Confucius’imminent birth is heralded by the appearance of the qilin.The mythical one-horned animal came to his mother at the door and cast out of its mouth a jade tablet bearing an inscription saying that she would g...Confucius’imminent birth is heralded by the appearance of the qilin.The mythical one-horned animal came to his mother at the door and cast out of its mouth a jade tablet bearing an inscription saying that she would give birth to“the son of the refinement of water,and that he would succeed the Zhou Dynasty,but as a king without a throne(su wang).”Stunned,Yan Zhengzai–Confucius’mother–tied an embroidered ribbon around the horn of the qilin,and the animal stayed for two nights.展开更多
AIM: To compare same-day whole-dose vs split-dose of 2-litre polyethylene glycol electrolyte lavage solution (PEG-ELS) plus bisacodyl for colon cleansing for morning colonoscopy.
To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODS...To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODSFrom February 2015 to March 2015, examinees of average risk who were scheduled for a colonoscopy in the morning were retrospectively enrolled.RESULTSThe 189 examinees were divided into split-dose and non-split-dose groups. The adequacy of bowel preparation for the split-dose group vs the non-split-dose group was 96.8% vs 85.2%, respectively, P < 0.001, and the compliance of the last meal restriction was 74.6% vs 58.2%, respectively, P < 0.001. The sleep disturbance (P < 0.001) was more prevalent in the split-dose group, however the willingness to repeat the same preparation method (P = 0.243) was not different in both groups. The split-dose regimen was the most important factor influencing adequate bowel preparation in multivariate analysis (HR = 10.89, 95%CI: 6.53-18.17, P < 0.001).CONCLUSIONA split-dose regimen of 2 L PEG/AA for an early morning colonoscopy was more effective and showed better compliance for diet restriction without any difference in satisfaction and discomfort. Introducing a split-dose regimen of 2 L PEG/AA to morning colonoscopy examinees is effective and tolerable in a comprehensive medical check-up setting.展开更多
BACKGROUND Split-dose regimens(SpDs)of 4 L of polyethylene glycol(PEG)have been established as the“gold standard”for bowel preparation;however,its use is limited by the large volumes of fluids required and sleep dis...BACKGROUND Split-dose regimens(SpDs)of 4 L of polyethylene glycol(PEG)have been established as the“gold standard”for bowel preparation;however,its use is limited by the large volumes of fluids required and sleep disturbance associated with night doses.Meanwhile,the same-day single-dose regimens(SSDs)of PEG has been recommended as an alternative;however,its superiority compared to other regimens is a matter of debate.AIM To compare the efficacy and tolerability between SSDs and large-volume SpDs PEG for bowel preparation.METHODS We searched MEDLINE/PubMed,the Cochrane Library,RCA,EMBASE and Science Citation Index Expanded for randomized trials comparing(2 L/4 L)SSDs to large-volume(4 L/3 L)SpDs PEG-based regimens,regardless of adjuvant laxative use.The pooled analysis of relative risk ratio and mean difference was calculated for bowel cleanliness,sleep disturbance,willingness to repeat the procedure using the same preparation and adverse effects.A random effects model or fixed-effects model was chosen based on heterogeneity analysis among studies.RESULTS A total of 18 studies were included.There was no statistically significant difference of adequate bowel preparation(relative risk=0.97;95%CI:0.92-1.02)(14 trials),right colon Boston Bowel Preparation Scale(mean difference=0.00;95%CI:-0.04,0.03)(9 trials)and right colon Ottawa Bowel Preparation Scale(mean difference=0.04;95%CI:-0.27,0.34)(5 trials)between(2 L/4 L)SSDs and large-volume(4 L/3 L)SpDs,regardless of adjuvant laxative use.The pooled analysis favored the use of SSDs with less sleep disturbance(relative risk=0.52;95%CI:0.40,0.68)and lower incidence of abdominal pain(relative risk=0.75;95%CI:0.62,0.90).During subgroup analysis,patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation than SpDs(P<0.05).No significant difference in adverse effects,including nausea,vomiting and bloating,was found between the two arms(P>0.05).CONCLUSION Regardless of adjuvant laxative use,the(2 L/4 L)SSD PEG-based arm was considered equal or better than the large-volume(≥3 L)SpDs PEG regimen in terms of bowel cleanliness and tolerability.Patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation due to the low-volume fluid requirement and less sleep disturbance.展开更多
BACKGROUND Quality of bowel preparation in afternoon colonoscopies has been a struggle.Currently,a choice of same-day preparation(SaD)or split-dose preparation(SpD)exists;however,randomized controlled trials’results ...BACKGROUND Quality of bowel preparation in afternoon colonoscopies has been a struggle.Currently,a choice of same-day preparation(SaD)or split-dose preparation(SpD)exists;however,randomized controlled trials’results have varied.AIM To examine the outcomes of SaD and SpD for afternoon colonoscopies.METHODS An extensive literature search was conducted using multiple databases.Only randomized controlled trials(RCTs)in adults that compared SaD to SpD with Ottawa bowel preparation score(OBPS)were included.Odds ratio(OR)or mean difference was used to analyze outcomes.RESULTS Eleven RCTs were included(n=1846).No difference was observed for satisfactory bowel preparation based on OBPS among participants receiving SaD vs SpD(OR 0.77;95%CI:-0.57-1.03;P=0.07;I2=5%).Subgroup analysis showed no difference in terms of satisfactory bowel preparation based on OBPS between the two groups when receiving same preparation formula(polyethylene glycol)(OR 0.83;95%CI:0.51-1.35;P=0.46;I2=39%)as well as receiving same formula and volume(4 L polyethylene glycol)(OR 1.14;95%CI:0.65-2.01;P=0.64;I2=0%).CONCLUSION In patients undergoing afternoon colonoscopies,SaD is comparable with SpD in terms of satisfactory bowel preparation.Further studies are needed to validate these results and determine the optimal formula and dosages.展开更多
BACKGROUND Rheumatic immune diseases are a group of chronic inflammatory diseases charac-terized by joint and systemic multi-organ involvement,including rheumatoid arthritis,systemic lupus erythematosus,and Sjogren’s...BACKGROUND Rheumatic immune diseases are a group of chronic inflammatory diseases charac-terized by joint and systemic multi-organ involvement,including rheumatoid arthritis,systemic lupus erythematosus,and Sjogren’s syndrome,among others.The pathogenesis of these diseases is related to the abnormal activation and regulatory imbalance of the immune system.The prevalence and morbidity of rheumatic immune diseases are high,imposing a significant burden on patients'quality of life and socio-economic costs.Currently,the treatment of rheumatic immune diseases mainly relies on Western medicine,such as non-steroidal anti-inflammatory drugs,glucocorticoids,disease-modifying antirheumatic drugs,and biologics.However,the therapeutic effects of Western medicine are not ideal,some patients poorly respond or are resistant to Western medicine,and long-term use often causes various adverse reactions.AIM To systematically evaluate the efficacy and safety of Tripterygium wilfordii gly-cosides tablets combined with Western medicine in the treatment of patients with rheumatic immune diseases.METHODS This study conducted a meta-analysis to systematically evaluate the efficacy and safety of Tripterygium wilfordii glycosides tablets combined with Western medicine for patients with rheumatic immune diseases.Chinese and English databases were searched for randomized controlled trials(RCTs)on the treatment of rheumatic immune diseases with Tripterygium wilfordii glycosides tablets combined with Western medicine.The quality of the included studies was assessed using the Cochrane risk of bias assessment tool.Meta-analysis was performed using RevMan 5.4 software.RESULTS The meta-analysis included 11 RCTs involving 1026 patients with rheumatic immune diseases.The combined treatment significantly reduced the risk of disease recurrence(relative risk=1.07,95%confidence interval:1.01-1.15,P<0.05)and showed no significant heterogeneity(I2=0%,P=0.53),indicating that Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective method to reduce the possibility of postoperative recurrence in patients with rheumatic immune diseases.However,due to the limited number and quality of the studies included,these results should be interpreted with caution.CONCLUSION Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective and safe treatment option for patients with rheumatic immune diseases and can be considered a clinical choice.However,more high-quality research is needed to validate this conclusion and provide more solid evidence for clinical practice.展开更多
Objective:To evaluate the efficacy and safety of rasagiline tablets in the treatment of Parkinson’s disease,in order to provide a more scientific basis for the application of the drug in Parkinson’s disease.Methods:...Objective:To evaluate the efficacy and safety of rasagiline tablets in the treatment of Parkinson’s disease,in order to provide a more scientific basis for the application of the drug in Parkinson’s disease.Methods:This study is a single-arm,prospective,observational study.The trial collected patients with primary Parkinson’s disease who met the inclusion and exclusion criteria after being assessed by the investigator to evaluate the efficacy and safety of rasagiline tablets in the treatment of Parkinson’s disease patients through UPDRSIII and UPDRSII scales,and evaluated the efficacy and safety of rasagiline tablets in the treatment of Parkinson’s disease patients.Results:A total of 3560 patients were included in this study.44.1%of patients had early Parkinson’s disease,52.4%had intermediate Parkinson’s disease,and 3.5%had advanced Parkinson’s disease.The UPDRSIII(exercise capacity)score was 26.76 at baseline,25.47 at 1 month,24.18 at 2 months,and 23.39 at 3 months after treatment,and scores significantly improved over time(P<0.001).The UPDRSII(ability to perform daily living)score was an average of 23.60 at baseline,22.49 at 1 month,21.53 at 2 months,and 21.09 at 3 months after treatment,with statistically significant differences in scores between months(P<0.001).A total of 18 adverse events/reactions occurred in this study,and adverse symptoms eventually disappeared or resolved,without termination due to adverse events/reactions or patient discharge.Conclusion:Rasagiline tablets have significant efficacy in improving daily exercise capacity and living ability in patients with Parkinson’s disease,and have a certain safety,which supports the effectiveness of rasagiline as a treatment for Parkinson’s disease and provides new evidence for its clinical application.展开更多
Objective:To evaluate the clinical effect of combined therapy with Diosmin Tablets and Mayinglong Musk Hemorrhoids Ointment for patients with acute hemorrhoids.Methods:A total of 50 patients with acute hemorrhoids who...Objective:To evaluate the clinical effect of combined therapy with Diosmin Tablets and Mayinglong Musk Hemorrhoids Ointment for patients with acute hemorrhoids.Methods:A total of 50 patients with acute hemorrhoids who visited the hospital from January 2023 to January 2025 were selected as samples and randomly divided into two groups.Group A was treated with Diosmin Tablets combined with Mayinglong Musk Hemorrhoids Ointment,while Group B was treated with Mayinglong Musk Hemorrhoids Ointment only.The efficacy,wound recovery time,perianal pain score,hemorrhoid symptom score,and stress indicators were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The postoperative perianal edema time and wound healing time in Group A were shorter than those in Group B,and the Visual Analog Scale(VAS)score was lower than that in Group B(P<0.05).The hemorrhoid symptom score in Group A was lower than that in Group B(P<0.05).The stress level in Group A was lower than that in Group B(P<0.05).Conclusion:The combination therapy of Diosmin Tablets and Mayinglong Musk Hemorrhoids Ointment for postoperative treatment of acute hemorrhoids can effectively relieve perianal pain,shorten the duration of hemorrhoids,and is highly feasible.展开更多
Objective:To analyze the efficacy of Bifidobacterium triple viable bacteria tablets on neonatal necrotizing enterocolitis(NEC)and its impact on serum factors of the patients.Methods:From January 2021 to May 2025,88 ne...Objective:To analyze the efficacy of Bifidobacterium triple viable bacteria tablets on neonatal necrotizing enterocolitis(NEC)and its impact on serum factors of the patients.Methods:From January 2021 to May 2025,88 neonates with NEC admitted to our hospital were selected as study subjects.During the study,these 88 patients were evenly divided into two groups,namely the observation group and the control group,with 44 patients in each group based on the random number table method.In terms of treatment,the control group was treated with meropenem,while the observation group received additional treatment with Bifidobacterium triple viable bacteria powder based on the treatment plan of the control group.The clinical efficacy and differences in serum inflammatory factor levels between the two groups were compared.Results:The efficacy of the observation group(90.91%)was better than that of the control group(72.73%)(P<0.05).After treatment,the levels of C-reactive protein(CRP)and procalcitonin(PCT)in both groups decreased compared to those before treatment,and the values of the above indicators in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on conventional treatment for NEC neonates,the use of Bifidobacterium triple viable bacteria tablets has significant efficacy and can effectively reduce serum inflammatory factor levels.展开更多
OBJECTIVE:To examine Hedan tablet(HDT,荷丹片)'s potential mechanisms in hyperlipidemic rats induced by a high-fat diet(HFD),as well as its regulatory effects and primary active constituents.METHODS:By using ultra-...OBJECTIVE:To examine Hedan tablet(HDT,荷丹片)'s potential mechanisms in hyperlipidemic rats induced by a high-fat diet(HFD),as well as its regulatory effects and primary active constituents.METHODS:By using ultra-performance liquid chromatography(UPLC)-quadrupole-time-of-flight(QTOF)-tandem mass spectrometry(MS/MS),the components of HDT that can enter the circulatory system were found,aiming to investigate its active constituents with pharmacological effects.Based on network pharmacology approaches,the relevant HDT targets in the therapy of hyperlipidemia were anticipated.The possible mechanism of HDT for hyperlipidemia treatment was verified by in-vivo experiments,and the main active components of HDT for hyperlipidemia treatment were analyzed via in-vitro experiments.RESULTS:UPLC-QTOF-MS/MS identified 30 components of HDT entering the circulatory system,primarily consisting of flavonoids,diterpenoids and alkaloids.The results of a network pharmacology study revealed that 30 active components mostly target 74 genes associated with hyperlipidemia.The primary active ingredients may include quercetin,kaempferol,and epicatechin,and the main gene targets may be tumor necrosis factor(TNF),interleukin-6(IL-6),interleukin 1 beta(IL-1β),etc.The results of animal experiments demonstrated that HDT can significantly regulate the blood lipid level in rats with HFD,improve the degree of inflammatory infiltration in rat liver cells,lower TNF-α,Creactive protein(CRP),IL-6,matrix metalloproteinase 9(MMP9) and malondialdehyde(MDA) levels while raising total superoxide dismutase(T-SOD) level.Meanwhile,HDT can considerably lower the expression of sterol regulatory element-binding transcription factor 2(SREBF2),3-hydroxy-3-methylglutaryl-CoA reductase(HMGCR),and MMP9 while significantly increasing the expression of peroxisome proliferator-activated receptor alpha(PPAR-α) and PPAR-γ.In vitro study confirmed that quercetin and kaempferol could reduce the levels of IL-6,IL1B,MMP9 and HMGCR in the high-fat model of hepatoma G2 cells.CONCLUSIONS:The mechanism by which HDT treats hyperlipidemia involves modification of the lipid metabolism targets such as downregulating SREBF2,HMGCR and MMP9,and upregulating PPAR-α and PPAR-γ,as well as anti-inflammatory and antioxidant actions.This study provides a pharmacological and biological rationale for the use of HDT in clinical hyperlipidemia management.展开更多
[Objectives]To explore the clinical efficacy of Qinjin Tablet in treating unstable angina with phlegm-stasis syndrome and preliminarily explore its intervention mechanism.[Methods]Sixty unstable angina patients with p...[Objectives]To explore the clinical efficacy of Qinjin Tablet in treating unstable angina with phlegm-stasis syndrome and preliminarily explore its intervention mechanism.[Methods]Sixty unstable angina patients with phlegm-stasis syndrome were randomly divided into a treatment group and a control group(30 each).The control group received standardized Western medicine treatment,while the treatment group also took Qinjin Tablet.After a 4-week treatment,comparisons were made on improvement of angina symptoms,TCM syndrome scores,blood stasis scores,reduction/cessation of short-acting anti-angina drugs,Seattle Angina Questionnaire(SAQ)scores,blood lipid levels,and matrix metalloproteinase-9(MMP-9)concentrations between the two groups.[Results]No statistical differences existed in baseline data like age,gender,and disease duration between the two groups(P>0.05).The treatment group showed significantly better efficacy than the control group in improving angina symptoms,TCM syndrome scores,blood stasis scores,and reduction or discontinuation of short-acting anti-anginal drugs(P<0.05).The SAQ score increase was more significant in the treatment group(P<0.05).The control group significantly reduced low-density lipoprotein cholesterol(LDL-C)(P<0.05),while the treatment group markedly increased high-density lipoprotein cholesterol(HDL-C)(P<0.05).Post-treatment,the treatment group had a marked reduction in serum MMP-9(P<0.05),with no significant change in the control group.[Conclusions]Qinjin Tablet can significantly alleviate clinical symptoms and improve quality of life in UA patients by modulating the HDL-C/MMP-9 signaling pathway.展开更多
OBJECTIVE:To investigate the impact of Shenhua tablet(肾华片,SHT)on renal macrophage polarization and renal injury in mice with diabetic kidney disease(DKD)and to explore the potential mechanism involving the hypoxia-...OBJECTIVE:To investigate the impact of Shenhua tablet(肾华片,SHT)on renal macrophage polarization and renal injury in mice with diabetic kidney disease(DKD)and to explore the potential mechanism involving the hypoxia-inducible factor-1α(HIF-1α)and pyruvate kinase M2(PKM2)signaling pathway,along with the glycolysis metabolism pathway.METHODS:The animals were divided into the following groups:Model,Control,dapagliflozin,SHT low-dose,SHT medium-dose,and SHT high-dose.We assessed 24-hour urine protein(24 h-UTP)levels,urinary albuminto-creatinine ratio,and regularly monitored fasting blood glucose during the treatment period.After treatment,we examined renal tissue structure,renal function(urea nitrogen,uric acid,creatinine,cystatin C,β2-microglobulin),and glycolysis in renal macrophages.Additionally,we observed macrophage polarization in renal tissue and measured inflammatory factors(tumor necrosis factor-α,interleukin-1β,interleukin-6,interleukin-10,monocyte chemoattractant protein-1)to assess the immunoinflammatory status of the renal tissue.Finally,we investigated the expression of the HIF-1α/PKM2 signaling pathway in macrophages to explore its role in the glycolysis process.RESULTS:SHT shows a beneficial effect in treating DKD by reducing 24 h-UTP,regulating blood glucose levels,improving renal tissue structure,protecting renal function,inhibiting macrophage glycolysis,reducing macrophage transformation to the M1 state,and suppressing the expression of the HIF-1α/PKM2 signaling pathway.CONCLUSION:SHT may exert renoprotective effects by inhibiting macrophage glycolysis via the HIF-1α/PKM2 signaling pathway.This inhibition decreases macrophage M1 polarization and reduces immunoinflammatory injury in the renal tissue of DKD mice.展开更多
This article presents a case study of a 20-year-old male patient diagnosed with dilated cardiomyopathy(DCM)(NYHA IV).This condition was diagnosed as"heart failure disease"(water overflowing due to yang defic...This article presents a case study of a 20-year-old male patient diagnosed with dilated cardiomyopathy(DCM)(NYHA IV).This condition was diagnosed as"heart failure disease"(water overflowing due to yang deficiency,intermingled phlegm and stasis)in traditional Chinese medicine(TCM).The treatment approach employed a combination of TCM and Western medicine.Western medicine involved the administration of sacubitril valsartan sodium tablets to inhibit ventricular remodeling,in conjunction with diuretics and cardiotonic agents.Initially,TCM utilized a static infusion of Shenfu injection,which was subsequently supplemented with Qiliqiangxin capsules to invigorate qi,warm yang,activate blood circulation,and promote diuresis.After a follow-up period of 3 years,the patient's ejection fraction(EF)improved from 23%to 51%,and the left ventricular end diastolic diameter(LVed)decreased from 68 to 52 mm,accompanied by a significant alleviation of symptoms.These findings indicate that the combined treatment of TCM and Western medicine can synergistically enhance cardiac function and impede the progression of the disease,thereby offering valuable insights for the optimal management of DCM.展开更多
Objective:To analyze the therapeutic efficacy of Shexiang Baoxin Pill combined with Rosuvastatin Calcium Tablets(ROS)in patients with angina pectoris due to coronary atherosclerotic heart disease(CHD-AP).Methods:Eight...Objective:To analyze the therapeutic efficacy of Shexiang Baoxin Pill combined with Rosuvastatin Calcium Tablets(ROS)in patients with angina pectoris due to coronary atherosclerotic heart disease(CHD-AP).Methods:Eighty CHD-AP patients admitted for treatment from January 2023 to December 2024 were selected and evenly divided using a random number table.The combined group(40 cases)received treatment with Shexiang Baoxin Pill combined with ROS,while the reference group(40 cases)received ROS monotherapy.The overall response rate,frequency and duration of AP attacks,blood lipid levels,and cardiac function indicators were compared between the two groups.Results:The combined group exhibited a higher overall response rate than the reference group.After treatment,the frequency and duration of AP attacks were lower in the combined group than in the reference group.Additionally,blood lipid levels and cardiac function indicators were superior in the combined group(p<0.05).Conclusion:The combination of Shexiang Baoxin Pill and ROS demonstrates favorable therapeutic effects in CHD-AP patients,effectively preventing AP attacks,regulating blood lipid levels,protecting cardiac function,and reducing disease risk.展开更多
目的:评估参郁宁神片(宁郁异形片)治疗轻度至中度抑郁症患者的临床疗效和安全性。方法:采用多中心、随机、双盲双模拟设计,纳入572例符合中国精神障碍分类方案与诊断标准(The Chinese Classification of Mental Disorders, Third Editio...目的:评估参郁宁神片(宁郁异形片)治疗轻度至中度抑郁症患者的临床疗效和安全性。方法:采用多中心、随机、双盲双模拟设计,纳入572例符合中国精神障碍分类方案与诊断标准(The Chinese Classification of Mental Disorders, Third Edition, CCMD-3)且基线汉密尔顿抑郁量表(Hamilton Depression Rating Scale, HAMD)-17评分为14~24分的受试者,随机分为3组:参郁宁神片组(2.4 g,tid,n=344)、盐酸氟西汀组(10 mg·d^(-1)首周,20 mg·d^(-1)后续7周,n=115)及安慰剂组(n=113),持续治疗8周。主要终点为HAMD-17评分自基线至第8周的组间差异,采用改良意向治疗分析集,与阳性药组进行非劣效性检验(非劣效界值=2.5),与安慰剂进行差异性检验。结果:治疗8周后,参郁宁神片组HAMD-17评分较基线降低(10.50±4.46)分,显著优于安慰剂组[(7.03±5.07),P<0.05],与盐酸氟西汀组(10.13±3.94)的组间差异为-0.25(95%CI[-1.18,0.68]),达到非劣效标准。安全性分析显示,参郁宁神片组未报告药物相关不良事件(0%vs盐酸氟西汀组8.8%)。结论:参郁宁神片在改善轻中度抑郁症状方面呈现与盐酸氟西汀相当的临床疗效,且具有更优的安全性特征。该结果为参郁宁神片在抑郁症治疗领域的应用提供了高级别循证医学证据。展开更多
文摘Confucius’imminent birth is heralded by the appearance of the qilin.The mythical one-horned animal came to his mother at the door and cast out of its mouth a jade tablet bearing an inscription saying that she would give birth to“the son of the refinement of water,and that he would succeed the Zhou Dynasty,but as a king without a throne(su wang).”Stunned,Yan Zhengzai–Confucius’mother–tied an embroidered ribbon around the horn of the qilin,and the animal stayed for two nights.
基金Supported by University of Malaya Research Grant,Project No.RG536-13HTM
文摘AIM: To compare same-day whole-dose vs split-dose of 2-litre polyethylene glycol electrolyte lavage solution (PEG-ELS) plus bisacodyl for colon cleansing for morning colonoscopy.
文摘To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODSFrom February 2015 to March 2015, examinees of average risk who were scheduled for a colonoscopy in the morning were retrospectively enrolled.RESULTSThe 189 examinees were divided into split-dose and non-split-dose groups. The adequacy of bowel preparation for the split-dose group vs the non-split-dose group was 96.8% vs 85.2%, respectively, P < 0.001, and the compliance of the last meal restriction was 74.6% vs 58.2%, respectively, P < 0.001. The sleep disturbance (P < 0.001) was more prevalent in the split-dose group, however the willingness to repeat the same preparation method (P = 0.243) was not different in both groups. The split-dose regimen was the most important factor influencing adequate bowel preparation in multivariate analysis (HR = 10.89, 95%CI: 6.53-18.17, P < 0.001).CONCLUSIONA split-dose regimen of 2 L PEG/AA for an early morning colonoscopy was more effective and showed better compliance for diet restriction without any difference in satisfaction and discomfort. Introducing a split-dose regimen of 2 L PEG/AA to morning colonoscopy examinees is effective and tolerable in a comprehensive medical check-up setting.
基金Supported by Startup Fund for scientific research,Fujian Medical University,No. 2019QH1181
文摘BACKGROUND Split-dose regimens(SpDs)of 4 L of polyethylene glycol(PEG)have been established as the“gold standard”for bowel preparation;however,its use is limited by the large volumes of fluids required and sleep disturbance associated with night doses.Meanwhile,the same-day single-dose regimens(SSDs)of PEG has been recommended as an alternative;however,its superiority compared to other regimens is a matter of debate.AIM To compare the efficacy and tolerability between SSDs and large-volume SpDs PEG for bowel preparation.METHODS We searched MEDLINE/PubMed,the Cochrane Library,RCA,EMBASE and Science Citation Index Expanded for randomized trials comparing(2 L/4 L)SSDs to large-volume(4 L/3 L)SpDs PEG-based regimens,regardless of adjuvant laxative use.The pooled analysis of relative risk ratio and mean difference was calculated for bowel cleanliness,sleep disturbance,willingness to repeat the procedure using the same preparation and adverse effects.A random effects model or fixed-effects model was chosen based on heterogeneity analysis among studies.RESULTS A total of 18 studies were included.There was no statistically significant difference of adequate bowel preparation(relative risk=0.97;95%CI:0.92-1.02)(14 trials),right colon Boston Bowel Preparation Scale(mean difference=0.00;95%CI:-0.04,0.03)(9 trials)and right colon Ottawa Bowel Preparation Scale(mean difference=0.04;95%CI:-0.27,0.34)(5 trials)between(2 L/4 L)SSDs and large-volume(4 L/3 L)SpDs,regardless of adjuvant laxative use.The pooled analysis favored the use of SSDs with less sleep disturbance(relative risk=0.52;95%CI:0.40,0.68)and lower incidence of abdominal pain(relative risk=0.75;95%CI:0.62,0.90).During subgroup analysis,patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation than SpDs(P<0.05).No significant difference in adverse effects,including nausea,vomiting and bloating,was found between the two arms(P>0.05).CONCLUSION Regardless of adjuvant laxative use,the(2 L/4 L)SSD PEG-based arm was considered equal or better than the large-volume(≥3 L)SpDs PEG regimen in terms of bowel cleanliness and tolerability.Patients that received low-volume(2 L)SSDs showed more willingness to repeat the procedure using the same preparation due to the low-volume fluid requirement and less sleep disturbance.
文摘BACKGROUND Quality of bowel preparation in afternoon colonoscopies has been a struggle.Currently,a choice of same-day preparation(SaD)or split-dose preparation(SpD)exists;however,randomized controlled trials’results have varied.AIM To examine the outcomes of SaD and SpD for afternoon colonoscopies.METHODS An extensive literature search was conducted using multiple databases.Only randomized controlled trials(RCTs)in adults that compared SaD to SpD with Ottawa bowel preparation score(OBPS)were included.Odds ratio(OR)or mean difference was used to analyze outcomes.RESULTS Eleven RCTs were included(n=1846).No difference was observed for satisfactory bowel preparation based on OBPS among participants receiving SaD vs SpD(OR 0.77;95%CI:-0.57-1.03;P=0.07;I2=5%).Subgroup analysis showed no difference in terms of satisfactory bowel preparation based on OBPS between the two groups when receiving same preparation formula(polyethylene glycol)(OR 0.83;95%CI:0.51-1.35;P=0.46;I2=39%)as well as receiving same formula and volume(4 L polyethylene glycol)(OR 1.14;95%CI:0.65-2.01;P=0.64;I2=0%).CONCLUSION In patients undergoing afternoon colonoscopies,SaD is comparable with SpD in terms of satisfactory bowel preparation.Further studies are needed to validate these results and determine the optimal formula and dosages.
文摘BACKGROUND Rheumatic immune diseases are a group of chronic inflammatory diseases charac-terized by joint and systemic multi-organ involvement,including rheumatoid arthritis,systemic lupus erythematosus,and Sjogren’s syndrome,among others.The pathogenesis of these diseases is related to the abnormal activation and regulatory imbalance of the immune system.The prevalence and morbidity of rheumatic immune diseases are high,imposing a significant burden on patients'quality of life and socio-economic costs.Currently,the treatment of rheumatic immune diseases mainly relies on Western medicine,such as non-steroidal anti-inflammatory drugs,glucocorticoids,disease-modifying antirheumatic drugs,and biologics.However,the therapeutic effects of Western medicine are not ideal,some patients poorly respond or are resistant to Western medicine,and long-term use often causes various adverse reactions.AIM To systematically evaluate the efficacy and safety of Tripterygium wilfordii gly-cosides tablets combined with Western medicine in the treatment of patients with rheumatic immune diseases.METHODS This study conducted a meta-analysis to systematically evaluate the efficacy and safety of Tripterygium wilfordii glycosides tablets combined with Western medicine for patients with rheumatic immune diseases.Chinese and English databases were searched for randomized controlled trials(RCTs)on the treatment of rheumatic immune diseases with Tripterygium wilfordii glycosides tablets combined with Western medicine.The quality of the included studies was assessed using the Cochrane risk of bias assessment tool.Meta-analysis was performed using RevMan 5.4 software.RESULTS The meta-analysis included 11 RCTs involving 1026 patients with rheumatic immune diseases.The combined treatment significantly reduced the risk of disease recurrence(relative risk=1.07,95%confidence interval:1.01-1.15,P<0.05)and showed no significant heterogeneity(I2=0%,P=0.53),indicating that Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective method to reduce the possibility of postoperative recurrence in patients with rheumatic immune diseases.However,due to the limited number and quality of the studies included,these results should be interpreted with caution.CONCLUSION Tripterygium wilfordii glycosides tablets combined with Western medicine is an effective and safe treatment option for patients with rheumatic immune diseases and can be considered a clinical choice.However,more high-quality research is needed to validate this conclusion and provide more solid evidence for clinical practice.
文摘Objective:To evaluate the efficacy and safety of rasagiline tablets in the treatment of Parkinson’s disease,in order to provide a more scientific basis for the application of the drug in Parkinson’s disease.Methods:This study is a single-arm,prospective,observational study.The trial collected patients with primary Parkinson’s disease who met the inclusion and exclusion criteria after being assessed by the investigator to evaluate the efficacy and safety of rasagiline tablets in the treatment of Parkinson’s disease patients through UPDRSIII and UPDRSII scales,and evaluated the efficacy and safety of rasagiline tablets in the treatment of Parkinson’s disease patients.Results:A total of 3560 patients were included in this study.44.1%of patients had early Parkinson’s disease,52.4%had intermediate Parkinson’s disease,and 3.5%had advanced Parkinson’s disease.The UPDRSIII(exercise capacity)score was 26.76 at baseline,25.47 at 1 month,24.18 at 2 months,and 23.39 at 3 months after treatment,and scores significantly improved over time(P<0.001).The UPDRSII(ability to perform daily living)score was an average of 23.60 at baseline,22.49 at 1 month,21.53 at 2 months,and 21.09 at 3 months after treatment,with statistically significant differences in scores between months(P<0.001).A total of 18 adverse events/reactions occurred in this study,and adverse symptoms eventually disappeared or resolved,without termination due to adverse events/reactions or patient discharge.Conclusion:Rasagiline tablets have significant efficacy in improving daily exercise capacity and living ability in patients with Parkinson’s disease,and have a certain safety,which supports the effectiveness of rasagiline as a treatment for Parkinson’s disease and provides new evidence for its clinical application.
文摘Objective:To evaluate the clinical effect of combined therapy with Diosmin Tablets and Mayinglong Musk Hemorrhoids Ointment for patients with acute hemorrhoids.Methods:A total of 50 patients with acute hemorrhoids who visited the hospital from January 2023 to January 2025 were selected as samples and randomly divided into two groups.Group A was treated with Diosmin Tablets combined with Mayinglong Musk Hemorrhoids Ointment,while Group B was treated with Mayinglong Musk Hemorrhoids Ointment only.The efficacy,wound recovery time,perianal pain score,hemorrhoid symptom score,and stress indicators were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The postoperative perianal edema time and wound healing time in Group A were shorter than those in Group B,and the Visual Analog Scale(VAS)score was lower than that in Group B(P<0.05).The hemorrhoid symptom score in Group A was lower than that in Group B(P<0.05).The stress level in Group A was lower than that in Group B(P<0.05).Conclusion:The combination therapy of Diosmin Tablets and Mayinglong Musk Hemorrhoids Ointment for postoperative treatment of acute hemorrhoids can effectively relieve perianal pain,shorten the duration of hemorrhoids,and is highly feasible.
基金Project Name:Correlation Analysis between Intestinal Flora and Differential Proteins in Intestinal Tissue of Neonatal Necrotizing Enterocolitis(Project No.:FYX202336)。
文摘Objective:To analyze the efficacy of Bifidobacterium triple viable bacteria tablets on neonatal necrotizing enterocolitis(NEC)and its impact on serum factors of the patients.Methods:From January 2021 to May 2025,88 neonates with NEC admitted to our hospital were selected as study subjects.During the study,these 88 patients were evenly divided into two groups,namely the observation group and the control group,with 44 patients in each group based on the random number table method.In terms of treatment,the control group was treated with meropenem,while the observation group received additional treatment with Bifidobacterium triple viable bacteria powder based on the treatment plan of the control group.The clinical efficacy and differences in serum inflammatory factor levels between the two groups were compared.Results:The efficacy of the observation group(90.91%)was better than that of the control group(72.73%)(P<0.05).After treatment,the levels of C-reactive protein(CRP)and procalcitonin(PCT)in both groups decreased compared to those before treatment,and the values of the above indicators in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on conventional treatment for NEC neonates,the use of Bifidobacterium triple viable bacteria tablets has significant efficacy and can effectively reduce serum inflammatory factor levels.
基金the National Natural Science Foundation of China:Effects of Hawthorn Leaves Flavonoids on Atherosclerosis Unstable Plaques based on the Mechanism of Liver-gut axis Liver X Receptor (LXR-a)-mediated Iron and Lipid Metabolism Disorders (No.82260794)the Natural Science Foundation of Jiangxi Province:based on Secreted Phospholipase A2 TypeⅡA (sPLA2-ⅡA) Regulating Lipid Mediated Foam Cell Formation to Explore the Effect and Molecular Mechanism of Hawthorn Leaf Flavonoids on Antiatherosclerosis (No.20212BAB206013)+1 种基金the Key R&D Program of Jiangxi Province:Research on the Quality Enhancement and Industrialization Technology Improvement of the Lipid-Lowering Traditional Chinese Medicine"Hedan Tablet"(No.20201BBG71005)Science and Technology Project of Jiangxi Provincial Department of Education:based on the"Phlegm-Stasis"Theory to Explore the Effects and Molecular Mechanisms of Hawthorn Leaves Flavonoids on Improving Iron and Lipid Metabolism Disorders in Atherosclerosis (No.GJJ2203502)。
文摘OBJECTIVE:To examine Hedan tablet(HDT,荷丹片)'s potential mechanisms in hyperlipidemic rats induced by a high-fat diet(HFD),as well as its regulatory effects and primary active constituents.METHODS:By using ultra-performance liquid chromatography(UPLC)-quadrupole-time-of-flight(QTOF)-tandem mass spectrometry(MS/MS),the components of HDT that can enter the circulatory system were found,aiming to investigate its active constituents with pharmacological effects.Based on network pharmacology approaches,the relevant HDT targets in the therapy of hyperlipidemia were anticipated.The possible mechanism of HDT for hyperlipidemia treatment was verified by in-vivo experiments,and the main active components of HDT for hyperlipidemia treatment were analyzed via in-vitro experiments.RESULTS:UPLC-QTOF-MS/MS identified 30 components of HDT entering the circulatory system,primarily consisting of flavonoids,diterpenoids and alkaloids.The results of a network pharmacology study revealed that 30 active components mostly target 74 genes associated with hyperlipidemia.The primary active ingredients may include quercetin,kaempferol,and epicatechin,and the main gene targets may be tumor necrosis factor(TNF),interleukin-6(IL-6),interleukin 1 beta(IL-1β),etc.The results of animal experiments demonstrated that HDT can significantly regulate the blood lipid level in rats with HFD,improve the degree of inflammatory infiltration in rat liver cells,lower TNF-α,Creactive protein(CRP),IL-6,matrix metalloproteinase 9(MMP9) and malondialdehyde(MDA) levels while raising total superoxide dismutase(T-SOD) level.Meanwhile,HDT can considerably lower the expression of sterol regulatory element-binding transcription factor 2(SREBF2),3-hydroxy-3-methylglutaryl-CoA reductase(HMGCR),and MMP9 while significantly increasing the expression of peroxisome proliferator-activated receptor alpha(PPAR-α) and PPAR-γ.In vitro study confirmed that quercetin and kaempferol could reduce the levels of IL-6,IL1B,MMP9 and HMGCR in the high-fat model of hepatoma G2 cells.CONCLUSIONS:The mechanism by which HDT treats hyperlipidemia involves modification of the lipid metabolism targets such as downregulating SREBF2,HMGCR and MMP9,and upregulating PPAR-α and PPAR-γ,as well as anti-inflammatory and antioxidant actions.This study provides a pharmacological and biological rationale for the use of HDT in clinical hyperlipidemia management.
基金Supported by Jiangsu Provincial Traditional Chinese Medicine Leading Talent Training Project[Su TCM Science-Education(2023)17]National Administration of Traditional Chinese Medicine Fifth Batch of National Excellent Clinical Talent Training Project[TCM Personnel-Education(2022)1].
文摘[Objectives]To explore the clinical efficacy of Qinjin Tablet in treating unstable angina with phlegm-stasis syndrome and preliminarily explore its intervention mechanism.[Methods]Sixty unstable angina patients with phlegm-stasis syndrome were randomly divided into a treatment group and a control group(30 each).The control group received standardized Western medicine treatment,while the treatment group also took Qinjin Tablet.After a 4-week treatment,comparisons were made on improvement of angina symptoms,TCM syndrome scores,blood stasis scores,reduction/cessation of short-acting anti-angina drugs,Seattle Angina Questionnaire(SAQ)scores,blood lipid levels,and matrix metalloproteinase-9(MMP-9)concentrations between the two groups.[Results]No statistical differences existed in baseline data like age,gender,and disease duration between the two groups(P>0.05).The treatment group showed significantly better efficacy than the control group in improving angina symptoms,TCM syndrome scores,blood stasis scores,and reduction or discontinuation of short-acting anti-anginal drugs(P<0.05).The SAQ score increase was more significant in the treatment group(P<0.05).The control group significantly reduced low-density lipoprotein cholesterol(LDL-C)(P<0.05),while the treatment group markedly increased high-density lipoprotein cholesterol(HDL-C)(P<0.05).Post-treatment,the treatment group had a marked reduction in serum MMP-9(P<0.05),with no significant change in the control group.[Conclusions]Qinjin Tablet can significantly alleviate clinical symptoms and improve quality of life in UA patients by modulating the HDL-C/MMP-9 signaling pathway.
基金National Natural Science Foundation of China:Basic Research on the Mechanism of Organ Immune Damage and the Diagnosis and Treatment of Integrated Traditional Chinese and Western Medicine(No.32141005)。
文摘OBJECTIVE:To investigate the impact of Shenhua tablet(肾华片,SHT)on renal macrophage polarization and renal injury in mice with diabetic kidney disease(DKD)and to explore the potential mechanism involving the hypoxia-inducible factor-1α(HIF-1α)and pyruvate kinase M2(PKM2)signaling pathway,along with the glycolysis metabolism pathway.METHODS:The animals were divided into the following groups:Model,Control,dapagliflozin,SHT low-dose,SHT medium-dose,and SHT high-dose.We assessed 24-hour urine protein(24 h-UTP)levels,urinary albuminto-creatinine ratio,and regularly monitored fasting blood glucose during the treatment period.After treatment,we examined renal tissue structure,renal function(urea nitrogen,uric acid,creatinine,cystatin C,β2-microglobulin),and glycolysis in renal macrophages.Additionally,we observed macrophage polarization in renal tissue and measured inflammatory factors(tumor necrosis factor-α,interleukin-1β,interleukin-6,interleukin-10,monocyte chemoattractant protein-1)to assess the immunoinflammatory status of the renal tissue.Finally,we investigated the expression of the HIF-1α/PKM2 signaling pathway in macrophages to explore its role in the glycolysis process.RESULTS:SHT shows a beneficial effect in treating DKD by reducing 24 h-UTP,regulating blood glucose levels,improving renal tissue structure,protecting renal function,inhibiting macrophage glycolysis,reducing macrophage transformation to the M1 state,and suppressing the expression of the HIF-1α/PKM2 signaling pathway.CONCLUSION:SHT may exert renoprotective effects by inhibiting macrophage glycolysis via the HIF-1α/PKM2 signaling pathway.This inhibition decreases macrophage M1 polarization and reduces immunoinflammatory injury in the renal tissue of DKD mice.
文摘This article presents a case study of a 20-year-old male patient diagnosed with dilated cardiomyopathy(DCM)(NYHA IV).This condition was diagnosed as"heart failure disease"(water overflowing due to yang deficiency,intermingled phlegm and stasis)in traditional Chinese medicine(TCM).The treatment approach employed a combination of TCM and Western medicine.Western medicine involved the administration of sacubitril valsartan sodium tablets to inhibit ventricular remodeling,in conjunction with diuretics and cardiotonic agents.Initially,TCM utilized a static infusion of Shenfu injection,which was subsequently supplemented with Qiliqiangxin capsules to invigorate qi,warm yang,activate blood circulation,and promote diuresis.After a follow-up period of 3 years,the patient's ejection fraction(EF)improved from 23%to 51%,and the left ventricular end diastolic diameter(LVed)decreased from 68 to 52 mm,accompanied by a significant alleviation of symptoms.These findings indicate that the combined treatment of TCM and Western medicine can synergistically enhance cardiac function and impede the progression of the disease,thereby offering valuable insights for the optimal management of DCM.
文摘Objective:To analyze the therapeutic efficacy of Shexiang Baoxin Pill combined with Rosuvastatin Calcium Tablets(ROS)in patients with angina pectoris due to coronary atherosclerotic heart disease(CHD-AP).Methods:Eighty CHD-AP patients admitted for treatment from January 2023 to December 2024 were selected and evenly divided using a random number table.The combined group(40 cases)received treatment with Shexiang Baoxin Pill combined with ROS,while the reference group(40 cases)received ROS monotherapy.The overall response rate,frequency and duration of AP attacks,blood lipid levels,and cardiac function indicators were compared between the two groups.Results:The combined group exhibited a higher overall response rate than the reference group.After treatment,the frequency and duration of AP attacks were lower in the combined group than in the reference group.Additionally,blood lipid levels and cardiac function indicators were superior in the combined group(p<0.05).Conclusion:The combination of Shexiang Baoxin Pill and ROS demonstrates favorable therapeutic effects in CHD-AP patients,effectively preventing AP attacks,regulating blood lipid levels,protecting cardiac function,and reducing disease risk.
