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Botanical origin identification of Rhei Radix et Rhizoma based on color digitalization

Zhongguo Zhong Yao Za Zhi. 2021 Feb;46(4):902-906. doi: 10.19540/j.cnki.cjcmm.20201122.103.

ABSTRACT

The color characteristic information of Rhei Radix et Rhizoma powder was obtained by spectrophotometer, the feasibility of rapid identification of Rhei Radix et Rhizoma origin based on chromaticity value was studied by statistical analysis. The results of rank correlation analysis showed that a~*(P<0.01), b~*(P<0.01) had significantly correlation with the origin of medicinal herbs, which could be used as two important parameters to distinguish the origin of Rhei Radix et Rhizoma, the larger the a~* value, the more red the powder color,and the greater the b~* value, the more yellow the powder color. Meanwhile, through Fisher discriminant analysis, the linear discriminant functions of different genus Rhei Radix et Rhizoma were established, which was Rheum tanguticum=40.666a~*+0.019b~*-213.303, Rh. palmatum=34.121a~*+0.061b~*-151.770, Rh. officinale=28.071a~*+0.113b~*-104.604 3, the coincidence rate of cross-validation was over 95%, among them, the discriminant rate of Rh. tanguticum and Rh. officinale reached 100%;In addition, using the percentile method to analyze the 90% reference value range of three different origin of Rhei Radix et Rhizoma, as a result, Rh. tanguticum a~*(10.236 5-10.604 7), b~*(32.294 8-34.841 7); Rh. palmatum a~*(8.602 7-8.770 0), b~*(27.534 8-28.968 6), and Rh. officinale a~*(6.825 7-7.464 3),b~*(21.001 6-27.716 4). According to this study, rank correlation analysis and Fisher discriminant analysis are feasible to distinguish the base of Rhei Radix et Rhizoma in a certain range, and provide some theoretical basis for the identification of Rhei Radix et Rhizoma. It also provides a new method and idea for the identification of other multi-base Chinese medicine.

PMID:33645095 | DOI:10.19540/j.cnki.cjcmm.20201122.103

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Bayesian network Meta-analysis of Chinese medicine injections in treatment of chronic renal insufficiency

Zhongguo Zhong Yao Za Zhi. 2021 Jan;46(2):454-466. doi: 10.19540/j.cnki.cjcmm.20200622.501.

ABSTRACT

In this study, Honghua Injection, Danshen Injection, Shenkang Injection, Shuxuetong Injection, Lulutong Injection, Shenxiong Glucose Injection and Chuanxiong Injection were compared for their clinical efficacy on chronic renal insufficiency by using the method of network Meta-analysis, with Western medicine as the common reference. The randomized controlled trial(RCT) of Hong-hua Injection, Danshen Injection, Shenkang Injection, Shuxuetong Injection, Lulutong Injection, Shenxiong Glucose Injection and Chuanxiong Injection for the treatment of chronic renal insufficiency were obtained by computer-based retrieval. The literature quality was evaluated by using the method in Cochrane Reviewer’s Handbook 5.1 after independent screening of the included literature by two reviewers. The RJAGS package and GEMTC package of RevMan 5.3, GEMTC software, R software were used for statistical analysis to compare and sort the different injections in terms of efficacy. A total of 6 197 patients with chronic renal failure were included in 79 RCTs, involving 8 treatment measures. The effective rates of conventional treatment combined with Shenxiong Injection(OR=3.55, 95%CI[1.98, 6.37], P<0.000 1), Honghua Injection(OR=3.77, 95%CI[2.45, 5.81], P<0.000 01), Shuxuetong Injection(OR=6.71, 95%CI[3.30, 13.65], P<0.000 01) and Shenkang Injection(OR=4.14, 95%CI[3.42, 5.03], P<0.000 01) were all better than that in control group, and the effective rate of Honghua Injection combined with conventional treatment(OR=3.89, 95%CI[1.73, 8.74], P=0.001) was better than that in Danshen Injection combined with conventional treatment, all with statistically significant differences. By comprehensive comparison, Shuxuetong Injection, Honghua Injection and Shenkang Injection combined with Western medicine had good clinical effect on the effective rate, serum creatinine reduction and urea nitrogen reduction in patients with chronic renal insufficiency. However, due to the relatively low quality of the included literature, the conclusion has yet to be verified clinically.

PMID:33645135 | DOI:10.19540/j.cnki.cjcmm.20200622.501

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Pulmonary Functions in Patients with End Stage Renal Disease and their Effect after Hemodialysis

J Coll Physicians Surg Pak. 2021 Feb;31(2):144-149. doi: 10.29271/jcpsp.2021.02.144.

ABSTRACT

OBJECTIVE: To determine the pulmonary functions in patients with End Stage Renal Disease (ESRD) and the associated factors including the acute effects of hemodialysis.

STUDY DESIGN: Observational, cross-sectional study. Place and Duration of Study: Nephrology Department in collaboration with Pulmonology Department, Shalamar Hospital, Lahore, from October to November 2019.

METHODOLOGY: All patients of age 18-75 years, on regular hemodialysis (HD) for more than three months, who quitted smoking 10 years back and stable, were included in the study. Demographic data was collected and blood samples were sent for hematological and biochemical laboratory parameters. Pulmonary functions were assessed by spirometry for Forced Vital Capacity (FVC) and Forced Expiratory Volume in first second (FEV1) and FVC/FEV1 before and after dialysis.

RESULTS: Out of 102 patients, 62 (60.8%) were males and 79 (77.5%) were on twice-weekly dialysis. DM 44 (43.1%) and chronic glomerulonephritis 21 (19.5%) were the major causes of ESRD in these patients. In this study, FVC and FEV1 were abnormal in majority of the patients 73 (71.6%) and 76 (74.5%), which was statistically significant (p<0.05) supporting restrictive lung disease (RLD). Factors associated with RLD were male gender (p=0.006) and diabetes mellitus (p=0.003). Hemodialysis did not improve pulmonary functions significantly. FEV1 and FVC had a negative correlation with age and body mass index (BMI).

CONCLUSION: Restrictive lung disease is the most common pulmonary dysfunction among ESRD patients. Factors associated with pulmonary dysfunctions were male gender and diabetes mellitus. Hemodialysis did not improve pulmonary functions. Key Words: ESRD, Pulmonary functions, Restrictive lung disease, Fluid overload.

PMID:33645179 | DOI:10.29271/jcpsp.2021.02.144

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The Effect of COVID-19 Pandemic on Performance of Postgraduate Medical Trainee Doctors: A Nationwide Epidemiological Study in Pakistan

J Coll Physicians Surg Pak. 2021 Feb;31(2):182-187. doi: 10.29271/jcpsp.2021.02.182.

ABSTRACT

OBJECTIVE: To find out various organizational, personal, and systemic factors influencing the performance of the postgraduate trainee doctors in managing COVID-19 pandemic.

STUDY DESIGN: Analytical cross-sectional study.

PLACE AND DURATION OF STUDY: Conducted in various medical institutions of Pakistan from 15th April to 30th June, 2020.

METHODOLOGY: An analytical cross-sectional study was conducted on 11,656 postgraduate doctors. They were contacted through the e-log system of College of Physicians and Surgeons Pakistan. Semi-structured questionnaire was used consisting of demographic details, presenting symptoms, systemic involvements, clinical features, diagnostic tests, management of cases, authenticity of the information used, telemedicine services, practice of preventive measures, training and interactive educational activities, performance-based tasks and details about workplace environment. Mean and standard deviation was reported for continuous variables. Bivariate and multivariate analyses were used to report p values.

RESULTS: Among 11,656 postgraduate doctors, 3,193 (27.4%) were directly involved in the management of COVID-19 patients in designated special corona facilities. Multivariate analysis was performed to control confounders. The risk factors, found statistically significant with performance, were presence of comorbidity (OR 1.261; 95% C.I.1.06-1.50), allergic and autoimmune disorders (OR 1.18; 95% C.I.1.03-1.35), confirmed COVID-19 status due to exposure (OR 0.570; 95% C.I.0.41-0.81), and care provision to old parents (OR 1.299; 95% C.I.1.19-1.42).

CONCLUSION: The effect of COVID-19 on performance of postgraduate doctors was multi-factorial. Significant risk factors were presence of a comorbidity, allergic and autoimmune disorders, and confirmed COVID-19 due to exposure. Key Words: COVID 19, Postgraduate trainee, Pandemic, Comorbidity, PCR.

PMID:33645186 | DOI:10.29271/jcpsp.2021.02.182

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Meta-analysis of Danhong Injection in treatment of diabetes mellitus complicated with coronary heart disease

Zhongguo Zhong Yao Za Zhi. 2021 Jan;46(1):237-246. doi: 10.19540/j.cnki.cjcmm.20200701.501.

ABSTRACT

To systematically evaluate the clinical efficacy and safety of Danhong Injection combined with conventional therapy in improving diabetes mellitus complicated with coronary heart disease. Based on the online literature database(CNKI, Wanfang, VIP, PubMed, Web of Science, Cochran Library), the Chinese and English papers about the randomized controlled trial(RCT) of Danhong Injection in the treatment of diabetes mellitus complicated with coronary heart disease were searched comprehensively from the establishment of the databases to January 1, 2020. The papers were screened strictly according to the inclusion and exclusion criteria. Based on Jadad scale, the risk assessment of literature was carried out, and Meta-analysis was performed by STATA 12.0 software. Seventeen RCTs were included, involving 1 453 patients. The results of Meta-analysis showed that the combination of Danhong Injection and conventio-nal treatment could improve the clinical comprehensive effective rate(RR=1.47, 95%CI[1.38, 1.58], P&lt;0.000 1), electrocardiogram(ECG) efficiency(RR=1.30, 95%CI[1.16, 1.46], P&lt;0.000 1), efficiency of the angina pectoris(RR=1.41, 95%CI[1.25, 1.58], P&lt;0.000 1), cholesterol level(SMD=-1.05, 95%CI[-1.95,-0.16], P=0.02), low-density lipoprotein(LDL) level(SMD=-0.50, 95%CI[-0.79,-0.21], P&lt;0.000 1), coronary angina attack frequency(SMD=-3.71, 95%CI[-4.05,-3.36], P&lt;0.000 1) and duration of angina pectoris(SMD=-2.96, 95%CI[-3.25,-2.66], P&lt;0.000 1), with statistically significant differences. But the differences in fasting plasma glucose(FPG)(SMD=-0.19, 95%CI[-0.45, 0.08], P=0.16), plasma glucose of two hours after meal(2 hPG)(SMD=0.19, 95%CI[-0.11, 0.49], P=0.22), and high-density lipoprotein(HDL) level(SMD=0.10, 95%CI[-0.30, 0.49], P=0.62) after treatment were not statistically significant. Compared with the control group, there was no significant difference in adverse reactions(SMD=-2.96, 95%CI[-3.25,-2.66], P=0.75). The existing evidence shows that the combination of Western medicine and Danhong Injection can improve the clinical effect for diabetes mellitus complicated with coronary heart disease and has no obvious adverse reactions. However, due to the low level of overall literature evidence, high risk and some kind of publication bias, it still needs more high-quality randomized controlled trials and low-bias studies for further verification.

PMID:33645075 | DOI:10.19540/j.cnki.cjcmm.20200701.501

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Animal model analysis of secretory otitis media based on characteristics of clinical symptoms of traditional Chinese and Western medicine

Zhongguo Zhong Yao Za Zhi. 2021 Feb;46(4):767-771. doi: 10.19540/j.cnki.cjcmm.20201113.601.

ABSTRACT

Based on the characteristics of clinical symptoms of secretory otitis media in traditional Chinese and Western medicine,by reference to clinical diagnostic criteria,efforts were made to analyze and establish the Western medical diagnostic criteria and traditional Chinese medicine( TCM) syndrome differentiation criteria for secretory otitis media,and summarize the modeling methods and model characteristics of secretory otitis media animal models. According to the clinical diagnostic criteria and symptom characteristics,the coincidence degree between the existing animal models and clinical symptoms was evaluated,and its advantages and disadvantages were defined. On the basis of the statistical results,there were fewer methods for modeling secretory otitis media animal models,and only a specific relevant pathogenic mechanism could be revealed. Among them,the model with a higher coincidence degree was genetic engineering technology modeling and injection into the middle ear vesicles. The two modeling methods of bacterial factors highly coincided with the clinical symptoms of Western medicine,but both failed to reflect the TCM syndrome type. Therefore,establishing an animal model that simultaneously reflects the characteristics of clinical symptoms of secretory otitis media in traditional Chinese and Western medicine,and improving the evaluation criteria of secretory otitis media based on animal models are the main tasks of future studies on secretory otitis media.

PMID:33645079 | DOI:10.19540/j.cnki.cjcmm.20201113.601

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Analysis of animal models of chronic atrophic gastritis based on characteristics of clinical symptoms of traditional Chinese and Western medicine

Zhongguo Zhong Yao Za Zhi. 2021 Feb;46(4):777-781. doi: 10.19540/j.cnki.cjcmm.20201123.601.

ABSTRACT

Based on the clinical characteristics of chronic atrophic gastritis in traditional Chinese and Western medicine, the domestic and foreign relevant literature reports and animal models of chronic atrophic as well as the clinical diagnostic indicators of traditional Chinese and western medicine, chronic atrophic gastritis evaluation standard was summarized to evaluate and analyze the coincidence degree of clinical symptoms of the existing chronic atrophic gastritis animal models. The statistical results found that modeling methods with a higher coincidence degree with the existing chronic atrophic gastritis animal models are disease and syndrome combination mode-ling, surgical modeling, multifactor comprehensive modeling and MNNG modeling. Although the animal models were reproduced by such methods as etiology, pathogenesis and disease and syndrome combination similar to those of human beings, there is still a big gap with the natural disease state. Further in-depth studies and improvement shall be made in clinical practice in the hope to provide refe-rence for clinical practice and experimental studies of chronic atrophic gastritis.

PMID:33645081 | DOI:10.19540/j.cnki.cjcmm.20201123.601

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Effect of Dahuang Zhechong Pills combined with TACE on VEGF, MMP-2, TGF-β1 and immune function of patients with primary liver cancer (blood stasis and collaterals blocking type)

Zhongguo Zhong Yao Za Zhi. 2021 Feb;46(3):722-729. doi: 10.19540/j.cnki.cjcmm.20200716.501.

ABSTRACT

To investigate the effects of Dahuang Zhechong Pills combined with hepatic arterial chemoembolization(TACE) on tumor index and immune function of patients with primary liver cancer(blood stasis and collaterals blocking type), observe its application values in treatment of such patients, and provide effective treatment means for this disease. From June 2019 to December 2019, 79 patients with confirmed primary liver cancer(blood stasis and collaterals blocking type) treated in Wenzhou Hospital of Traditional Chinese Medicine were included in this study, all of which were grouped with random number table method before inclusion in this study. 40 patients in the control group were treated with TACE, while 39 patients in the observation group were treated with Dahuang Zhechong Pills combined with TACE. The efficacy was compared between two groups after 4 weeks of treatment. The immune function indexes of serum CD4~+ cells, CD4~+/CD8~+, CD3~+ cells of the observation group were higher than those in control group after treatment(P&lt;0.05), and tumor indexes such as serum alpha-fetoprotein(AFP), carbohydrate antigen 199(CA199) and glutamic-pyruvic transaminase(ALT), total bilirubin(TBiL) levels were lower than those in the control group, with statistically significant differences(P&lt;0.05). Plasma vascular endothelial growth factor(VEGF), transforming growth factor-β1(TGF-β1), and matrix metalloprotei-nase-2(MMP-2) levels in the observation group were lower than those in the control group after treatment, with statistically significant differences(P&lt;0.05). The total effective rate of the observation group was 87.18%, higher than 67.50% in the control group, and the benefit rate was 94.87% in the observation group, higher than 85.00% in the control group(P&lt;0.05). The total incidence of adverse reactions such as bone marrow suppression, gastrointestinal reaction, fever, renal function injury and peripheral nerve injury in the observation group was 48.72%, lower than 82.50% in the control group, with statistically significant difference(P&lt;0.05). In summary, the combination of Dahuang Zhechong Pills with TACE could improve immunity, protect liver function, and reduce the risk of metastasis and the incidence of adverse reactions from chemotherapy, so it is worth popularizing for patients with primary liver cancer(blood stasis and collaterals blocking type).

PMID:33645040 | DOI:10.19540/j.cnki.cjcmm.20200716.501

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Meta-analysis of efficacy and safety of sinomenine combined with methotrexate in treatment of rheumatoid arthritis

Zhongguo Zhong Yao Za Zhi. 2021 Jan;46(1):214-224. doi: 10.19540/j.cnki.cjcmm.20200322.501.

ABSTRACT

To systemically evaluate the efficacy and safety of sinomenine combined with methotrexate(SIN+MTX) in the treatment of rheumatoid arthritis(RA). Literature databases of Wanfang, CNKI, VIP, SinoMed, PubMed, Cochrane Library and Web of Science were retrieved comprehensively for relevant clinical trials. The literature retrieval time was from database establishment to February 4, 2020. The quality of literatures was assessed by the Cochrane Evaluation Handbook 5.1.0, and qualified literature was reviewed and analyzed by using the RevMan 5.3 statistical software. Twenty randomized controlled trials met the inclusion criteria, and were enrolled in the Meta-analysis. The results showed that SIN+MTX remarkably reduced DAS28(MD=-0.85, 95%CI[-1.03,-0.67], P&lt;0.000 01), and improved total efficiency(P&lt;0.000 01). SIN+MTX could inhibit swollen joint count(MD=-1.19, 95%CI[-1.75,-0.63], P&lt;0.000 1), tender joint count(MD=-1.58, 95%CI[-2.89,-0.28], P=0.02) and reduce morning stiffness time(MD=-8.44, 95%CI[-11.82,-5.07], P&lt;0.000 01) compared with control group. The results showed that SIN+MTX was equal to control group in grip strength(SMD=0.20,95%CI[-1.11,1.51],P=0.77). SIN+MTX remarkably alleviated the erythrocyte sedimentation rate(MD=-9.87, 95%CI[-14.52,-5.22], P&lt;0.000 1), C-reactive protein(SMD=-0.30, 95%CI[-0.51,-0.09], P=0.005), and rheumatoid factor(MD=-11.23,95%CI[-13.81,-8.65],P&lt;0.000 01). The frequency of adverse reactions were reduced compared with that in the control group(P&lt;0.000 01). Current clinical studies demonstrate that the efficacy and safety of SIN+MTX in the treatment of RA were superior to control group. However, due to the low quality and quantity of the included studies, high-quality randomized controlled trials are necessary to support the clinical evidences.

PMID:33645073 | DOI:10.19540/j.cnki.cjcmm.20200322.501

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Systematic evaluation and sequential Meta-analysis of modified Xuefu Zhuyu Decoction combined with Western medicine in treatment of leiomyoma

Zhongguo Zhong Yao Za Zhi. 2021 Jan;46(1):225-236. doi: 10.19540/j.cnki.cjcmm.20200401.501.

ABSTRACT

CNKI, PubMed and other databases were retrieved to extract eligible randomized controlled trial(RCT) about modified Xuefu Zhuyu Decoction(MXZD) combined with Western medicine(trial group) versus Western medicine alone(control group) in the treatment of leiomyoma. Therefore, a total of 25 RCTs were included, involving 2 328 patients. Bias risk evaluation tool in Cochrane Handbook 5.1.0 was used for evaluating the quality of these RCTs. Meta-analysis was performed for the reported indicators, including total efficiency, serum hormone level [progesterone(P), luteinizing hormone(LH), estradiol(E_2), follicle stimulating hormone(FSH)], uterine size, fibroids size and adverse reactions by using Stata 14.0 software. Meta-analysis showed that the total efficiency(RR=1.21,95%CI[1.17,1.25],P&lt;0.05) of trial group was better than that of control group. Serum hormone level(WMD_P=-3.86,95%CI[-4.31,-3.41],P&lt;0.05; WMD_(LH)=-3.64,95%CI[-4.47,-2.82],P&lt;0.05; WMD_(E_2)=-39.99,95%CI[-53.45,-26.52],P&lt;0.05; WMD_(FSH)=-3.79,95%CI[-4.86,-2.72],P&lt;0.05), uterine size(WMD=-50.02,95%CI[-55.98,-44.06],P&lt;0.05), fibroids size(WMD=-15.79,95%CI[-18.11,-13.46],P&lt;0.05) and adverse reactions(RR=0.65,95%CI[0.48,0.88],P&lt;0.05) of trial group were all lower than those of control group, with statistical significances. Trial sequential analysis(TSA) was performed by using TSA 0.9 software, and showed a reliable therapeutic effect of the experimental group. In short, our study indicated that modified Xuefu Zhuyu Decoction combined with Western medicine had a better therapeutic effect on leiomyoma than Western medicine alone, but more high-quality studies are needed to verify this conclusion in the future.

PMID:33645074 | DOI:10.19540/j.cnki.cjcmm.20200401.501