Effect of Buyang Huanwu decoction for the rehabilitation of ischemic stroke patients: a meta-analysis of randomized controlled trials.

PURPOSE: Buyang Huanwu decoction (BHD) is a widely used traditional Chinese medicine for the rehabilitation of ischemic stroke patients in China, but its clinical efficacy and safety have not been adequately assessed. In this paper, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of BHD. METHODS: We searched seven electronic databases from inception to 31 March 2019. The language was limited to Chinese and English. Randomized controlled trials evaluating the efficacy and safety of BHD for the rehabilitation of ischemic stroke patients were included in the meta-analysis. Reviewers independently performed the screening, data extraction, bias assessment, and data analysis. The treatment efficacy was pooled in a meta-analysis using RevMan 5.3 software with a random-effect model. Any disagreement was resolved by discussion among all reviewers. The PRISMA statement was used in the review process. RESULTS: A total of 11 studies with 1084 patients were included in the meta-analysis. The results suggested that BHD was superior to other treatments in terms of clinical efficacy in symptoms and daily activities (n = 684, RR = 1.12, 95% CI: 0.99 to 1.27), clinical efficacy in TCM symptoms (n = 280, RR = 1.45, 95% CI: 1.03 to 2.03), National Institute of Health stroke scale (n = 192, MD = 1.66, 95% CI: -1.08 to 4.40), and activities of daily living (n = 200, MD = 8.20, 95% CI: -3.95 to 20.35). CONCLUSIONS: The results supported the clinical use of BHD for the rehabilitation of ischemic stroke patients. However, the methodological qualities of the included studies were relatively low, and there were limited reports on adverse events. The clinical efficacy and safety of BHD need to be further confirmed by more well-designed and high-quality randomized controlled trials to warrant the clinical recommendation of BHD for the rehabilitation of ischemic stroke patients.

Danggui Sini Decoction (herbal medicine) for the treatment of primary dysmenorrhoea: a systematic review and meta-analysis.

Danggui Sini Decoction (DSD), a traditional herbal prescription, has been commonly used in the treatment of primary dysmenorrhoea (PD). We investigated the current evidence of randomised controlled trials (RCTs) and performed a systematic review to evaluate the efficacy of DSD in the treatment of PD. We registered the protocol for this systemic review in PROSPERO with the registration number CRD 42017074062 on August 10, 2017. Nine databases were searched from inception to August 2019. Eleven RCTs with 1005 patients were included. DSD was shown to have more favourable effects on the clinical effective rate than western medicine, which support the clinical use of DSD in the treatment of PD. However, considering the high risk of bias in the included studies, more well-designed RCTs are needed to further evaluate the efficacy of DSD in the treatment of PD.

Paediatric massage for treatment of acute diarrhoea in children: a meta-analysis.

BACKGROUND: Massage therapy has been used by many traditional Chinese medicine physicians to treat acute diarrhoea in children. Since no relevant systematic reviews assessed the clinical effectiveness or the risk of massage therapy, in this study, a meta-analysis was conducted to evaluate the efficacy of paediatric massage for the treatment of acute diarrhoea in children. METHODS: In this meta-analysis, paediatric patients who were diagnosed with acute diarrhoea were included. Interventions using massage therapy alone or combined with other non-pharmacological approaches were included, while in the control groups, patients received pharmacotherapy. The primary outcome was clinical effective rate. Seven databases were used in our research, and the following search terms were used: (massage OR tui na OR manipulation OR acupressure) AND (infant OR child OR baby OR paediatrics) AND (diarrhoea OR diarrhoea) AND (randomized controlled trial). The search date was up to April 30, 2018. RESULTS: A total of 26 studies encompassing 2644 patients were included in this meta-analysis. It was shown that paediatric massage was significantly better than pharmacotherapy in treating acute diarrhoea in children in terms of clinical effective rate (n = 2213, RR = 1.20, 95% CI: 1.14 to 1.27), clinical cure rate (n = 345, RR = 1.37, 95% CI: 1.19 to 1.57), and cure time (n = 513, MD = - 0.77, 95% CI: -0.89 to - 0.64). However, the quality of evidence for this finding was low due to high risk of bias of the included studies. CONCLUSIONS: The present work supported paediatric massage in treating acute diarrhoea in children. More well-designed randomized controlled trials are still needed to further evaluate the efficacy of paediatric massage.

Wenjing decoction (herbal medicine) for the treatment of primary dysmenorrhea: a systematic review and meta-analysis.

PURPOSE: Wenjing decoction is a well-accepted traditional Chinese medicine for the treatment of primary dysmenorrhea in East Asia, but its clinical effectiveness and risk have not been adequately assessed. In this paper, we conducted a systematic review and meta-analysis to evaluate the efficacy of Wenjing decoction for the treatment of primary dysmenorrhea. METHODS: Eight databases were used in our research: the Cochrane Library, the Web of Science, PubMed, EMBASE, the Chinese Biomedical Literature Database (CBM), the Chinese National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database, and the Wan-fang Database. The following search terms were used: (Wenjing decoction OR Wenjing formula OR Wenjing tang) AND (primary dysmenorrhea OR dysmenorrhea OR painful menstruation) AND (randomized controlled trial). No language limitation was used. RESULTS: A total of 18 studies, including 1736 patients, were included in the meta-analysis. Wenjing decoction was shown to be significantly better than nonsteroidal anti-inflammatory drugs for the improvement of primary dysmenorrhea according to the clinical effective rate (RR 1.41, 95% CI 1.24-1.61), the visual analogue scale (MD -1.77, 95% CI -2.69 to -0.84), and the pain scale for dysmenorrhea (MD -1.81, 95% CI -2.41 to -1.22). CONCLUSIONS: The results supported the clinical use of Wenjing decoction for the treatment of primary dysmenorrhea. However, the quality of the evidence for this finding was low due to a high risk of bias in the included studies. Therefore, well-designed randomized controlled trials are still needed to further evaluate the efficacy of Wenjing decoction for the treatment of primary dysmenorrhea.

Features analysis of five-element theory and its basal effects on construction of visceral manifestation theory.

OBJECTIVE: To study the Chinese ancient five-element theory, one of the philosophical foundations of Traditional Chinese Medicine (TCM) theory construction, from the perspective of comtemporary cognitive science, and to reveal the important functions of five-element theory in the construction of TCM theory. METHODS: The basic effects of five-element theory in the construction of TCM theory are intensively expounded and proved from the following aspects: embodiment of five-element theory in cognizing the world, quasi axiom of five-element theory in essence, classification thery of family resemblance and deductive inference pattern of five-element theory, and the openness and expansibility of five-element theory. RESULTS: If five-element theory is considered a cognitive pattern or cognitive system related to culture, then there should be features of cognitive embodiment in the cognitive system. If five-element theory is regarded as a symbolic system, however, then there should be a quasi-axiom for the system, and inferential deduction. If, however, five-element theory is taken as a theoretical constructive metaphor, then there should be features of opening and expansibility for the metaphor. CONCLUSION: Based on five-element theory, this study provides a cognitive frame for the construction of TCM (a medicine that originated in China, and is characterized by holism and treatment based on pattern identification differentiation) theory with the function of constructing a concept base, thereby implying further research strategies. Useful information may be produced from the creative inferences obtained from the incorporation of five-element theory.

Understanding association of spleen system with earth on traditional Chinese medicine theory.

OBJECTIVE: The association of spleen system including both spleen and stomach with earth, one of the five elements, is a part of the theory of five elements. Practitioners of Traditional Chinese Medicine (TCM) used the theory as a reasoning tool to illustrate the Zang-Fu organs' physiological functions and the interaction among them. The exploration of how the theory of that spleen system is associated with earth was created may provide insights into how five-element theory is applied to TCM practice. METHODS: Using analogism as a method to explore the relationship between earth and spleen system in TCM. RESULTS: Chinese ancestors experienced and observed the features of earth from agricultural practice and used the knowledge for the explanation of spleen system functions including physiological functions, pathological characteristics and for the treatment of related illnesses. CONCLUSION: The theory of the five elements in TCM is a kind of metaphor, which depends on observation and exploration of the natural world and experience of human beings.

The addition of discrimination inhibitors stimulations discrimination potential and N2O emissions were linked to predation among microorganisms in long term nitrogen application and straw returning systems.

Introduction: Ammonia oxidizing archaea (AOA) and ammonia oxidizing bacteria (AOB) have been proven to be key microorganisms driving the ammonia oxidation process. However, under different fertilization practices, there is a lack of research on the impact of interaction between predators and AOA or AOB on nitrogen cycling at the multi-trophic level. Methods: In this study, a network-oriented microscopic culture experiment was established based on four different long-term fertilization practices soils. We used the nitrification inhibitors 2-phenyl-4,4,5,5-tetramethylimidazoline-1-oxide-3-oxyl (PTIO) and 3, 4-Dimethylpyrazole phosphate (DMPP) inhibited AOA and AOB, respectively, to explore the impact of interaction between protists and AOA or AOB on nitrogen transformation. Results: The results showed that long-term nitrogen application promoted the potential nitrification rate (PNR) and nitrous oxide (N2O) emission, and significantly increased the gene abundance of AOB, but had no obvious effect on AOA gene abundance. DMPP significantly reduced N2O emission and PNR, while PTIO had no obvious effect on them. Accordingly, in the multi-trophic microbial network, Cercozoa and Proteobacteria were identified as keystone taxa of protists and AOB, respectively, and were significantly positively correlated with N2O, PNR and nitrate nitrogen. However, Nitrososphaerota archaeon as the keystone species of AOA, had an obvious negative linkage to these indicators. The structural equation model (SEM) showed that AOA and AOB may be competitors to each other. Protists may promote AOB diversity through direct trophic interaction with AOA. Conclusion: The interaction pattern between protists and ammonia-oxidizing microorganisms significantly affects potential nitrification rate and N2O emission, which has important implications for soil nitrogen cycle.

The Clinical Efficacy of Phytochemical Medicines Containing Tanshinol and Ligustrazine in the Treatment of Stable Angina: A Systematic Review and Meta-Analysis.

BACKGROUND: Phytochemical medicines containing tanshinol and ligustrazine are commonly used in the treatment of stable angina in China, but their clinical effectiveness and risk have not been adequately assessed. In this paper, we conducted a systematic review and meta-analysis to evaluate the clinical efficacy. METHODS: Relevant randomized controlled trials (RCTs) of phytochemical medicines containing tanshinol and ligustrazine in the treatment of stable angina were searched in electronic databases. The search date was up to March 31, 2020, and the languages of the RCTs were limited to English and Chinese. RESULTS: A total of 28 studies, including 2518 patients, were included in the meta-analysis. It was shown that the adjunctive therapy of phytochemical medicines containing tanshinol and ligustrazine was better than the conventional therapies in the improvement of stable angina according to the clinical efficacy in symptoms (n = 2518, RR = 1.24, 95% CI: 1.20 to 1.29, P < 0.01) and clinical efficacy in electrocardiography (n = 1766, RR = 1.29, 95% CI: 1.19 to 1.40, P < 0.01). CONCLUSION: The meta-analysis supported the use of phytochemical medicines containing tanshinol and ligustrazine in the treatment of stable angina. However, quality of the evidence for this finding was low due to a high risk of bias in the included studies. Therefore, well-designed RCTs are still needed to further evaluate the efficacy.

Prevalence of depression among Chinese university students: a systematic review and meta-analysis.

Estimates of the depression prevalence among Chinese university students vary considerably across studies. This systematic review and meta-analysis aimed to comprehensively analyze the depression prevalence among Chinese university students. We searched four electronic databases with the search terms of depression, China, university student, and questionnaire. Studies reporting depression among Chinese university students were included in the analysis. Two reviewers independently extracted the data and assessed the qualities of the studies. The package of "meta" in R Foundation for Statistical Computing was used to calculate an overall proportion in a random-effects model with 95% confidence intervals. Subgroup analysis was conducted to analyze the influencing factors on the depression prevalence. Any conflict in the data analysis was discussed by all the reviewers. A total of 113 studies were included in the meta-analysis. The overall prevalence of depression among Chinese university students was shown to be 28.4% (n = 185,787), with 95%CI from 25.7 to 31.2%. The overall depression prevalence among Chinese university students was still relatively high. More efforts need to be done to provide better mental healthcare to university students in China.

Chinese herbal fumigant and lotion for postoperative complication in surgical wound of anal fistula: A protocol for a systematic review and meta-analysis.

BACKGROUND: Surgery is the most common and effective therapy for anal fistula, while the postoperative complication, such as pain, edema, pruritus, turgescence, and exudation in surgical wound, can have serious impact on wound healing and patients' quality of life. Chinese herbal fumigant and lotion have been commonly used in postoperative treatment and achieved satisfied effect in China. However, clinical evidence-based literature of Chinese herbal fumigant and lotion for postoperative anal fistula is not sufficient. This protocol is described for a systematic review to investigate the beneficial effects. METHODS: A systematic search will be conducted in database involving PubMed, the Cochrane library, Embase, Web of Science, Google Scholar, SinoMed, China National Knowledge Infrastructure(CNKI), VIP, Wanfang Database, CiNii(National Institute of Informatics), and KISS(Koreanstudies Information Service System) from inceptions to December 31, 2019. We will include randomized controlled trials (RCT) regarding Chinese herbal fumigant and lotion in the treatment of complication in surgical wound of anal fistula. Quality of included RCTs will be assessed according to the Cochrane Handbook 5.1.0. GRADE will be used to assess the quality of evidence. The summary results will be pooled using the random-effects model or fixed-effects model according to the heterogeneity of included studies. RESULTS: After peer-review, the study will be disseminated in scientific journals and conferences. CONCLUSION: This systematic review will provide evidence for the efficacy of Chinese herbal fumigant and lotion for curing postoperative complication of anal fistula. In addition, it might provide suggestions for Chinese medicine clinical practice or guideline. PROSPERO REGISTRATION: CRD42020164975.

A comparison of the efficacy of Chinese herbal medicines in the treatment of primary dysmenorrhea: A network meta-analysis protocol.

INTRODUCTION: Chinese herbal medicines (CHM) have been commonly used in the treatment of primary dysmenorrhea in East Asia. Several systematic reviews have been conducted to assess the clinical efficacy of CHM in the treatment of primary dysmenorrhea. However, their comparative efficacy is still unclear. Therefore, the purpose of this study is to conduct a network meta-analysis (NMA) to systematically compare the advantages of different CHM in the treatment of primary dysmenorrhea. METHODS AND ANALYSIS: The following electronic databases will be searched in this study: Web of Science, PubMed, Cochrane Library, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wan-fang Database. Search terms include (Chinese herbal medicine or Chinese patent medicine or medicinal plants or phytotherapy or traditional medicine or Chinese herbal drugs or plant extracts or herbal medicine or herbal extract or herb or traditional Chinese medicine) and (primary dysmenorrhea or dysmenorrhea or painful menstruation) and (randomized controlled trial). The language will be limited to Chinese and English, and the search date will be up to May 2019. The included studies must be randomized controlled trials (RCTs) with patients diagnosed with primary dysmenorrhea. CHM must be used as interventions in the experimental group. While in the control group, studies that used a different herbal medicine, nonsteroidal anti-inflammatory drugs (NSAIDs), or placebo will be included. The primary outcomes include clinical efficacy and visual analog scale (VAS), and the secondary outcomes include adverse events and quality of life. Four reviewers will independently extract the data and assess the qualities of the studies. Statistical analysis will be conducted with R package for each outcome. ETHICS AND DISSEMINATION: Ethical approval is not required as this NMA is based on published studies. The completed NMA will be published in a peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER: PROSPERO CRD42018095254.

Theoretical proposal of a low-loss wide-bandwidth silicon photonic crystal fiber for supporting 30 orbital angular momentum modes.

We propose a novel four-ring hollow-core silicon photonic crystal fiber (PCF), and we systematically and theoretically investigate the properties of their vector modes. Our PCF can stably support 30 OAM states from the wavelength of 1.5 µm to 2.4 µm, with a large effective refractive index separation of above 1×10-4. The confinement loss is less than 1×10-9 dB/m at the wavelength of 1.55 µm, and the average confinement loss is less than 1×10-8 dB/m from the wavelength of 1.2 µm to 2.4 µm. Moreover, the curve of the dispersion tends to flatten as the wavelength increases. In addition, we comparably investigate PCFs with different hole spacing. This kind of fiber structure will be a potential candidate for high-capacity optical fiber communications and OAM sensing applications using fibers.

Risk of Developing Coronary Artery Disease in Patients with Type 2 Diabetes Receiving Traditional Chinese Medicine Therapy.

OBJECTIVES: To compare risk of developing coronary artery disease (CAD) between diabetic patients receiving Traditional Chinese Medicine (TCM) therapy and those treated by Western medicine (WM). METHODS: This prospective cohort study included 13,655 diabetic patients receiving solely TCM and 435,165 patients treated exclusively by WM. Study patients were identified from Taiwan's National Health Insurance (NHI) ambulatory claims in 2000-2001. These patients were then linked to the 2000-2008 NHI inpatient claims, searching for possible new onset of hospitalization for CAD. A Cox proportional hazard model and logistic regression model were used to assess the hazard ratio of CAD admission and odds ratio (OR) of higher rates of admission for CAD in relation to TCM. RESULTS: During 9 years of follow-up, 2607 diabetic patients with TCM were hospitalized for CAD, representing a cumulative incidence rate of 19.1% and an incidence density of 50.5 per 1000 person-years. The corresponding figures for patients treated by WM were 24.1% and 72.7 per 1000 person-years. Compared with the patients treated by WM, those treated by TCM were associated with a slightly reduced, but insignificantly, adjusted OR of CAD admission (0.96; 95% confidence interval, 0.92-1.01). Moreover, the adjusted OR for a higher rate (≥0.212 admission per person-year) of CAD admission for the patients with TCM was also insignificantly decreased at 0.97. CONCLUSIONS: After adjustment for prior co-morbidity score, risk or rate of CAD admission did not significantly differ between diabetic patients receiving TCM therapy and those treated by WM, suggesting that TCM is as efficacious as WM in preventing diabetes from being complicated with CAD.

Levels of Urbanization and Parental Education in Relation to the Mortality Risk of Young Children.

BACKGROUND: The establishment of the National Health Insurance program in Taiwan in 1995 effectively removed the financial barrier to access health care services of Taiwanese people. This population-based cohort study aimed to determine the independent and joint effects of parental education and area urbanization on the mortality risk among children under the universal health insurance coverage in Taiwan since 1995. METHODS: We linked 1,501,620 births from 1996 to 2000 to the Taiwan Death Registry to estimate the neonatal, infant, and under-five mortality rates, according to the levels of parental education and urbanization of residential areas. We used a logistic regression model that considers data clustering to estimate the independent and joint effects. RESULTS: Lower levels of parental education and area urbanization exerted an independent effect of mortality on young children, with a stronger magnitude noted for areas with lower levels of urbanization. Children whose parents had lower levels of education and who were born in areas with lower levels of urbanization experienced the highest risk for neonatal (odds ratio (OR) = 1.60, 95% CI = 1.46-1.76), infant (OR = 1.58, 95% CI = 1.48-1.70), and under-five (OR = 1.71, 95% CI = 1.61-1.82) mortality. CONCLUSIONS: Even with universal health insurance coverage, lower levels of area urbanization and parental education still exerted independent and joint effects on mortality in young children. This finding implies the inadequate accessibility to health care resources for children from socially disadvantaged families and less urbanized areas.