The FuTURE 4G Time Division Duplex (TDD) trial system uses 3.5 GHz carrier frequency and several crucial technologies including broadband Multiple Input Multiple Output (MIMO) and Orthogonal Frequency Division Multipl...The FuTURE 4G Time Division Duplex (TDD) trial system uses 3.5 GHz carrier frequency and several crucial technologies including broadband Multiple Input Multiple Output (MIMO) and Orthogonal Frequency Division Multiplexing (OFDM). These technologies challenge the link budget and networking analysis of the FuTURE 4G TDD trial network. This paper analyzes the practical 3.5 GHz propagation model and the link budget of Radio Frequency (RF) parameters of the trial system. Moreover,it introduces networking analysis and network planning of the trial system,which combines the field test results of the MIMO system. The FuTURE 4G TDD trial system and its trial network have been accomplished with successful checkup. The trial system fulfills all the requirements with two Access Points (AP) and three Mobile Terminals (MT),which supports multi-user,mobility,a high peak rate of 100 Mb/s,High-Definition TV (HDTV),high-speed data download,and Voice over IP (VoIP) services.展开更多
Objective To study the extended clinical trial systems in the United States,the European Union and Australia,and to provide a reference for the improvement of China’s extended clinical trial system.Methods Literature...Objective To study the extended clinical trial systems in the United States,the European Union and Australia,and to provide a reference for the improvement of China’s extended clinical trial system.Methods Literature research method,risk management analysis method and comparative research were used in this paper to analyze the development history,scope of use,status quo of the extended clinical trial systems in the United States,the European Union,and Australia.Then,the current situation and shortcomings of China’s extended clinical trial system were compare with these foreign countries so as to put forward some suggestions for improvement.Results and Conclusion China should improve existing laws and regulations by establishing a fast application procedure,increasing application channels,and providing an information disclosure platform to meet the needs of patients in extended clinical trials.展开更多
Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we exa...Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we examined the effectiveness of the SHURUI single-port robotic surgical system in urological interventions.The first 50 patients from four centers in China underwent single-port surgeries including partial nephrectomy,radical prostatectomy,partial adrenalectomy,and pyeloureteroplasty,exclusively by the SHURUI single-port robotic surgical system.The study's primary endpoints focused on the success of surgeries,defined as no deviations from planned procedures,no need for more than one port,and no re-operations within 24 h after surgery.Secondary endpoints encompassed a range of surgical metrics,functional outcomes,and patient demographic data.Clinical assessments were conducted before surgery,before discharge,and 1 month after discharge.Results:The surgical procedures were executed successfully without requiring intraoperative conversions or transfusions.Both estimated blood loss and operation durations were maintained within satisfactory limits.For each type of surgery,the mean console times and estimated blood loss were 179.8(standard deviation[SD]39.4)min and 125.6(SD 126.0)mL for radical prostatectomy,126.7(SD 47.8)min and 39.2(SD 54.4)mL for partial nephrectomy,112.6(SD 37.4)min and 20.0(SD 13.2)mL for partial adrenalectomy,and 148.0(SD 18.2)min and 18.0(SD 17.9)mL for pyeloureteroplasty,respectively.Across the cohort,17 patients experienced a total of 25 adverse events,while 10 postoperative complications,all rated as Clavien-Dindo grade I,were encountered by eight patients.All patients had shown recovery or improvement from these events before the end of this trial.Conclusion:The SHURUI single-port robotic surgical system demonstrated feasibility and safety in the performance of major urological surgeries.These initial findings highlight the system's potential,though further research and longer follow-up are required to assess long-term outcomes.展开更多
Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systemat...Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systematic review and meta-analysis examined the effect of HP treatment on clinical and laboratory parameters in NAFLD patients.Methods We conducted a literature search of the PubMed,Embase,Scopus,and Web of Science databases through Septem-ber 2023 for randomized controlled trials(RCTs)examining the effect of HP treatment on NAFLD patients versus lifestyle changes alone.The primary outcome was the change in steatosis parameters.The secondary endpoints were changes in anthropometric parameters,inflammatory markers(TNF-α),and metabolic parameters(fasting blood glucose,homeostasis model assessment of insulin resistance,AST/ALT,and lipid profile).The random effects model was used to calculate the standardized mean difference(SMD)with associated 95%confidence intervals(CIs)for our desired outcome.Results Four RCTs met our inclusion criteria.A total of 453 patients were included(mean age 42.8 years,58.5%males),228(50.3%)of whom were in the HP eradication group and 225(49.7%)of whom were in the lifestyle modification group.Compared with lifestyle modification alone,HP eradication had a significant effect on reducing liver steatosis and TNF-αlevels(SMD:-0.9;95%CI-14.67,-3.82,I^(2)=0%and SMD:-6.3;95%CI-9.04,-3.56,I^(2)=0%,respectively).No sig-nificant effect on other metabolic parameters was found.Conclusions HP eradication significantly reduced liver steatosis and TNF-αlevels in NAFLD patients.However,HP eradi-cation did not significantly affect other metabolic indices compared to lifestyle changes alone.展开更多
BACKGROUND Systematic reviews(SRs)synthesize and evaluate data,mainly from randomized trials,which then guides the development of clinical recommendations in evidence-based medicine.However,the data and methodological...BACKGROUND Systematic reviews(SRs)synthesize and evaluate data,mainly from randomized trials,which then guides the development of clinical recommendations in evidence-based medicine.However,the data and methodological information in the included papers can often be lacking or unclear,and reviewers usually need to contact the authors of included studies for clarifications.Contacting authors is recommended,but it is unclear how often SR teams do it,or what the level of response is.AIM To investigate how often reviewers undertake contact with the authors of included randomized controlled trials(RCTs)for clarification on data and risk of bias concerns,to explore the factors that influence whether SR authors contact or do not contact the authors,and the content and level of responses.METHODS We conducted a systematic electronic database search in MEDLINE using the search string“(systematic review)”AND“(RCT OR randomized OR trial)”for articles published between 1 January 2024 and 19 February 2024,without language restrictions.Screening and data extraction was done independently by two reviewers,and conflicts resolved by a senior author.Contact authors of included SRs were contacted for clarifications.RESULTS Of the 329 included SRs,38%(n=125)explicitly mentioned contact with the authors of included studies.The remaining 62%(n=204)did not.We attempted contact with all SR teams for clarifications and received 90 responses(19.4%).Of the 50 respondents who did not explicitly mention contact in their SRs,25(50%)replied that they did make contact.We received a total of 64 responses on the level and content of information sought.The mean±SD contacts SR teams made were 10(10),replies received 5(6.7),and response waiting time 10.1(28.3)weeks.Resources,time,poor previous experience,perceived likelihood of poor response and bias concerns were reported as barriers to attempting contact.CONCLUSION The majority of SRs published in 2024 did not confirm seeking clarifying or missing information from primary study authors.However,SR teams reported that 50%of contacted primary authors respond.Additional research can clarify this rate of response and establish methods to increase the integration of this core methodological element in SRs.展开更多
BACKGROUND Pediatric short bowel syndrome(SBS)poses management challenges,and teduglutide is a potential therapy.However,comprehensive data on its pediatric safety are lacking.AIM To evaluate the impact of teduglutide...BACKGROUND Pediatric short bowel syndrome(SBS)poses management challenges,and teduglutide is a potential therapy.However,comprehensive data on its pediatric safety are lacking.AIM To evaluate the impact of teduglutide on infection and gastrointestinal adverse events in pediatric SBS patients via systematic review and meta-analysis.METHODS Following PRISMA 2009 guidelines and PROSPERO registration,we searched PubMed,Web of Science,and EMBASE for randomized controlled trials(RCTs)(pediatric SBS patients≤18 years;teduglutide vs placebo/standard care).Two reviewers screened studies,extracted data,and assessed bias(ROB2).Metaanalyses used RevMan 5.4(Mantel-Haenszel method,random-effects if I^(2)≠0).Trial sequential analysis and GRADE were applied.RESULTS Three RCTs involving 115 pediatric patients were included.Pooled analysis revealed no statistically significant differences between the teduglutide and control groups for the primary outcome of infection events[RR=0.83;(95%CI:0.44-1.56);P=0.57;I^(2)=0%;2 studies,n=55].Similarly,no significant differences were found for secondary outcomes:Upper respiratory tract infection[RR=0.68;(95%CI:0.32-1.47);P=0.33;I^(2)=0%],catheter site infection[RR=1.86;(95%CI:0.23-14.78);P=0.56;I^(2)=0%],vomiting[RR=1.35;(95%CI:0.10-18.23);P=0.82;I^(2)=72%],abdominal pain[RR=2.47;(95%CI:0.50-12.16);P=0.27;I^(2)=0%],nausea[RR=1.31;(95%CI:0.24-7.22);P=0.75;I^(2)=0%],diarrhea[RR=1.02;(95%CI:0.23-4.43);P=0.98;I^(2)=0%],and abdominal distension[RR=1.49;(95%CI:0.18-12.35);P=0.71;I^(2)=0%].The overall certainty of evidence assessed by GRADE was moderate.CONCLUSION Teduglutide does not increase infection or gastrointestinal adverse event risk in pediatric SBS,but small sample sizes limit conclusions.Larger studies are needed.展开更多
BACKGROUND Prolonged immobility during intensive care unit(ICU)admission has been a cause of muscle atrophy and worsening functional outcomes with longer recovery times.Prior research has demonstrated that mobilizatio...BACKGROUND Prolonged immobility during intensive care unit(ICU)admission has been a cause of muscle atrophy and worsening functional outcomes with longer recovery times.Prior research has demonstrated that mobilization within a week of ICU admission potentially benefits physical function in critically ill patients.AIM To evaluate the effects of initiating mobilization within 72 hours of ICU admission in critically ill patients through an updated systematic review and meta-analysis.METHODS A systematic search was performed through MEDLINE,Scopus,and Cochrane Library from inception until September 2024 for randomized controlled trials(RCTs)comparing early mobilization(EM)with usual or conventional care in critically ill adult patients.Primary outcomes included length of ICU(days)and ventilation duration(days).Secondary outcomes included muscle strength,functional status,adverse events,all-cause mortality,and quality of life(QOL).A random effects meta-analysis was performed for pooled effect estimates and to derive risk ratios(RR)and corresponding 95%confidence intervals(CI).RESULTS Out of 3487 results,16 RCTs were included with a population of 2385 patients(1195 receiving EM and 1190 with usual care.)A significant reduction in the length of ICU stays[mean difference(MD)=-1.02,95%CI:-1.96 to-0.09;P=0.03;I2=60%]and ventilation duration(MD=-1.07,95%CI:-1.91 to-0.23,P=0.01;I2=57%)was observed in the EM group compared to usual care.EM significantly improved muscle strength[standard MD(SMD)=0.47,95%CI:0.18-0.75,P=0.001;I2=79%]and functional status(SMD=0.70,95%CI:0.40-1.00,P<0.00001;I2=81%)in ICU patients.No statistically significant difference was observed in adverse events(RR=1.72,95%CI:1.01-2.94,P=0.05;I2=31%),all-cause mortality(RR=1.10,95%CI:0.79-1.53,P=0.57;I2=30%),and QOL(SMD=0.04,95%CI:-0.07-0.15,P=0.50;I2=9%)between the two groups.CONCLUSION Initiating mobilization within 72 hours of ICU admission is associated with improved functional outcomes and reduced ICU length of stay and ventilation duration.These findings indicate that EM may be a safe option for ICU patients,contributing to lower recovery times and healthcare costs.Further extensive research is required to validate the long-term effects on survival and QOL.展开更多
Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroa...Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.展开更多
Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of U...Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of UC remain elusive. Currenttherapeutic approaches, including anti-inflammatory, immunosuppressiveand immunomodulating agents, are often limited in efficacy and frequently associatedwith adverse drug reactions. Therefore, there is an urgent need to developsafer and more effective treatment strategies to address the limitations of existingtherapies. Scutellaria baicalensis Georgi (HQ), a traditional Chinese medicinal herb,has been employed in the treatment of UC for over 2000 years. Recent studieshave demonstrated that HQ contains multiple active components capable oftreating UC through anti-inflammation, immune modulation, intestinal barrierprotection, antioxidant activity, and regulation of the gut microbiota. This paperreviews recent studies on the mechanism of action and clinical trials of HQ intreating UC based on relevant literature, with the aim of providing valuable insightsinto future treatment approaches.展开更多
In constructing a smart court,to provide intelligent assistance for achieving more efficient,fair,and explainable trial proceedings,we propose a full-process intelligent trial system(FITS).In the proposed FITS,we intr...In constructing a smart court,to provide intelligent assistance for achieving more efficient,fair,and explainable trial proceedings,we propose a full-process intelligent trial system(FITS).In the proposed FITS,we introduce essential tasks for constructing a smart court,including information extraction,evidence classification,question generation,dialogue summarization,judgment prediction,and judgment document generation.Specifically,the preliminary work involves extracting elements from legal texts to assist the judge in identifying the gist of the case efficiently.With the extracted attributes,we can justify each piece of evidence’s validity by establishing its consistency across all evidence.During the trial process,we design an automatic questioning robot to assist the judge in presiding over the trial.It consists of a finite state machine representing procedural questioning and a deep learning model for generating factual questions by encoding the context of utterance in a court debate.Furthermore,FITS summarizes the controversy focuses that arise from a court debate in real time,constructed under a multi-task learning framework,and generates a summarized trial transcript in the dialogue inspectional summarization(DIS)module.To support the judge in making a decision,we adopt first-order logic to express legal knowledge and embed it in deep neural networks(DNNs)to predict judgments.Finally,we propose an attentional and counterfactual natural language generation(AC-NLG)to generate the court’s judgment.展开更多
AIM:To systematically evaluate and update evidence on the efficacy and safety of probiotic supplementation for the treatment of constipation. METHODS:The MEDLINE,EMBASE,CINAHL,and Cochrane Library databases were searc...AIM:To systematically evaluate and update evidence on the efficacy and safety of probiotic supplementation for the treatment of constipation. METHODS:The MEDLINE,EMBASE,CINAHL,and Cochrane Library databases were searched in May 2009 for randomised controlled trials(RCTs)performed in paediatric or adult populations related to the study aim. RESULTS:We included five RCTs with a total of 377 subjects(194 in the experimental group and 183 in the control group).The participants were adults (three RCTs,n=266)and children(two RCTs,n= 111)with constipation.In adults,data suggests a favourable effect of treatment with Bifidobacterium lactis DN-173 010,Lactobacillus casei Shirota,and Escherichia coli Nissle 1917 on defecation frequency and stool consistency.In children,L.casei rhamnosusLcr35,but not L.rhamnosus GG,showed a beneficial effect. CONCLUSION:Until more data are available,we believe the use of probiotics for the treatment of constipation condition should be considered investigational.展开更多
OBJECTIVE:To evaluated the effectiveness and safety of Chinese herbal medicines(CHMs)for coronary heart disease(CHD)complicated with anxiety.METHODS:Randomized controlled clinical trials(RCTs)with parallel-groups were...OBJECTIVE:To evaluated the effectiveness and safety of Chinese herbal medicines(CHMs)for coronary heart disease(CHD)complicated with anxiety.METHODS:Randomized controlled clinical trials(RCTs)with parallel-groups were included after searching through electric-databases from inception to May,2017.Meta-analysis was undertaken with Rev Man 5.3 software.RESULTS:Twenty-three RCTs enrolling 1654 patients were included in this systematic review.The combination therapy(CHMs combined with anxiolytic)appeared to be superior to anxiolytic in terms of reducing the score of Zung Self-rating Anxiety scale(SAS)(mean Difference(MD),-12.25;95%confidence interval(CI),-14.01 to-10.48,eliminating method;MD,-3.92;95%CI,-5.48 to-2.35,tranquilizing method),improving the total effect rate(relative risk(RR),1.26;95%CI,1.08 to 1.46,eliminating method)and reducing the TCM symptoms scores(MD,-2.24;95%CI,-4.25 to-0.23,tranquilizing method)with a lower incidence of adverse events(RR,0.46;95%CI,0.25 to 0.85,tonifying method).CHMs demonstrated benefits in lowering the score of Hamilton Anxiety Rating scale(MD,-6.77;95%CI,-8.16 to-5.37,tonifying method),lowering the score of SAS(MD,-10.1;95%CI,-13.73 to-6.30,tonifying method)and reducing the TCM symptoms scores(MD,-2.18;95%CI,-3.12 to-1.24,tranquilizing method).CONCLUSION:We got a low evidence that CHMs,which had less side effects,showed potentially benefits to patients with CHD complicated with anxiety.While the results should be interpreted with caution.Trails with higher quality are required to verify the effectiveness and safety of CHMs for CHD complicated with anxiety.展开更多
OBJECTIVE： This is a review of the effects of Chi- nese herbal medicine （CHM） used alone to treat lumbar disc herniation （LDH）. METHORDS： A literature search of the following electronic databases from their ince...OBJECTIVE： This is a review of the effects of Chi- nese herbal medicine （CHM） used alone to treat lumbar disc herniation （LDH）. METHORDS： A literature search of the following electronic databases from their inception to Febru- ary 2013 was conducted： Chinese Biomedical data- bases, Chinese National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, Cochrane Library, Web of Sci- ence, MEDLINE, and EMBASE. Randomized con- trolled trials where CHM had been used to treat LDH were selected. Data extraction, quality assess- ment, and data analysis were carried out by two in- dependent reviewers. RESULTS： Of the 2415 studies identified, eight with complete data on 1146 patients were selected. The methodological quality was poor in all trials. Five studies reported that CHM was better than WesternMedicine [OR=2.81, 95% CI （1.27, 6.18）; OR=3.34, 95% CI （1.92, 5.79）; 0R=2.22, 95% CI （1.08, 4.57）; OR= 6.67, 95% CI （1.34, 33.28）; and OR=1.94, 95% CI （1.23, 3.06）]. Two studies reported that the clinical outcome was better in CHM groups than in physio- therapy and placebo groups, [OR=3.02, 9.5% CI （1.08, 8.46）; and OR=2.67, 95% CI （1.26, 5.64）, re- spectively], whereas one study reported no differ- ence between CHM and physiotherapy groups. One study reported that CHM resulted in higher Japanese Orthopedic Association scores [MD=7.78, 95% CI （6.67, 8.89）] than in a control group and an- other that participants treated with CHM had lower Visual Analogue Scale scores [MD=- 0.72, 95% CI （ - 0.86, 0.58）] than those in a control group. Three studies reported that the adverse effects of CHM and Western Medicine did not differ signifi- cantly [OR=0.10, 95% CI （0.01, 1.85）; OR=0.19, 95% CI （0.01,4.07）; and OR=O.07, 95% CI （0.00, 1.32）]. CONCLUSION： CHM may be more effective than other interventions for LDH; however, methodologi- cal weaknesses in the studies assessed in this re- view prevent a definitive conclusion. More high-quality large-scale studies are required to clar- ify this matter.展开更多
OBJECTIVE:To evaluate the effectiveness and safety of Chinese herbal medicine(CHM) in the treatmentofsubacutethyroiditis.METHODS: Randomized controlled trials found in PubMed, Cochrane Library, and three Chinese datab...OBJECTIVE:To evaluate the effectiveness and safety of Chinese herbal medicine(CHM) in the treatmentofsubacutethyroiditis.METHODS: Randomized controlled trials found in PubMed, Cochrane Library, and three Chinese databases were selected. RevMan 5.2 software was used to analyze the data with relative risk or mean difference, expressed with 95% of confidence interval. The quality of trials was assessed and gradedthe quality of evidence with GRADE profiler software.RESULTS: Twenty one studies were included. CHM was superior to Western Medicine(include prednisone and NSAIDs) in abating fever, relieving thyroid pain, recovering blood sedimentation, improving thyroid function, and preventing hypothyroidism(P<0.05), while no statistical differences were found in eliminating goiter and reducing relapse rate.CHM plusWestern Medicine were superior toWestern Medicine in abating fever, relieving thyroid pain, eliminating goiter, and reducing relapse rate,while no statistical differences(P>0.05) were found in recovering blood sedimentation and improving thyroid function. The incidence of adverse reactions in treatment group was lower than that in control group(relative risk was 0.12 and 95% confidence interval was 0.03-0.51). The methodological quality of trials is generally poor with a high risk of bias.CONCLUSION: CHM(particularly CHM combined withWestern Medicine) used to treat subacute thyroiditis may improve clinical symptoms and signs,reduce relapse rate, and alleviate the side effects of hormones. Due to poor methodological quality of included trials, further more high-quality studies are warranted to confirm the effectiveness and safety of CHM.展开更多
OBJECTIVE:To assess the effectiveness and safety of traditional Chinese medical therapy for cancer-related fatigue.METHODS:We systematically searched eight electronic databases up to June 2017 for randomized clinical ...OBJECTIVE:To assess the effectiveness and safety of traditional Chinese medical therapy for cancer-related fatigue.METHODS:We systematically searched eight electronic databases up to June 2017 for randomized clinical trials of traditional Chinese medical therapy for cancer-related fatigue.Two authors independently extracted data and assessed the risk bias of the included trials using the Cochrane Handbook.Data were analyzed by Rev Man 5.2 software.RESULTS:A total of 23 trials involving 1832 participants identified with cancer-related fatigue were included.Twenty trials reported a beneficial effect of traditional Chinese medical therapy on cancer-related fatigue.On pooling the data from Chinese herbal medicine therapy and acupuncture or moxibustion therapy,respectively,significant differences were found between experimental groups and control groups.Fatigue improvement rates showed significant differences between traditional Chinese medical therapy and control groups[odds ratio(OR),7.62;95%confidence interval(CI),3.75-15.49;P<0.00001;and OR,3.78;95%CI,2.29-6.23;P<0.00001).Fatigue change scores also showed significant differences between the two groups(mean difference,-0.91;95%CI,-1.16 to-0.65;P<0.00001).Eleven trials demonstrated that traditional Chinese medical therapy improved the quality of life of cancer patients.No severe adverse effects occurred in traditional Chinese medical therapy groups.CONCLUSION:Meta-analysis showed that Chinese medical therapy seems to be effective and safe in the treatment of cancer-related fatigue.展开更多
OBJECTIVE: To evaluate the effectiveness of the Traditional Chinese Medicine tonifying-kidney and regulating-liver therapy on diminished ovarian reserve(DOR).METHODS: The literature was comprehensively searched up to ...OBJECTIVE: To evaluate the effectiveness of the Traditional Chinese Medicine tonifying-kidney and regulating-liver therapy on diminished ovarian reserve(DOR).METHODS: The literature was comprehensively searched up to August 2019 using four Chinese and three English electronic databases to extract randomized clinical trials(RCTs) comparing Traditional Chinese Medicine tonifying-kidney and regulating-liver prescriptions(combined with hormone therapy or not) with Western Medicine. Data quality evaluation was conducted using the Cochrane risk of bias tool. Meta-analysis was conducted using Revman 5.3 software with effect estimates presented as mean difference(MD), risk ratio(RR), and95% confidence interval(CI).RESULTS: A total of nine RCTs with 512 participants were extracted and eligible for Meta-analysis.There were no significant differences between Chinese medicine and Western Medicine on basal serum follicle-stimulating hormone(FSH) level(MD0.11, 95% CI-0.52 to 0.74, 392 participants, seven trials), anti-Müllerian hormone level(MD 0.48, 95%CI-0.62 to 1.58, 95 participants, two trials), and the FSH and luteinizing hormone ratio(MD 0.01,95% CI-0.95 to 0.96, 115 participants, two trials).Chinese medicine was more effective at improving Traditional Chinese Medicine symptom scores(TCMSS)(MD-2.39, 95% CI-3.83 to-0.94, 160 participants, three trials), effective rate of TCMSS(RR1.18, 95% CI 1.02 to 1.36, 160 participants, three trials), antral follicle count(AFC)(MD 0.55, 95% CI 0.05 to 1.04, 155 participants, three trials), and FSH levels at 3 months post-treatment(MD-4.77, 95% CI-6.09 to-3.45, 137 participants, two trials).CONCLUSION: Compared with Western Medicine,tonifying-kidney and regulating-liver therapy is more effective at relieving symptoms and improving AFC and FSH at 3 months post-treatment.展开更多
Background: The therapeutic evidence collected from well-designed studies is needed to help manage the global pandemic of the coronavirus disease 2019(COVID-19). Evaluating the quality of therapeutic data collected du...Background: The therapeutic evidence collected from well-designed studies is needed to help manage the global pandemic of the coronavirus disease 2019(COVID-19). Evaluating the quality of therapeutic data collected during this most recent pandemic is important for improving future clinical research under similar circumstances.Objective: To assess the methodological quality and variability in implementation of randomized controlled trials(RCTs) for treating COVID-19, and to analyze the support that should be provided to improve data collected during an urgent pandemic situation.Search strategy: Pub Med, Excerpta Medica Database, China National Knowledge Infrastructure, Wanfang,and Chongqing VIP, and the preprint repositories including Social Science Research Network and Med Rxiv were systematically searched, up to September 30, 2020, using the keywords "coronavirus disease 2019(COVID-19)," "2019 novel coronavirus(2019-n Co V)," "severe acute respiratory syndrome-related coronavirus-2(SARS-Co V-2)," "novel coronavirus pneumonia(NCP)," "randomized controlled trial(RCT)" and "random."Inclusion criteria: RCTs studying the treatment of COVID-19 were eligible for inclusion.Data extraction and analysis: Screening of published RCTs for inclusion and data extraction were each conducted by two researchers. Analysis of general information on COVID-19 RCTs was done using descriptive statistics. Methodological quality was assessed using the risk-of-bias tools in the Cochrane Handbook for Systematic Reviews of Interventions(Version 5.1.0). Variability in implementation was assessed by comparing consistency between RCT reports and registration information.Results: A total of 5886 COVID-19 RCTs were identified. Eighty-one RCTs were finally included, of which,45 had registration information. Methodological quality of the RTCs was not optimal due to deficiencies in five main domains: allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, and selective reporting. Comparisons of consistency between published protocols and registration information showed that the 45 RCTs with registration information had common deviations in seven items: inclusion and exclusion criteria, sample size, outcomes, research sites of recruitment, interventions, and blinding.Conclusion: The methodological quality of COVID-19 RCTs conducted in early to mid 2020 was consistently low and variability in implementation was common. More support for implementing highquality methodology is needed to obtain the quality of therapeutic evidence needed to provide positive guidance for clinical care. We make an urgent appeal for accelerating the construction of a collaborative sharing platform and preparing multidisciplinary talent and professional teams to conduct excellent clinical research when faced with epidemic diseases of the future. Further, variability in RCT implementation should be clearly reported and interpreted to improve the utility of data resulting from those trials.展开更多
OBJECTIVE: To systematically assess the effects and safety of Sini decoction as an adjuvant therapy for patients with angina pectoris.METHODS: We searched Pub Med, Excerpt Medica Database, the Cochrane library, Wanfan...OBJECTIVE: To systematically assess the effects and safety of Sini decoction as an adjuvant therapy for patients with angina pectoris.METHODS: We searched Pub Med, Excerpt Medica Database, the Cochrane library, Wanfang Database,China National Knowledge Infrastructure Database,China Science and Technology Journal Database from the date of its inception until August 1, in2014. Available literatures were selected according to the inclusion criteria. Two reviewers finished data extraction, checked the data and assessed the methodological quality of studies, independently.The Review Manage Software 5.1.0 was used for data analysis.RESULTS: Six trials involving 453 participants were eligible. None of the trials reported the mortality due to angina pectoris. The secondary outcomes showed that Sini decoction, together with nitroglycerin when necessary, may have some effects on reducing the number of angina attacks and the amount of nitroglycerin. But in terms of reducing the duration of angina and improvement of electrocardiogram, there were no statistical differences between Sini decoction group and isosorbide dinitrate group. Only one reported that no adverse events were found.CONCLUSION: Based on this systematic review, Sini decoction can reduce the dosage of nitroglycerin, when compared with isosorbide dinitrate group.And there were no enough evidence in the papers to draw any conclusions for the safety of Sini decoction.展开更多
OBJECTIVE: To justify the clinical use of Traditional Chinese Medicine(TCM) in the treatment of influenza.METHODS: MEDLINE, EMBASE, Chinese Biomedical Literature Database, China National Knowledge Infrastructure Datab...OBJECTIVE: To justify the clinical use of Traditional Chinese Medicine(TCM) in the treatment of influenza.METHODS: MEDLINE, EMBASE, Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wanfang Database and the Cochrane Database of Systematic Reviews were searched from thedate of inception until January 1,2013, for the literature on treatment of influenza with TCM.RESULTS: A total of 7 randomized controlled trials were identified and reviewed. Of these trials, 2 compared a(modified) prescription of TCM with oseltamivir and 5 compared a patent traditional Chinese drug with oseltamivir. Based on the Meta-analysis,compared to oseltamivir, the(modified) prescription had similar effect in defervescence [WMD=5.66, 95% CI(﹣32.02, 43.35), P=0.77] and viral shedding [WMD=﹣ 6.21, 95% CI(﹣84.19, 71.76), P=0.88], and the patent traditional Chinese drug also had similar effect in viral shedding [WMD=﹣ 0.24,95% CI(﹣4.79, 4.31), P=0.92] but more effective in defervescence [WMD=﹣4.65, 95%CI(﹣8.91, ﹣0.38),P=0.03].CONCLUSION: TCM has potential positive effects in the treatment of influenza.展开更多
基金the National Natural Science Foundation of China under Grant 60496312the 863 Program of China under Grants 2003AA12331004 and 2006AA01Z260.
文摘The FuTURE 4G Time Division Duplex (TDD) trial system uses 3.5 GHz carrier frequency and several crucial technologies including broadband Multiple Input Multiple Output (MIMO) and Orthogonal Frequency Division Multiplexing (OFDM). These technologies challenge the link budget and networking analysis of the FuTURE 4G TDD trial network. This paper analyzes the practical 3.5 GHz propagation model and the link budget of Radio Frequency (RF) parameters of the trial system. Moreover,it introduces networking analysis and network planning of the trial system,which combines the field test results of the MIMO system. The FuTURE 4G TDD trial system and its trial network have been accomplished with successful checkup. The trial system fulfills all the requirements with two Access Points (AP) and three Mobile Terminals (MT),which supports multi-user,mobility,a high peak rate of 100 Mb/s,High-Definition TV (HDTV),high-speed data download,and Voice over IP (VoIP) services.
文摘Objective To study the extended clinical trial systems in the United States,the European Union and Australia,and to provide a reference for the improvement of China’s extended clinical trial system.Methods Literature research method,risk management analysis method and comparative research were used in this paper to analyze the development history,scope of use,status quo of the extended clinical trial systems in the United States,the European Union,and Australia.Then,the current situation and shortcomings of China’s extended clinical trial system were compare with these foreign countries so as to put forward some suggestions for improvement.Results and Conclusion China should improve existing laws and regulations by establishing a fast application procedure,increasing application channels,and providing an information disclosure platform to meet the needs of patients in extended clinical trials.
基金funded by the National Key Research and Development Program of China(Grant No.2022YFB4700904 to Wang L)the Shanghai Shenkang Hospital Development Center's project for the Promotion of Clinical Skills and Clinical Innovation Three-Year Action Plan(Project No.SHDC2022CRT006 to Wang L and SHDC2022CRS010B to Tang S).
文摘Objective:This study aimed to assess the feasibility and safety of the SHURUI single-port robotic surgical system for a range of major urological surgeries.Methods:In this prospective,multicenter clinical trial,we examined the effectiveness of the SHURUI single-port robotic surgical system in urological interventions.The first 50 patients from four centers in China underwent single-port surgeries including partial nephrectomy,radical prostatectomy,partial adrenalectomy,and pyeloureteroplasty,exclusively by the SHURUI single-port robotic surgical system.The study's primary endpoints focused on the success of surgeries,defined as no deviations from planned procedures,no need for more than one port,and no re-operations within 24 h after surgery.Secondary endpoints encompassed a range of surgical metrics,functional outcomes,and patient demographic data.Clinical assessments were conducted before surgery,before discharge,and 1 month after discharge.Results:The surgical procedures were executed successfully without requiring intraoperative conversions or transfusions.Both estimated blood loss and operation durations were maintained within satisfactory limits.For each type of surgery,the mean console times and estimated blood loss were 179.8(standard deviation[SD]39.4)min and 125.6(SD 126.0)mL for radical prostatectomy,126.7(SD 47.8)min and 39.2(SD 54.4)mL for partial nephrectomy,112.6(SD 37.4)min and 20.0(SD 13.2)mL for partial adrenalectomy,and 148.0(SD 18.2)min and 18.0(SD 17.9)mL for pyeloureteroplasty,respectively.Across the cohort,17 patients experienced a total of 25 adverse events,while 10 postoperative complications,all rated as Clavien-Dindo grade I,were encountered by eight patients.All patients had shown recovery or improvement from these events before the end of this trial.Conclusion:The SHURUI single-port robotic surgical system demonstrated feasibility and safety in the performance of major urological surgeries.These initial findings highlight the system's potential,though further research and longer follow-up are required to assess long-term outcomes.
文摘Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systematic review and meta-analysis examined the effect of HP treatment on clinical and laboratory parameters in NAFLD patients.Methods We conducted a literature search of the PubMed,Embase,Scopus,and Web of Science databases through Septem-ber 2023 for randomized controlled trials(RCTs)examining the effect of HP treatment on NAFLD patients versus lifestyle changes alone.The primary outcome was the change in steatosis parameters.The secondary endpoints were changes in anthropometric parameters,inflammatory markers(TNF-α),and metabolic parameters(fasting blood glucose,homeostasis model assessment of insulin resistance,AST/ALT,and lipid profile).The random effects model was used to calculate the standardized mean difference(SMD)with associated 95%confidence intervals(CIs)for our desired outcome.Results Four RCTs met our inclusion criteria.A total of 453 patients were included(mean age 42.8 years,58.5%males),228(50.3%)of whom were in the HP eradication group and 225(49.7%)of whom were in the lifestyle modification group.Compared with lifestyle modification alone,HP eradication had a significant effect on reducing liver steatosis and TNF-αlevels(SMD:-0.9;95%CI-14.67,-3.82,I^(2)=0%and SMD:-6.3;95%CI-9.04,-3.56,I^(2)=0%,respectively).No sig-nificant effect on other metabolic parameters was found.Conclusions HP eradication significantly reduced liver steatosis and TNF-αlevels in NAFLD patients.However,HP eradi-cation did not significantly affect other metabolic indices compared to lifestyle changes alone.
文摘BACKGROUND Systematic reviews(SRs)synthesize and evaluate data,mainly from randomized trials,which then guides the development of clinical recommendations in evidence-based medicine.However,the data and methodological information in the included papers can often be lacking or unclear,and reviewers usually need to contact the authors of included studies for clarifications.Contacting authors is recommended,but it is unclear how often SR teams do it,or what the level of response is.AIM To investigate how often reviewers undertake contact with the authors of included randomized controlled trials(RCTs)for clarification on data and risk of bias concerns,to explore the factors that influence whether SR authors contact or do not contact the authors,and the content and level of responses.METHODS We conducted a systematic electronic database search in MEDLINE using the search string“(systematic review)”AND“(RCT OR randomized OR trial)”for articles published between 1 January 2024 and 19 February 2024,without language restrictions.Screening and data extraction was done independently by two reviewers,and conflicts resolved by a senior author.Contact authors of included SRs were contacted for clarifications.RESULTS Of the 329 included SRs,38%(n=125)explicitly mentioned contact with the authors of included studies.The remaining 62%(n=204)did not.We attempted contact with all SR teams for clarifications and received 90 responses(19.4%).Of the 50 respondents who did not explicitly mention contact in their SRs,25(50%)replied that they did make contact.We received a total of 64 responses on the level and content of information sought.The mean±SD contacts SR teams made were 10(10),replies received 5(6.7),and response waiting time 10.1(28.3)weeks.Resources,time,poor previous experience,perceived likelihood of poor response and bias concerns were reported as barriers to attempting contact.CONCLUSION The majority of SRs published in 2024 did not confirm seeking clarifying or missing information from primary study authors.However,SR teams reported that 50%of contacted primary authors respond.Additional research can clarify this rate of response and establish methods to increase the integration of this core methodological element in SRs.
文摘BACKGROUND Pediatric short bowel syndrome(SBS)poses management challenges,and teduglutide is a potential therapy.However,comprehensive data on its pediatric safety are lacking.AIM To evaluate the impact of teduglutide on infection and gastrointestinal adverse events in pediatric SBS patients via systematic review and meta-analysis.METHODS Following PRISMA 2009 guidelines and PROSPERO registration,we searched PubMed,Web of Science,and EMBASE for randomized controlled trials(RCTs)(pediatric SBS patients≤18 years;teduglutide vs placebo/standard care).Two reviewers screened studies,extracted data,and assessed bias(ROB2).Metaanalyses used RevMan 5.4(Mantel-Haenszel method,random-effects if I^(2)≠0).Trial sequential analysis and GRADE were applied.RESULTS Three RCTs involving 115 pediatric patients were included.Pooled analysis revealed no statistically significant differences between the teduglutide and control groups for the primary outcome of infection events[RR=0.83;(95%CI:0.44-1.56);P=0.57;I^(2)=0%;2 studies,n=55].Similarly,no significant differences were found for secondary outcomes:Upper respiratory tract infection[RR=0.68;(95%CI:0.32-1.47);P=0.33;I^(2)=0%],catheter site infection[RR=1.86;(95%CI:0.23-14.78);P=0.56;I^(2)=0%],vomiting[RR=1.35;(95%CI:0.10-18.23);P=0.82;I^(2)=72%],abdominal pain[RR=2.47;(95%CI:0.50-12.16);P=0.27;I^(2)=0%],nausea[RR=1.31;(95%CI:0.24-7.22);P=0.75;I^(2)=0%],diarrhea[RR=1.02;(95%CI:0.23-4.43);P=0.98;I^(2)=0%],and abdominal distension[RR=1.49;(95%CI:0.18-12.35);P=0.71;I^(2)=0%].The overall certainty of evidence assessed by GRADE was moderate.CONCLUSION Teduglutide does not increase infection or gastrointestinal adverse event risk in pediatric SBS,but small sample sizes limit conclusions.Larger studies are needed.
文摘BACKGROUND Prolonged immobility during intensive care unit(ICU)admission has been a cause of muscle atrophy and worsening functional outcomes with longer recovery times.Prior research has demonstrated that mobilization within a week of ICU admission potentially benefits physical function in critically ill patients.AIM To evaluate the effects of initiating mobilization within 72 hours of ICU admission in critically ill patients through an updated systematic review and meta-analysis.METHODS A systematic search was performed through MEDLINE,Scopus,and Cochrane Library from inception until September 2024 for randomized controlled trials(RCTs)comparing early mobilization(EM)with usual or conventional care in critically ill adult patients.Primary outcomes included length of ICU(days)and ventilation duration(days).Secondary outcomes included muscle strength,functional status,adverse events,all-cause mortality,and quality of life(QOL).A random effects meta-analysis was performed for pooled effect estimates and to derive risk ratios(RR)and corresponding 95%confidence intervals(CI).RESULTS Out of 3487 results,16 RCTs were included with a population of 2385 patients(1195 receiving EM and 1190 with usual care.)A significant reduction in the length of ICU stays[mean difference(MD)=-1.02,95%CI:-1.96 to-0.09;P=0.03;I2=60%]and ventilation duration(MD=-1.07,95%CI:-1.91 to-0.23,P=0.01;I2=57%)was observed in the EM group compared to usual care.EM significantly improved muscle strength[standard MD(SMD)=0.47,95%CI:0.18-0.75,P=0.001;I2=79%]and functional status(SMD=0.70,95%CI:0.40-1.00,P<0.00001;I2=81%)in ICU patients.No statistically significant difference was observed in adverse events(RR=1.72,95%CI:1.01-2.94,P=0.05;I2=31%),all-cause mortality(RR=1.10,95%CI:0.79-1.53,P=0.57;I2=30%),and QOL(SMD=0.04,95%CI:-0.07-0.15,P=0.50;I2=9%)between the two groups.CONCLUSION Initiating mobilization within 72 hours of ICU admission is associated with improved functional outcomes and reduced ICU length of stay and ventilation duration.These findings indicate that EM may be a safe option for ICU patients,contributing to lower recovery times and healthcare costs.Further extensive research is required to validate the long-term effects on survival and QOL.
基金supported by the National Natural Science Foundation of China,Nos.82174496(to NW),82374574(to NW),82302865(to LL)Shanghai Science and Technology Committee Sailing Program,Nos.23YF1403800(to LL),23YF1405200(to YX)Shanghai Hospital Development Center Foundation-Shanghai Municipal Hospital Rehabilitation Medicine Specialty Alliance,No.SHDC22023304(to YW).
文摘Stroke remains a leading cause of death and disability worldwide,and electroacupuncture has a long history of use in stroke treatment.This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke.The PubMed,EMBASE,Web of Science,CENTRAL,and CINAHL databases were comprehensively searched up to May 1,2024.This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke.Data from 70 eligible studies were analyzed in Stata 18.0,using a random-effects model to calculate the standardized mean difference(Hedge’s g).The risk of bias was assessed using RevMan 5.4 software,and the quality of evidence was rated according to the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness.The quality assessment revealed that most studies adequately handled incomplete data and selective reporting.However,several methodological limitations were identified:only 4 studies demonstrated a low risk of allocation concealment,26 achieved a low risk of outcome assessment bias,and 9 had a high risk of randomization bias.Additionally,there was an unclear risk regarding participant blinding and other methodological aspects.The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality.The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways:(1)Electroacupuncture significantly reduced infarct volume and apoptotic cell death(P<0.01)in ischemic stroke models;(2)electroacupuncture significantly decreased the levels of pro-inflammatory factors(P<0.01)while increasing the levels of anti-inflammatory factors(P=0.02);(3)electroacupuncture reduced the levels of oxidative stress indicators(P<0.01)and enhanced the expression of antioxidant enzymes(P<0.01);(4)electroacupuncture significantly promoted nerve regeneration(P<0.01);and(5)electroacupuncture influenced blood flow remodeling(P<0.01)and angiogenesis(P<0.01).Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model(P<0.01)and in post-middle cerebral artery occlusion intervention(P<0.01).Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects(P<0.01),while scalp acupoints demonstrated greater efficacy than body acupoints(P<0.01).The heterogeneity among the included studies was minimal,and sensitivity analyses indicated stable results.Their methodological quality was generally satisfactory.In conclusion,electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis,oxidative stress,inflammation,stroke-induced nerve regeneration,blood flow remodeling,and angiogenesis.The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model,the timing of intervention onset,waveform,and acupoint selection.Despite the moderate to low quality of evidence,these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.
基金Supported by National Natural Science Foundation of China,No.82374200Construction of Traditional Chinese Medicine Inheritance and Innovation Development Demonstration Pilot Projects in Pudong New Area-High-Level Research-Oriented Traditional Chinese Medicine Hospital Construction,No.YC-2023-0901.
文摘Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized byclinical symptoms of diarrhea and mucopurulent bloody stools, and its incidenceis increasing globally. The etiology and pathogenesis of UC remain elusive. Currenttherapeutic approaches, including anti-inflammatory, immunosuppressiveand immunomodulating agents, are often limited in efficacy and frequently associatedwith adverse drug reactions. Therefore, there is an urgent need to developsafer and more effective treatment strategies to address the limitations of existingtherapies. Scutellaria baicalensis Georgi (HQ), a traditional Chinese medicinal herb,has been employed in the treatment of UC for over 2000 years. Recent studieshave demonstrated that HQ contains multiple active components capable oftreating UC through anti-inflammation, immune modulation, intestinal barrierprotection, antioxidant activity, and regulation of the gut microbiota. This paperreviews recent studies on the mechanism of action and clinical trials of HQ intreating UC based on relevant literature, with the aim of providing valuable insightsinto future treatment approaches.
基金supported by the Key R&D Projects of the Ministry of Science and Technology of China(No.2020YFC0832500)the National Key Research and Development Program of China(No.2018AAA0101900)+3 种基金the National Social Science Foundation of China(No.20&ZD047)the National Natural Science Foundation of China(Nos.61625107 and 62006207)the Key R&D Project of Zhejiang Province,China(No.2020C01060)the Fundamental Research Funds for the Central Universities,China(Nos.LQ21F020020 and 2020XZA202)。
文摘In constructing a smart court,to provide intelligent assistance for achieving more efficient,fair,and explainable trial proceedings,we propose a full-process intelligent trial system(FITS).In the proposed FITS,we introduce essential tasks for constructing a smart court,including information extraction,evidence classification,question generation,dialogue summarization,judgment prediction,and judgment document generation.Specifically,the preliminary work involves extracting elements from legal texts to assist the judge in identifying the gist of the case efficiently.With the extracted attributes,we can justify each piece of evidence’s validity by establishing its consistency across all evidence.During the trial process,we design an automatic questioning robot to assist the judge in presiding over the trial.It consists of a finite state machine representing procedural questioning and a deep learning model for generating factual questions by encoding the context of utterance in a court debate.Furthermore,FITS summarizes the controversy focuses that arise from a court debate in real time,constructed under a multi-task learning framework,and generates a summarized trial transcript in the dialogue inspectional summarization(DIS)module.To support the judge in making a decision,we adopt first-order logic to express legal knowledge and embed it in deep neural networks(DNNs)to predict judgments.Finally,we propose an attentional and counterfactual natural language generation(AC-NLG)to generate the court’s judgment.
基金Supported by The Medical University of Warsaw,Poland
文摘AIM:To systematically evaluate and update evidence on the efficacy and safety of probiotic supplementation for the treatment of constipation. METHODS:The MEDLINE,EMBASE,CINAHL,and Cochrane Library databases were searched in May 2009 for randomised controlled trials(RCTs)performed in paediatric or adult populations related to the study aim. RESULTS:We included five RCTs with a total of 377 subjects(194 in the experimental group and 183 in the control group).The participants were adults (three RCTs,n=266)and children(two RCTs,n= 111)with constipation.In adults,data suggests a favourable effect of treatment with Bifidobacterium lactis DN-173 010,Lactobacillus casei Shirota,and Escherichia coli Nissle 1917 on defecation frequency and stool consistency.In children,L.casei rhamnosusLcr35,but not L.rhamnosus GG,showed a beneficial effect. CONCLUSION:Until more data are available,we believe the use of probiotics for the treatment of constipation condition should be considered investigational.
文摘OBJECTIVE:To evaluated the effectiveness and safety of Chinese herbal medicines(CHMs)for coronary heart disease(CHD)complicated with anxiety.METHODS:Randomized controlled clinical trials(RCTs)with parallel-groups were included after searching through electric-databases from inception to May,2017.Meta-analysis was undertaken with Rev Man 5.3 software.RESULTS:Twenty-three RCTs enrolling 1654 patients were included in this systematic review.The combination therapy(CHMs combined with anxiolytic)appeared to be superior to anxiolytic in terms of reducing the score of Zung Self-rating Anxiety scale(SAS)(mean Difference(MD),-12.25;95%confidence interval(CI),-14.01 to-10.48,eliminating method;MD,-3.92;95%CI,-5.48 to-2.35,tranquilizing method),improving the total effect rate(relative risk(RR),1.26;95%CI,1.08 to 1.46,eliminating method)and reducing the TCM symptoms scores(MD,-2.24;95%CI,-4.25 to-0.23,tranquilizing method)with a lower incidence of adverse events(RR,0.46;95%CI,0.25 to 0.85,tonifying method).CHMs demonstrated benefits in lowering the score of Hamilton Anxiety Rating scale(MD,-6.77;95%CI,-8.16 to-5.37,tonifying method),lowering the score of SAS(MD,-10.1;95%CI,-13.73 to-6.30,tonifying method)and reducing the TCM symptoms scores(MD,-2.18;95%CI,-3.12 to-1.24,tranquilizing method).CONCLUSION:We got a low evidence that CHMs,which had less side effects,showed potentially benefits to patients with CHD complicated with anxiety.While the results should be interpreted with caution.Trails with higher quality are required to verify the effectiveness and safety of CHMs for CHD complicated with anxiety.
文摘OBJECTIVE： This is a review of the effects of Chi- nese herbal medicine （CHM） used alone to treat lumbar disc herniation （LDH）. METHORDS： A literature search of the following electronic databases from their inception to Febru- ary 2013 was conducted： Chinese Biomedical data- bases, Chinese National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, Cochrane Library, Web of Sci- ence, MEDLINE, and EMBASE. Randomized con- trolled trials where CHM had been used to treat LDH were selected. Data extraction, quality assess- ment, and data analysis were carried out by two in- dependent reviewers. RESULTS： Of the 2415 studies identified, eight with complete data on 1146 patients were selected. The methodological quality was poor in all trials. Five studies reported that CHM was better than WesternMedicine [OR=2.81, 95% CI （1.27, 6.18）; OR=3.34, 95% CI （1.92, 5.79）; 0R=2.22, 95% CI （1.08, 4.57）; OR= 6.67, 95% CI （1.34, 33.28）; and OR=1.94, 95% CI （1.23, 3.06）]. Two studies reported that the clinical outcome was better in CHM groups than in physio- therapy and placebo groups, [OR=3.02, 9.5% CI （1.08, 8.46）; and OR=2.67, 95% CI （1.26, 5.64）, re- spectively], whereas one study reported no differ- ence between CHM and physiotherapy groups. One study reported that CHM resulted in higher Japanese Orthopedic Association scores [MD=7.78, 95% CI （6.67, 8.89）] than in a control group and an- other that participants treated with CHM had lower Visual Analogue Scale scores [MD=- 0.72, 95% CI （ - 0.86, 0.58）] than those in a control group. Three studies reported that the adverse effects of CHM and Western Medicine did not differ signifi- cantly [OR=0.10, 95% CI （0.01, 1.85）; OR=0.19, 95% CI （0.01,4.07）; and OR=O.07, 95% CI （0.00, 1.32）]. CONCLUSION： CHM may be more effective than other interventions for LDH; however, methodologi- cal weaknesses in the studies assessed in this re- view prevent a definitive conclusion. More high-quality large-scale studies are required to clar- ify this matter.
基金Supported by Effectiveness of External Therapy of Traditional Chinese Medicine for Subacute Thyroiditis:a Evaluation Research(sci-tech project,No.WZF2012-12)Research on Professor Wu Ruimin's Academic Thought on Treating Subacute Thyroiditis(research project,No.JJ2010-65)from Beijing Municipality of Traditional Chinese Medicine
文摘OBJECTIVE:To evaluate the effectiveness and safety of Chinese herbal medicine(CHM) in the treatmentofsubacutethyroiditis.METHODS: Randomized controlled trials found in PubMed, Cochrane Library, and three Chinese databases were selected. RevMan 5.2 software was used to analyze the data with relative risk or mean difference, expressed with 95% of confidence interval. The quality of trials was assessed and gradedthe quality of evidence with GRADE profiler software.RESULTS: Twenty one studies were included. CHM was superior to Western Medicine(include prednisone and NSAIDs) in abating fever, relieving thyroid pain, recovering blood sedimentation, improving thyroid function, and preventing hypothyroidism(P<0.05), while no statistical differences were found in eliminating goiter and reducing relapse rate.CHM plusWestern Medicine were superior toWestern Medicine in abating fever, relieving thyroid pain, eliminating goiter, and reducing relapse rate,while no statistical differences(P>0.05) were found in recovering blood sedimentation and improving thyroid function. The incidence of adverse reactions in treatment group was lower than that in control group(relative risk was 0.12 and 95% confidence interval was 0.03-0.51). The methodological quality of trials is generally poor with a high risk of bias.CONCLUSION: CHM(particularly CHM combined withWestern Medicine) used to treat subacute thyroiditis may improve clinical symptoms and signs,reduce relapse rate, and alleviate the side effects of hormones. Due to poor methodological quality of included trials, further more high-quality studies are warranted to confirm the effectiveness and safety of CHM.
基金Supported by Grants from the Natural Science Foundation of China(No.81903991,No.81974543)the Natural Science Foundation of Guangdong Province(No.2017A030310326,No.2019A1515011362)+3 种基金the Guangzhou science and technology plan project(No.201804010149,No.202002030155)the Chinese medicine science and technology research project of Guangdong Provincial Hospital of Chinese Medicine(No.YN2019MJ09)the Major Research Projects in First-class Disciplines of Guangzhou University of Chinese Medicine(No.A1260619111001)the Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome(No.ZH2020KF03)
文摘OBJECTIVE:To assess the effectiveness and safety of traditional Chinese medical therapy for cancer-related fatigue.METHODS:We systematically searched eight electronic databases up to June 2017 for randomized clinical trials of traditional Chinese medical therapy for cancer-related fatigue.Two authors independently extracted data and assessed the risk bias of the included trials using the Cochrane Handbook.Data were analyzed by Rev Man 5.2 software.RESULTS:A total of 23 trials involving 1832 participants identified with cancer-related fatigue were included.Twenty trials reported a beneficial effect of traditional Chinese medical therapy on cancer-related fatigue.On pooling the data from Chinese herbal medicine therapy and acupuncture or moxibustion therapy,respectively,significant differences were found between experimental groups and control groups.Fatigue improvement rates showed significant differences between traditional Chinese medical therapy and control groups[odds ratio(OR),7.62;95%confidence interval(CI),3.75-15.49;P<0.00001;and OR,3.78;95%CI,2.29-6.23;P<0.00001).Fatigue change scores also showed significant differences between the two groups(mean difference,-0.91;95%CI,-1.16 to-0.65;P<0.00001).Eleven trials demonstrated that traditional Chinese medical therapy improved the quality of life of cancer patients.No severe adverse effects occurred in traditional Chinese medical therapy groups.CONCLUSION:Meta-analysis showed that Chinese medical therapy seems to be effective and safe in the treatment of cancer-related fatigue.
基金Supported by the Fundamental Research Funds for the Central Universities Study on the Mechanism of Tonifying-Kidney and Smoothing-Liver on Rats With Diminished Ovarian Reserve Based on PI3K-AKT-mTOR Signaling Pathway(No.2019-JYB-XS-148)National Natural Science Foundation of China Study on the Mechanism of Regulating Endometrial Receptivity by Erbu Zhuyu Decoction Based on NK/M-CSF/NO Signaling Pathway(No.81473721)。
文摘OBJECTIVE: To evaluate the effectiveness of the Traditional Chinese Medicine tonifying-kidney and regulating-liver therapy on diminished ovarian reserve(DOR).METHODS: The literature was comprehensively searched up to August 2019 using four Chinese and three English electronic databases to extract randomized clinical trials(RCTs) comparing Traditional Chinese Medicine tonifying-kidney and regulating-liver prescriptions(combined with hormone therapy or not) with Western Medicine. Data quality evaluation was conducted using the Cochrane risk of bias tool. Meta-analysis was conducted using Revman 5.3 software with effect estimates presented as mean difference(MD), risk ratio(RR), and95% confidence interval(CI).RESULTS: A total of nine RCTs with 512 participants were extracted and eligible for Meta-analysis.There were no significant differences between Chinese medicine and Western Medicine on basal serum follicle-stimulating hormone(FSH) level(MD0.11, 95% CI-0.52 to 0.74, 392 participants, seven trials), anti-Müllerian hormone level(MD 0.48, 95%CI-0.62 to 1.58, 95 participants, two trials), and the FSH and luteinizing hormone ratio(MD 0.01,95% CI-0.95 to 0.96, 115 participants, two trials).Chinese medicine was more effective at improving Traditional Chinese Medicine symptom scores(TCMSS)(MD-2.39, 95% CI-3.83 to-0.94, 160 participants, three trials), effective rate of TCMSS(RR1.18, 95% CI 1.02 to 1.36, 160 participants, three trials), antral follicle count(AFC)(MD 0.55, 95% CI 0.05 to 1.04, 155 participants, three trials), and FSH levels at 3 months post-treatment(MD-4.77, 95% CI-6.09 to-3.45, 137 participants, two trials).CONCLUSION: Compared with Western Medicine,tonifying-kidney and regulating-liver therapy is more effective at relieving symptoms and improving AFC and FSH at 3 months post-treatment.
基金supported by the National Key R&D Program of China(2019YFC1710400,2019YFC1710405)the National Natural Science Foundation of China(No.81803963)。
文摘Background: The therapeutic evidence collected from well-designed studies is needed to help manage the global pandemic of the coronavirus disease 2019(COVID-19). Evaluating the quality of therapeutic data collected during this most recent pandemic is important for improving future clinical research under similar circumstances.Objective: To assess the methodological quality and variability in implementation of randomized controlled trials(RCTs) for treating COVID-19, and to analyze the support that should be provided to improve data collected during an urgent pandemic situation.Search strategy: Pub Med, Excerpta Medica Database, China National Knowledge Infrastructure, Wanfang,and Chongqing VIP, and the preprint repositories including Social Science Research Network and Med Rxiv were systematically searched, up to September 30, 2020, using the keywords "coronavirus disease 2019(COVID-19)," "2019 novel coronavirus(2019-n Co V)," "severe acute respiratory syndrome-related coronavirus-2(SARS-Co V-2)," "novel coronavirus pneumonia(NCP)," "randomized controlled trial(RCT)" and "random."Inclusion criteria: RCTs studying the treatment of COVID-19 were eligible for inclusion.Data extraction and analysis: Screening of published RCTs for inclusion and data extraction were each conducted by two researchers. Analysis of general information on COVID-19 RCTs was done using descriptive statistics. Methodological quality was assessed using the risk-of-bias tools in the Cochrane Handbook for Systematic Reviews of Interventions(Version 5.1.0). Variability in implementation was assessed by comparing consistency between RCT reports and registration information.Results: A total of 5886 COVID-19 RCTs were identified. Eighty-one RCTs were finally included, of which,45 had registration information. Methodological quality of the RTCs was not optimal due to deficiencies in five main domains: allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete outcome data, and selective reporting. Comparisons of consistency between published protocols and registration information showed that the 45 RCTs with registration information had common deviations in seven items: inclusion and exclusion criteria, sample size, outcomes, research sites of recruitment, interventions, and blinding.Conclusion: The methodological quality of COVID-19 RCTs conducted in early to mid 2020 was consistently low and variability in implementation was common. More support for implementing highquality methodology is needed to obtain the quality of therapeutic evidence needed to provide positive guidance for clinical care. We make an urgent appeal for accelerating the construction of a collaborative sharing platform and preparing multidisciplinary talent and professional teams to conduct excellent clinical research when faced with epidemic diseases of the future. Further, variability in RCT implementation should be clearly reported and interpreted to improve the utility of data resulting from those trials.
基金National Science and Technology Major Projects for Major New Drugs Innovation and Development,Key Technology Research on Clinical Efficacy Evaluation of Chinese Herbal Medicines(No.2009ZX09502-029)National Natural Science Foundation of China and the National Key Basic Research Special Foundation of China(No.2013CB531704)
文摘OBJECTIVE: To systematically assess the effects and safety of Sini decoction as an adjuvant therapy for patients with angina pectoris.METHODS: We searched Pub Med, Excerpt Medica Database, the Cochrane library, Wanfang Database,China National Knowledge Infrastructure Database,China Science and Technology Journal Database from the date of its inception until August 1, in2014. Available literatures were selected according to the inclusion criteria. Two reviewers finished data extraction, checked the data and assessed the methodological quality of studies, independently.The Review Manage Software 5.1.0 was used for data analysis.RESULTS: Six trials involving 453 participants were eligible. None of the trials reported the mortality due to angina pectoris. The secondary outcomes showed that Sini decoction, together with nitroglycerin when necessary, may have some effects on reducing the number of angina attacks and the amount of nitroglycerin. But in terms of reducing the duration of angina and improvement of electrocardiogram, there were no statistical differences between Sini decoction group and isosorbide dinitrate group. Only one reported that no adverse events were found.CONCLUSION: Based on this systematic review, Sini decoction can reduce the dosage of nitroglycerin, when compared with isosorbide dinitrate group.And there were no enough evidence in the papers to draw any conclusions for the safety of Sini decoction.
基金Supported by the Beijing 302 Hospital Inner Research Foundation(No.YNKT2012021)the PLA 12th Five-Year Grand Project for Key Techniques and Devices in Management of Infectious Diseases(No.BWS11J048)
文摘OBJECTIVE: To justify the clinical use of Traditional Chinese Medicine(TCM) in the treatment of influenza.METHODS: MEDLINE, EMBASE, Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wanfang Database and the Cochrane Database of Systematic Reviews were searched from thedate of inception until January 1,2013, for the literature on treatment of influenza with TCM.RESULTS: A total of 7 randomized controlled trials were identified and reviewed. Of these trials, 2 compared a(modified) prescription of TCM with oseltamivir and 5 compared a patent traditional Chinese drug with oseltamivir. Based on the Meta-analysis,compared to oseltamivir, the(modified) prescription had similar effect in defervescence [WMD=5.66, 95% CI(﹣32.02, 43.35), P=0.77] and viral shedding [WMD=﹣ 6.21, 95% CI(﹣84.19, 71.76), P=0.88], and the patent traditional Chinese drug also had similar effect in viral shedding [WMD=﹣ 0.24,95% CI(﹣4.79, 4.31), P=0.92] but more effective in defervescence [WMD=﹣4.65, 95%CI(﹣8.91, ﹣0.38),P=0.03].CONCLUSION: TCM has potential positive effects in the treatment of influenza.
