi-center, double-blind, randomized, and placebo-controlled study that randomized 120 participants into 2 groups. The treatment group will receive TCM granules and conventional medicine, while the control group will receive placebo in addition to conventional medicine. Two groups will receive 12-week treatment and 48-week follow-up, with a total of 13 visits. Primary efficacy outcomes included ankle brachial index. Secondary efficacy outcomes included fasting plasma glucose, blood lipid, hemorheology indexes, advanced glycation end products, the inner diameter, peak systolic velocity, end diastolic velocity and mean average velocity of the anterior tibial artery, posterior tibial artery and dorsalis pedis artery, and TCM syndrome score. The safety and endpoint outcomes will be evaluated in this trial. The study will explain the biological therapeutic mechanism of Shen-Qi Hua-Yu formula for diabetic LEAD, and try to use Isobaric tags for Relative and Absolute Quantitation (iTRAQ) and Western blot to screen biomarkers of characteristic diagnosis and clinical efficiency evaluation of the TCM syndrome. DISCUSSION: This study is a multi-center, randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of CHM in patients with diabetic LEAD, and to interpret the therapeutic mechanism of Shen-Qi Hua-Yu formula in treatment of diabetic LEAD through proteomics technology, and to screen biomarkers with characteristics of TCM diagnosis and clinical efficacy evaluation. On the other hand, to our knowledge, this study may be the first trial of CHM formulas to observe cardiovascular outcomes through long-term follow-up for the treatment of diabetic LEAD, which is of great value. TRIAL REGISTRATION: This study is registered on the Chinese Clinical Trial Registry: ChiCTR1900026372.


Assuntos
Angiopatias Diabéticas/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Adulto , Idoso , Índice Tornozelo-Braço , Biomarcadores , Glicemia , Diabetes Mellitus Tipo 2/complicações , Método Duplo-Cego , Feminino , Humanos , Lipídeos/sangue , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Qi , Projetos de Pesquisa , Artérias da Tíbia
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