Focusing on the ultralow expansion functionality of the crystalized glass containing the cordierite crystal phase with the molar composition 20.7MgO·20.7Al_(2)O_(3)·51.6SiO_(2)·7.0TiO_(2),we systematica...Focusing on the ultralow expansion functionality of the crystalized glass containing the cordierite crystal phase with the molar composition 20.7MgO·20.7Al_(2)O_(3)·51.6SiO_(2)·7.0TiO_(2),we systematically investigated impacts of thermal treatment protocols on T dependence of coefficients of thermal expansion(CTE).Except for the phase compositions,morphology is identified as another important factor to control the T dependence of CTE.By using X-ray diffraction and scanning electron microscope,various modes of T dependence of CTE for crystallized glasses are ascribed to their different phase compositions and microstructure with finely dispersed nanoparticles.These understanding contributes to the further modification of CTE of the crystalized glass by altering their thermal treatment scenarios.展开更多
BACKGROUND Diabetes mellitus has become one of the major pandemics of the 21st century.In this scenario,nursing interventions are essential for improving self-care and quality of life in patients with type 2 diabetes ...BACKGROUND Diabetes mellitus has become one of the major pandemics of the 21st century.In this scenario,nursing interventions are essential for improving self-care and quality of life in patients with type 2 diabetes mellitus.Nursing interventions are crucial for managing the disease and preventing complications.AIM To analyse nursing interventions in recent years through a systematic review and meta-analysis and to propose improvements in care plans.METHODS This study conducted a systematic review and meta-analysis of the impact of nursing interventions on quantitative glycaemic variables,such as glycated haemoglobin and fasting plasma glucose.RESULTS After confirming that the combined effect of all studies from the past 5 years positively impacts quantitative variables,a descriptive analysis of the studies with the most significant changes was conducted.Based on this,an improvement in diabetic patient care protocols has been proposed through follow-up plans tailored to the patient’s technological skills.CONCLUSION The combined results obtained and the proposal for improvement developed in this manuscript could help to improve the quality of life of many people around the world.展开更多
Background: Studies have shown a strong correlation between the growth of E2 in serum and estrone-3-glucuronide (E1-3G) in urine during ovarian stimulation. Thus, we developed theoretical models for using urinary E1-3...Background: Studies have shown a strong correlation between the growth of E2 in serum and estrone-3-glucuronide (E1-3G) in urine during ovarian stimulation. Thus, we developed theoretical models for using urinary E1-3G in ovarian stimulation and focused on their experimental verification and analysis. Methods: A prospective, observational pilot study was conducted involving 54 patients who underwent 54 cycles of ovarian stimulation. The goal was to establish the growth rate of urinary E1-3G during the course of stimulation and to determine the daily upper and lower limits of growth rates at which stimulation is appropriate and safe. Controlled ovarian stimulation was performed using two different stimulation protocols—an antagonist protocol in 25 cases and a progestin-primed ovarian stimulation protocol (PPOS) in 29 cases, with fixed doses of gonadotropins. From the second day of stimulation, patients self-measured their daily urine E1-3G levels at home using a portable analyzer. In parallel, a standard ultrasound follow-up protocol accompanied by a determination of E2, LH, and P levels was applied to optimally control stimulation. Results: The average daily growth rates in both groups were about 50%. The daily increase in E1-3G for the antagonist protocol ranged from 14% to 79%, while they were 28% to 79% for the PPOS protocol. Conclusion: This is the first study to analyze the dynamics of E1-3G in two different protocols and to estimate the limits of its increase during the entire course of the stimulation. The results confirm our theoretical model for the viability of using urinary E1-3G for monitoring ovarian stimulation.展开更多
This paper investigates the problem of global/semi-global finite-time consensus for integrator-type multi-agent sys-tems.New hyperbolic tangent function-based protocols are pro-posed to achieve global and semi-global ...This paper investigates the problem of global/semi-global finite-time consensus for integrator-type multi-agent sys-tems.New hyperbolic tangent function-based protocols are pro-posed to achieve global and semi-global finite-time consensus for both single-integrator and double-integrator multi-agent systems with leaderless undirected and leader-following directed commu-nication topologies.These new protocols not only provide an explicit upper-bound estimate for the settling time,but also have a user-prescribed bounded control level.In addition,compared to some existing results based on the saturation function,the pro-posed approach considerably simplifies the protocol design and the stability analysis.Illustrative examples and an application demonstrate the effectiveness of the proposed protocols.展开更多
Glaucoma,characterized by a degenerative loss of retinal ganglion cells,is the second leading cause of blindness worldwide.There is currently no cure for vision loss in glaucoma because retinal ganglion cells do not r...Glaucoma,characterized by a degenerative loss of retinal ganglion cells,is the second leading cause of blindness worldwide.There is currently no cure for vision loss in glaucoma because retinal ganglion cells do not regenerate and are not replaced after injury.Human stem cell-derived retinal ganglion cell transplant is a potential therapeutic strategy for retinal ganglion cell degenerative diseases.In this review,we first discuss a 2D protocol for retinal ganglion cell differentiation from human stem cell culture,including a rapid protocol that can generate retinal ganglion cells in less than two weeks and focus on their transplantation outcomes.Next,we discuss using 3D retinal organoids for retinal ganglion cell transplantation,comparing cell suspensions and clusters.This review provides insight into current knowledge on human stem cell-derived retinal ganglion cell differentiation and transplantation,with an impact on the field of regenerative medicine and especially retinal ganglion cell degenerative diseases such as glaucoma and other optic neuropathies.展开更多
This paper contributes a sophisticated statistical method for the assessment of performance in routing protocols salient Mobile Ad Hoc Network(MANET)routing protocols:Destination Sequenced Distance Vector(DSDV),Ad hoc...This paper contributes a sophisticated statistical method for the assessment of performance in routing protocols salient Mobile Ad Hoc Network(MANET)routing protocols:Destination Sequenced Distance Vector(DSDV),Ad hoc On-Demand Distance Vector(AODV),Dynamic Source Routing(DSR),and Zone Routing Protocol(ZRP).In this paper,the evaluation will be carried out using complete sets of statistical tests such as Kruskal-Wallis,Mann-Whitney,and Friedman.It articulates a systematic evaluation of how the performance of the previous protocols varies with the number of nodes and the mobility patterns.The study is premised upon the Quality of Service(QoS)metrics of throughput,packet delivery ratio,and end-to-end delay to gain an adequate understanding of the operational efficiency of each protocol under different network scenarios.The findings explained significant differences in the performance of different routing protocols;as a result,decisions for the selection and optimization of routing protocols can be taken effectively according to different network requirements.This paper is a step forward in the general understanding of the routing dynamics of MANETs and contributes significantly to the strategic deployment of robust and efficient network infrastructures.展开更多
This paper is concerned with consensus of a secondorder linear time-invariant multi-agent system in the situation that there exists a communication delay among the agents in the network.A proportional-integral consens...This paper is concerned with consensus of a secondorder linear time-invariant multi-agent system in the situation that there exists a communication delay among the agents in the network.A proportional-integral consensus protocol is designed by using delayed and memorized state information.Under the proportional-integral consensus protocol,the consensus problem of the multi-agent system is transformed into the problem of asymptotic stability of the corresponding linear time-invariant time-delay system.Note that the location of the eigenvalues of the corresponding characteristic function of the linear time-invariant time-delay system not only determines the stability of the system,but also plays a critical role in the dynamic performance of the system.In this paper,based on recent results on the distribution of roots of quasi-polynomials,several necessary conditions for Hurwitz stability for a class of quasi-polynomials are first derived.Then allowable regions of consensus protocol parameters are estimated.Some necessary and sufficient conditions for determining effective protocol parameters are provided.The designed protocol can achieve consensus and improve the dynamic performance of the second-order multi-agent system.Moreover,the effects of delays on consensus of systems of harmonic oscillators/double integrators under proportional-integral consensus protocols are investigated.Furthermore,some results on proportional-integral consensus are derived for a class of high-order linear time-invariant multi-agent systems.展开更多
Fair exchange protocols play a critical role in enabling two distrustful entities to conduct electronic data exchanges in a fair and secure manner.These protocols are widely used in electronic payment systems and elec...Fair exchange protocols play a critical role in enabling two distrustful entities to conduct electronic data exchanges in a fair and secure manner.These protocols are widely used in electronic payment systems and electronic contract signing,ensuring the reliability and security of network transactions.In order to address the limitations of current research methods and enhance the analytical capabilities for fair exchange protocols,this paper proposes a formal model for analyzing such protocols.The proposed model begins with a thorough analysis of fair exchange protocols,followed by the formal definition of fairness.This definition accurately captures the inherent requirements of fair exchange protocols.Building upon event logic,the model incorporates the time factor into predicates and introduces knowledge set axioms.This enhancement empowers the improved logic to effectively describe the state and knowledge of protocol participants at different time points,facilitating reasoning about their acquired knowledge.To maximize the intruder’s capabilities,channel errors are translated into the behaviors of the intruder.The participants are further categorized into honest participants and malicious participants,enabling a comprehensive evaluation of the intruder’s potential impact.By employing a typical fair exchange protocol as an illustrative example,this paper demonstrates the detailed steps of utilizing the proposed model for protocol analysis.The entire process of protocol execution under attack scenarios is presented,shedding light on the underlying reasons for the attacks and proposing corresponding countermeasures.The developedmodel enhances the ability to reason about and evaluate the security properties of fair exchange protocols,thereby contributing to the advancement of secure network transactions.展开更多
This paper is aimed at the distributed fault estimation issue associated with the potential loss of actuator efficiency for a type of discrete-time nonlinear systems with sensor saturation.For the distributed estimati...This paper is aimed at the distributed fault estimation issue associated with the potential loss of actuator efficiency for a type of discrete-time nonlinear systems with sensor saturation.For the distributed estimation structure under consideration,an estimation center is not necessary,and the estimator derives its information from itself and neighboring nodes,which fuses the state vector and the measurement vector.In an effort to cut down data conflicts in communication networks,the stochastic communication protocol(SCP)is employed so that the output signals from sensors can be selected.Additionally,a recursive security estimator scheme is created since attackers randomly inject malicious signals into the selected data.On this basis,sufficient conditions for a fault estimator with less conservatism are presented which ensure an upper bound of the estimation error covariance and the mean-square exponential boundedness of the estimating error.Finally,a numerical example is used to show the reliability and effectiveness of the considered distributed estimation algorithm.展开更多
Background:Acupuncture protocols are essential as they guide study design and improve the quality of clinical trial,thus preventing avoid research waste.Given the increasing number of publications on acupuncture proto...Background:Acupuncture protocols are essential as they guide study design and improve the quality of clinical trial,thus preventing avoid research waste.Given the increasing number of publications on acupuncture protocols,this study aimed to assess the publications trends of acupuncture protocols over the past two decades and provided an overview for future research directions.Methods:Publications focusing on acupuncture protocols in clinical settings were retrieved and compiled from the Web of Science Core Collection spanning the period from 2004 to 2023.CiteSpace and Microsoft Excel software were used to analyze the relationship of publication with countries,institutions,authors,co-cited author,journals,references,keywords and other literature aspects.Results:This study analyzed 721 articles encompassing acupuncture protocols.A continuous yet fluctuating growth in publications volume were observed from 2004 to 2023.Notably,China stands at the forefront in contributing to acupuncture protocols,publishing 513 papers and demonstrating a high centrality score of 1.07 in cooperative network.Furthermore,China has fostered close collaborations with the USA and South Korea.Beijing University of Chinese Medicine(89),Zhishun Liu(36)and Trials(306)emerged as the top contributors in terms of institution,author,and journal,respectively.However,inter-institutional and author collaboration was relatively weak.Macpherson H was the most frequently cited author.High-frequency keywords included“randomized controlled trials”,“acupuncture”,“management”,“study protocol”,“quality of life”.Analysis of timeline diagram of keywords indicated that“functional dyspepsia”,“stroke”,“electroacupuncture”,and“colorectal cancer”were the research development trends and focus.Conclusion:Clinical acupuncture protocols have experienced robust development over the past two decades,with current research hotspots focusing on disease management and quality of life,which remain key research concerns.Moreover,we advocate for researchers to publish acupuncture protocols,which remain key research concerns.This approach allows for thorough pre-study planning of methodologies and objectives,enhancing scientific rigor through peer review,thereby laying the foundation for conducting high-quality research.展开更多
The extracellular matrix(ECM)is a non-cellular three-dimensional structure present in all tissues that is essential for the intestinal maintenance,function and structure,as well as for providing physical support for t...The extracellular matrix(ECM)is a non-cellular three-dimensional structure present in all tissues that is essential for the intestinal maintenance,function and structure,as well as for providing physical support for tissue integrity and elasticity.ECM enables the regulation of various processes involved in tissue homeostasis,being vital for healing,growth,migration and cell differentiation.Structurally,ECM is composed of water,polysaccharides and proteins,such as collagen fibers and proteoglycans,which are specifically arranged for each tissue.In pathological scenarios,such as inflammatory bowel disease(IBD),the deposition and remodeling of the ECM can be altered in relation to the homeostatic composition.IBD,such as Ulcerative colitis and Crohn’s disease,can be differentiated according to ECM alterations,such as circulating levels of collagen,laminin and vimentin neoepitopes.In this context,ECM presents parti-cularities in both physiological and pathological processes,however,exploring methods of tissue decellularization is emerging as a promising frontier for new therapeutic interventions and clinical protocols,promoting the development of new approaches to intestinal diseases.展开更多
The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary care.During initial resuscitation...The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary care.During initial resuscitation of a patient in the emergency department(ED),Code Crimson activation facilitates rapid decisionmaking by multi-disciplinary specialists for definitive haemorrhage control in operating theatre(OT)and/or interventional radiology(IR)suite.Once this decision has been made,there may still be various factors that lead to delay in transporting the patient from ED to OT/IR.Red Blanket protocol identifies and addresses these factors and processes which cause delay,and aims to facilitate rapid and safe transport of the haemodynamically unstable patient from ED to OT,while minimizing delay in resuscitation during the transfer.The two processes,Code Crimson and Red Blanket,complement each other.It would be ideal to merge the two processes into a single protocol rather than having two separate workflows.Introducing these quality improvement strategies and coor-dinated processes within the trauma framework of the hospitals/healthcare systems will help in further improving the multi-disciplinary care for the complex trauma patients requiring rapid and definitive haemorrhage control.展开更多
Protocol Reverse Engineering(PRE)is of great practical importance in Internet security-related fields such as intrusion detection,vulnerability mining,and protocol fuzzing.For unknown binary protocols having fixed-len...Protocol Reverse Engineering(PRE)is of great practical importance in Internet security-related fields such as intrusion detection,vulnerability mining,and protocol fuzzing.For unknown binary protocols having fixed-length fields,and the accurate identification of field boundaries has a great impact on the subsequent analysis and final performance.Hence,this paper proposes a new protocol segmentation method based on Information-theoretic statistical analysis for binary protocols by formulating the field segmentation of unsupervised binary protocols as a probabilistic inference problem and modeling its uncertainty.Specifically,we design four related constructions between entropy changes and protocol field segmentation,introduce random variables,and construct joint probability distributions with traffic sample observations.Probabilistic inference is then performed to identify the possible protocol segmentation points.Extensive trials on nine common public and industrial control protocols show that the proposed method yields higher-quality protocol segmentation results.展开更多
“Flying Ad Hoc Networks(FANETs)”,which use“Unmanned Aerial Vehicles(UAVs)”,are developing as a critical mechanism for numerous applications,such as military operations and civilian services.The dynamic nature of F...“Flying Ad Hoc Networks(FANETs)”,which use“Unmanned Aerial Vehicles(UAVs)”,are developing as a critical mechanism for numerous applications,such as military operations and civilian services.The dynamic nature of FANETs,with high mobility,quick node migration,and frequent topology changes,presents substantial hurdles for routing protocol development.Over the preceding few years,researchers have found that machine learning gives productive solutions in routing while preserving the nature of FANET,which is topology change and high mobility.This paper reviews current research on routing protocols and Machine Learning(ML)approaches applied to FANETs,emphasizing developments between 2021 and 2023.The research uses the PRISMA approach to sift through the literature,filtering results from the SCOPUS database to find 82 relevant publications.The research study uses machine learning-based routing algorithms to beat the issues of high mobility,dynamic topologies,and intermittent connection in FANETs.When compared with conventional routing,it gives an energy-efficient and fast decision-making solution in a real-time environment,with greater fault tolerance capabilities.These protocols aim to increase routing efficiency,flexibility,and network stability using ML’s predictive and adaptive capabilities.This comprehensive review seeks to integrate existing information,offer novel integration approaches,and recommend future research topics for improving routing efficiency and flexibility in FANETs.Moreover,the study highlights emerging trends in ML integration,discusses challenges faced during the review,and discusses overcoming these hurdles in future research.展开更多
Accurate time synchronization is fundamental to the correct and efficient operation of Wireless Sensor Networks(WSNs),especially in security-critical,time-sensitive applications.However,most existing protocols degrade...Accurate time synchronization is fundamental to the correct and efficient operation of Wireless Sensor Networks(WSNs),especially in security-critical,time-sensitive applications.However,most existing protocols degrade substantially under malicious interference.We introduce iSTSP,an Intelligent and Secure Time Synchronization Protocol that implements a four-stage defense pipeline to ensure robust,precise synchronization even in hostile environments:(1)trust preprocessing that filters node participation using behavioral trust scoring;(2)anomaly isolation employing a lightweight autoencoder to detect and excise malicious nodes in real time;(3)reliability-weighted consensus that prioritizes high-trust nodes during time aggregation;and(4)convergence-optimized synchronization that dynamically adjusts parameters using theoretical stability bounds.We provide rigorous convergence analysis including a closed-form expression for convergence time,and validate the protocol through both simulations and realworld experiments on a controlled 16-node testbed.Under Sybil attacks with five malicious nodes within this testbed,iSTSP maintains synchronization error increases under 12%and achieves a rapid convergence.Compared to state-ofthe-art protocols like TPSN,SE-FTSP,and MMAR-CTS,iSTSP offers 60%faster detection,broader threat coverage,and more than 7 times lower synchronization error,with a modest 9.3%energy overhead over 8 h.We argue this is an acceptable trade-off for mission-critical deployments requiring guaranteed security.These findings demonstrate iSTSP’s potential as a reliable solution for secure WSN synchronization and motivate future work on large-scale IoT deployments and integration with energy-efficient communication protocols.展开更多
BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increas...BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increase re-tear rates.AIM To investigate the potential inhibitory effects of alpha-tocopherol(vitamin E)and OTR-4131 on muscle atrophy,fatty infiltration,and fibrosis in rotator cuff muscles following a massive RCT using a Wistar rat model,and establish a standardized methodology for evaluating potential therapeutic agents.METHODS This protocol outlines a controlled animal study using 40 male Wistar rats,randomized into five groups.The experimental groups will receive either systemic administration of alpha-tocopherol or local administration of OTR-4131 via intramuscular injection into the supraspinatus and infraspinatus muscles.Two sham groups will receive systemic and local saline injections respectively,while a control group will undergo no intervention.The interventions will be administered after surgical transection of the supraspinatus and infraspinatus tendons.Outcomes will be assessed via wet muscle weight measurements,muscle fiber diameter,fatty infiltration percentage,and fibrosis evaluation using histological methods.RESULTS The study anticipates that alpha-tocopherol and OTR-4131 will reduce muscle atrophy,fatty infiltration,and fibrosis compared to control and sham groups,supporting their potential protective role in rotator cuff muscle degeneration.CONCLUSION The results are expected to improve the understanding on the role of alpha-tocopherol and OTR-4131 in rotator cuff muscle protection after massive RCT and may serve as a foundation for further preclinical and clinical research aimed at improving rotator cuff repair outcomes.展开更多
Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some sugge...Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some suggestions and reference for promoting the timely marketing of drugs.Methods Based on the comparability protocol guidelines issued by the US FDA in October 2022,the regulatory status quo of PAC between China and the US was compared to explore the feasibility of implementing comparability protocols in China.Results and Conclusion According to the specific situation of post-approval of drug change supervision,some suggestions were put forward to optimize the PAC management procedure,such as establishing the communication pathways between holders and health authorities,publishing relevant guidance and strengthening training,so as to provide reference for the implementation of comparability protocols in China.展开更多
Developing highly active and stable oxygen evolution reaction(OER)catalysts necessitates the establishment of a comprehensive OER catalyst database.However,the absence of a standardized benchmarking protocol has hinde...Developing highly active and stable oxygen evolution reaction(OER)catalysts necessitates the establishment of a comprehensive OER catalyst database.However,the absence of a standardized benchmarking protocol has hindered this progress.In this work,we present a systematic protocol for electrochemical measurements to thoroughly evaluate the activity and stability of OER electrocatalysts.We begin with a detailed introduction to constructing the electrochemical system,encompassing experimental setup and the selection criteria for electrodes and electrolytes.Potential contaminants originating from electrolytes,cells,and electrodes are identified and their impacts are discussed.We also examine the effects of external factors,such as temperature,magnetic fields,and natural light,on OER measurements.The protocol outlines operational mechanisms and recommended settings for various electrochemical techniques,including cyclic voltammetry(CV),potentiostatic electrochemical impedance spectroscopy(PEIS),Tafel slope analysis,and pulse voltammetry(PV).We summarize existing evaluation methodologies for assessing intrinsic activities and long-term stabilities of catalysts.Based on these discussions,we propose a comprehensive protocol for evaluating OER electrocatalysts’performance.Finally,we offer perspectives on advancing OER catalysts from laboratory research to industrial applications.展开更多
The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted wor...The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted worldwide.The same recommendation,initially made during the coronavirus disease 2019(COVID-19)pandemic,was subsequently proven incorrect.In this clinical report,we present evidence,for the first time globally,from a real-life practice that NSAIDs may actually be lifesaving in the early management of DVD as they have proved to be in COVID-19.Moreover,we propose that the personalized immunemodulatory Kelleni’s protocol,which includes nitazoxanide as a key component,can be safely and effectively used to manage various separate or concomitant viral infections and co-infections,including DVD.Importantly,this article contributes to the current medical knowledge in the global pursuit of a safe and effective broad-spectrum antiviral protocol that can be used to early manage multiple highly infectious viruses.However,it’s crucial that sufficiently powered controlled randomized clinical trials be conducted to thoroughly assess and evaluate the safety of NSAIDs in the early management of DVD as well as the efficacy of nitazoxanide with or without NSAIDs in its management.展开更多
Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods...Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods for CKD(stages 1–3)are lacking.Guben Tongluo Formula(GTF)is the experience formula of Professor Liqun He,a famous traditional Chinese medicine(TCM)doctor in Shanghai.Our previous studies demonstrated that GTF might effectively alleviate CKD via multi-mechanisms.As the first angiotensin-2 receptor antagonist for treating hypertension,losartan potassium(LP)could effectively reduce blood pressure,decrease cardiovascular risk,and delay the occurrence of end-stage renal disease.Thus,we design this clinical protocol of GTF combining LP to observe the efficacy and safety of GTF and try to provide a novel drug treatment method for treating CKD(stages 1–3)patients.Methods and analysis:This is a multicenter randomized controlled clinical trial.160 participants will be enrolled in this trial and divided into LP group,GTF group,LP+GTF group,and placebo group randomly assigning 1:1:1:1 principle.LP group will receive general treatments combining LP,GTF group will receive general treatments combining GTF,and the GTF+LP group will receive general treatments combining GTF and LP.Placebo group will receive general treatments combining placebo treatment.The primary evaluation index will be the change of serum creatinine after treatment.Secondary evaluation indexes include changes in blood urea nitrogen,serum uric acid,estimated glomerular filtration rate,etc.;immune indicators and renal fibrosis indicators,as well as TCM symptoms.Besides,vital sign indicators and adverse events will be closely observed.Ethics and dissemination:The protocol has been approved by the Ethics Committee of Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine(reference number:2024-7th-HIRB-094)and other ethics committees at each center.With the implementation of this clinical trial,it would offer a TCM formula for the treatment of CKD(stages 1–3)and clarify the underlying mechanism of GTF for alleviating CKD.Trial registration:This trial is registered with ChiCTR2400090125 and registered on September 24,2024.展开更多
基金Funded by National Natural Science Foundation of China(No.52172007)Jiangsu Science and Technology Innovation Project for Carbon Peaking and Carbon Neutrality(No.BE2022035)。
文摘Focusing on the ultralow expansion functionality of the crystalized glass containing the cordierite crystal phase with the molar composition 20.7MgO·20.7Al_(2)O_(3)·51.6SiO_(2)·7.0TiO_(2),we systematically investigated impacts of thermal treatment protocols on T dependence of coefficients of thermal expansion(CTE).Except for the phase compositions,morphology is identified as another important factor to control the T dependence of CTE.By using X-ray diffraction and scanning electron microscope,various modes of T dependence of CTE for crystallized glasses are ascribed to their different phase compositions and microstructure with finely dispersed nanoparticles.These understanding contributes to the further modification of CTE of the crystalized glass by altering their thermal treatment scenarios.
文摘BACKGROUND Diabetes mellitus has become one of the major pandemics of the 21st century.In this scenario,nursing interventions are essential for improving self-care and quality of life in patients with type 2 diabetes mellitus.Nursing interventions are crucial for managing the disease and preventing complications.AIM To analyse nursing interventions in recent years through a systematic review and meta-analysis and to propose improvements in care plans.METHODS This study conducted a systematic review and meta-analysis of the impact of nursing interventions on quantitative glycaemic variables,such as glycated haemoglobin and fasting plasma glucose.RESULTS After confirming that the combined effect of all studies from the past 5 years positively impacts quantitative variables,a descriptive analysis of the studies with the most significant changes was conducted.Based on this,an improvement in diabetic patient care protocols has been proposed through follow-up plans tailored to the patient’s technological skills.CONCLUSION The combined results obtained and the proposal for improvement developed in this manuscript could help to improve the quality of life of many people around the world.
文摘Background: Studies have shown a strong correlation between the growth of E2 in serum and estrone-3-glucuronide (E1-3G) in urine during ovarian stimulation. Thus, we developed theoretical models for using urinary E1-3G in ovarian stimulation and focused on their experimental verification and analysis. Methods: A prospective, observational pilot study was conducted involving 54 patients who underwent 54 cycles of ovarian stimulation. The goal was to establish the growth rate of urinary E1-3G during the course of stimulation and to determine the daily upper and lower limits of growth rates at which stimulation is appropriate and safe. Controlled ovarian stimulation was performed using two different stimulation protocols—an antagonist protocol in 25 cases and a progestin-primed ovarian stimulation protocol (PPOS) in 29 cases, with fixed doses of gonadotropins. From the second day of stimulation, patients self-measured their daily urine E1-3G levels at home using a portable analyzer. In parallel, a standard ultrasound follow-up protocol accompanied by a determination of E2, LH, and P levels was applied to optimally control stimulation. Results: The average daily growth rates in both groups were about 50%. The daily increase in E1-3G for the antagonist protocol ranged from 14% to 79%, while they were 28% to 79% for the PPOS protocol. Conclusion: This is the first study to analyze the dynamics of E1-3G in two different protocols and to estimate the limits of its increase during the entire course of the stimulation. The results confirm our theoretical model for the viability of using urinary E1-3G for monitoring ovarian stimulation.
基金supported by the National Natural Science Foundation of China(62073019)。
文摘This paper investigates the problem of global/semi-global finite-time consensus for integrator-type multi-agent sys-tems.New hyperbolic tangent function-based protocols are pro-posed to achieve global and semi-global finite-time consensus for both single-integrator and double-integrator multi-agent systems with leaderless undirected and leader-following directed commu-nication topologies.These new protocols not only provide an explicit upper-bound estimate for the settling time,but also have a user-prescribed bounded control level.In addition,compared to some existing results based on the saturation function,the pro-posed approach considerably simplifies the protocol design and the stability analysis.Illustrative examples and an application demonstrate the effectiveness of the proposed protocols.
基金supported by NIH Core Grants P30-EY008098the Eye and Ear Foundation of Pittsburghunrestricted grants from Research to Prevent Blindness,New York,NY,USA(to KCC)。
文摘Glaucoma,characterized by a degenerative loss of retinal ganglion cells,is the second leading cause of blindness worldwide.There is currently no cure for vision loss in glaucoma because retinal ganglion cells do not regenerate and are not replaced after injury.Human stem cell-derived retinal ganglion cell transplant is a potential therapeutic strategy for retinal ganglion cell degenerative diseases.In this review,we first discuss a 2D protocol for retinal ganglion cell differentiation from human stem cell culture,including a rapid protocol that can generate retinal ganglion cells in less than two weeks and focus on their transplantation outcomes.Next,we discuss using 3D retinal organoids for retinal ganglion cell transplantation,comparing cell suspensions and clusters.This review provides insight into current knowledge on human stem cell-derived retinal ganglion cell differentiation and transplantation,with an impact on the field of regenerative medicine and especially retinal ganglion cell degenerative diseases such as glaucoma and other optic neuropathies.
基金supported by Northern Border University,Arar,KSA,through the Project Number“NBU-FFR-2024-2248-02”.
文摘This paper contributes a sophisticated statistical method for the assessment of performance in routing protocols salient Mobile Ad Hoc Network(MANET)routing protocols:Destination Sequenced Distance Vector(DSDV),Ad hoc On-Demand Distance Vector(AODV),Dynamic Source Routing(DSR),and Zone Routing Protocol(ZRP).In this paper,the evaluation will be carried out using complete sets of statistical tests such as Kruskal-Wallis,Mann-Whitney,and Friedman.It articulates a systematic evaluation of how the performance of the previous protocols varies with the number of nodes and the mobility patterns.The study is premised upon the Quality of Service(QoS)metrics of throughput,packet delivery ratio,and end-to-end delay to gain an adequate understanding of the operational efficiency of each protocol under different network scenarios.The findings explained significant differences in the performance of different routing protocols;as a result,decisions for the selection and optimization of routing protocols can be taken effectively according to different network requirements.This paper is a step forward in the general understanding of the routing dynamics of MANETs and contributes significantly to the strategic deployment of robust and efficient network infrastructures.
基金supported in part by the National Natural Science Foundation of China (NSFC)(61703086, 61773106)the IAPI Fundamental Research Funds (2018ZCX27)
文摘This paper is concerned with consensus of a secondorder linear time-invariant multi-agent system in the situation that there exists a communication delay among the agents in the network.A proportional-integral consensus protocol is designed by using delayed and memorized state information.Under the proportional-integral consensus protocol,the consensus problem of the multi-agent system is transformed into the problem of asymptotic stability of the corresponding linear time-invariant time-delay system.Note that the location of the eigenvalues of the corresponding characteristic function of the linear time-invariant time-delay system not only determines the stability of the system,but also plays a critical role in the dynamic performance of the system.In this paper,based on recent results on the distribution of roots of quasi-polynomials,several necessary conditions for Hurwitz stability for a class of quasi-polynomials are first derived.Then allowable regions of consensus protocol parameters are estimated.Some necessary and sufficient conditions for determining effective protocol parameters are provided.The designed protocol can achieve consensus and improve the dynamic performance of the second-order multi-agent system.Moreover,the effects of delays on consensus of systems of harmonic oscillators/double integrators under proportional-integral consensus protocols are investigated.Furthermore,some results on proportional-integral consensus are derived for a class of high-order linear time-invariant multi-agent systems.
基金the National Natural Science Foundation of China(Nos.61562026,61962020)Academic and Technical Leaders of Major Disciplines in Jiangxi Province(No.20172BCB22015)+1 种基金Special Fund Project for Postgraduate Innovation in Jiangxi Province(No.YC2020-B1141)Jiangxi Provincial Natural Science Foundation(No.20224ACB202006).
文摘Fair exchange protocols play a critical role in enabling two distrustful entities to conduct electronic data exchanges in a fair and secure manner.These protocols are widely used in electronic payment systems and electronic contract signing,ensuring the reliability and security of network transactions.In order to address the limitations of current research methods and enhance the analytical capabilities for fair exchange protocols,this paper proposes a formal model for analyzing such protocols.The proposed model begins with a thorough analysis of fair exchange protocols,followed by the formal definition of fairness.This definition accurately captures the inherent requirements of fair exchange protocols.Building upon event logic,the model incorporates the time factor into predicates and introduces knowledge set axioms.This enhancement empowers the improved logic to effectively describe the state and knowledge of protocol participants at different time points,facilitating reasoning about their acquired knowledge.To maximize the intruder’s capabilities,channel errors are translated into the behaviors of the intruder.The participants are further categorized into honest participants and malicious participants,enabling a comprehensive evaluation of the intruder’s potential impact.By employing a typical fair exchange protocol as an illustrative example,this paper demonstrates the detailed steps of utilizing the proposed model for protocol analysis.The entire process of protocol execution under attack scenarios is presented,shedding light on the underlying reasons for the attacks and proposing corresponding countermeasures.The developedmodel enhances the ability to reason about and evaluate the security properties of fair exchange protocols,thereby contributing to the advancement of secure network transactions.
基金supported in part by the National Natural Science Foundation of China(62073189,62173207)the Taishan Scholar Project of Shandong Province(tsqn202211129)。
文摘This paper is aimed at the distributed fault estimation issue associated with the potential loss of actuator efficiency for a type of discrete-time nonlinear systems with sensor saturation.For the distributed estimation structure under consideration,an estimation center is not necessary,and the estimator derives its information from itself and neighboring nodes,which fuses the state vector and the measurement vector.In an effort to cut down data conflicts in communication networks,the stochastic communication protocol(SCP)is employed so that the output signals from sensors can be selected.Additionally,a recursive security estimator scheme is created since attackers randomly inject malicious signals into the selected data.On this basis,sufficient conditions for a fault estimator with less conservatism are presented which ensure an upper bound of the estimation error covariance and the mean-square exponential boundedness of the estimating error.Finally,a numerical example is used to show the reliability and effectiveness of the considered distributed estimation algorithm.
基金supported by the Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-C-202006)the High-level traditional Chinese medicine key subject construction project of National Administration of Traditional Chinese Medicine--Evidence-based Traditional Chinese Medicine(ZYYZDXK-2023249).
文摘Background:Acupuncture protocols are essential as they guide study design and improve the quality of clinical trial,thus preventing avoid research waste.Given the increasing number of publications on acupuncture protocols,this study aimed to assess the publications trends of acupuncture protocols over the past two decades and provided an overview for future research directions.Methods:Publications focusing on acupuncture protocols in clinical settings were retrieved and compiled from the Web of Science Core Collection spanning the period from 2004 to 2023.CiteSpace and Microsoft Excel software were used to analyze the relationship of publication with countries,institutions,authors,co-cited author,journals,references,keywords and other literature aspects.Results:This study analyzed 721 articles encompassing acupuncture protocols.A continuous yet fluctuating growth in publications volume were observed from 2004 to 2023.Notably,China stands at the forefront in contributing to acupuncture protocols,publishing 513 papers and demonstrating a high centrality score of 1.07 in cooperative network.Furthermore,China has fostered close collaborations with the USA and South Korea.Beijing University of Chinese Medicine(89),Zhishun Liu(36)and Trials(306)emerged as the top contributors in terms of institution,author,and journal,respectively.However,inter-institutional and author collaboration was relatively weak.Macpherson H was the most frequently cited author.High-frequency keywords included“randomized controlled trials”,“acupuncture”,“management”,“study protocol”,“quality of life”.Analysis of timeline diagram of keywords indicated that“functional dyspepsia”,“stroke”,“electroacupuncture”,and“colorectal cancer”were the research development trends and focus.Conclusion:Clinical acupuncture protocols have experienced robust development over the past two decades,with current research hotspots focusing on disease management and quality of life,which remain key research concerns.Moreover,we advocate for researchers to publish acupuncture protocols,which remain key research concerns.This approach allows for thorough pre-study planning of methodologies and objectives,enhancing scientific rigor through peer review,thereby laying the foundation for conducting high-quality research.
基金Supported by São Paulo Research Foundation(Fundação de AmparoàPesquisa do Estado de São Paulo-FAPESP,Brazil),No.2014/25927-2,No.2018/07862-1,No.2021/05445-7,and No.2022/00086-1the Brazilian National Council for Scientific and Technological Development(Conselho Nacional de Desenvolvimento Científico e Tecnológico-CNPq,Brazil)and the Brazilian Federal Agency for Support and Evaluation of Graduate Education(Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-CAPES,Brazil).
文摘The extracellular matrix(ECM)is a non-cellular three-dimensional structure present in all tissues that is essential for the intestinal maintenance,function and structure,as well as for providing physical support for tissue integrity and elasticity.ECM enables the regulation of various processes involved in tissue homeostasis,being vital for healing,growth,migration and cell differentiation.Structurally,ECM is composed of water,polysaccharides and proteins,such as collagen fibers and proteoglycans,which are specifically arranged for each tissue.In pathological scenarios,such as inflammatory bowel disease(IBD),the deposition and remodeling of the ECM can be altered in relation to the homeostatic composition.IBD,such as Ulcerative colitis and Crohn’s disease,can be differentiated according to ECM alterations,such as circulating levels of collagen,laminin and vimentin neoepitopes.In this context,ECM presents parti-cularities in both physiological and pathological processes,however,exploring methods of tissue decellularization is emerging as a promising frontier for new therapeutic interventions and clinical protocols,promoting the development of new approaches to intestinal diseases.
文摘The care of a patient involved in major trauma with exsanguinating haemorrhage is time-critical to achieve definitive haemorrhage control,and it requires coordinated multidisciplinary care.During initial resuscitation of a patient in the emergency department(ED),Code Crimson activation facilitates rapid decisionmaking by multi-disciplinary specialists for definitive haemorrhage control in operating theatre(OT)and/or interventional radiology(IR)suite.Once this decision has been made,there may still be various factors that lead to delay in transporting the patient from ED to OT/IR.Red Blanket protocol identifies and addresses these factors and processes which cause delay,and aims to facilitate rapid and safe transport of the haemodynamically unstable patient from ED to OT,while minimizing delay in resuscitation during the transfer.The two processes,Code Crimson and Red Blanket,complement each other.It would be ideal to merge the two processes into a single protocol rather than having two separate workflows.Introducing these quality improvement strategies and coor-dinated processes within the trauma framework of the hospitals/healthcare systems will help in further improving the multi-disciplinary care for the complex trauma patients requiring rapid and definitive haemorrhage control.
文摘Protocol Reverse Engineering(PRE)is of great practical importance in Internet security-related fields such as intrusion detection,vulnerability mining,and protocol fuzzing.For unknown binary protocols having fixed-length fields,and the accurate identification of field boundaries has a great impact on the subsequent analysis and final performance.Hence,this paper proposes a new protocol segmentation method based on Information-theoretic statistical analysis for binary protocols by formulating the field segmentation of unsupervised binary protocols as a probabilistic inference problem and modeling its uncertainty.Specifically,we design four related constructions between entropy changes and protocol field segmentation,introduce random variables,and construct joint probability distributions with traffic sample observations.Probabilistic inference is then performed to identify the possible protocol segmentation points.Extensive trials on nine common public and industrial control protocols show that the proposed method yields higher-quality protocol segmentation results.
基金support the findings of this study are openly available in(Scopus database)at www.scopus.com(accessed on 07 January 2025).
文摘“Flying Ad Hoc Networks(FANETs)”,which use“Unmanned Aerial Vehicles(UAVs)”,are developing as a critical mechanism for numerous applications,such as military operations and civilian services.The dynamic nature of FANETs,with high mobility,quick node migration,and frequent topology changes,presents substantial hurdles for routing protocol development.Over the preceding few years,researchers have found that machine learning gives productive solutions in routing while preserving the nature of FANET,which is topology change and high mobility.This paper reviews current research on routing protocols and Machine Learning(ML)approaches applied to FANETs,emphasizing developments between 2021 and 2023.The research uses the PRISMA approach to sift through the literature,filtering results from the SCOPUS database to find 82 relevant publications.The research study uses machine learning-based routing algorithms to beat the issues of high mobility,dynamic topologies,and intermittent connection in FANETs.When compared with conventional routing,it gives an energy-efficient and fast decision-making solution in a real-time environment,with greater fault tolerance capabilities.These protocols aim to increase routing efficiency,flexibility,and network stability using ML’s predictive and adaptive capabilities.This comprehensive review seeks to integrate existing information,offer novel integration approaches,and recommend future research topics for improving routing efficiency and flexibility in FANETs.Moreover,the study highlights emerging trends in ML integration,discusses challenges faced during the review,and discusses overcoming these hurdles in future research.
基金this project under Geran Putra Inisiatif(GPI)with reference of GP-GPI/2023/976210。
文摘Accurate time synchronization is fundamental to the correct and efficient operation of Wireless Sensor Networks(WSNs),especially in security-critical,time-sensitive applications.However,most existing protocols degrade substantially under malicious interference.We introduce iSTSP,an Intelligent and Secure Time Synchronization Protocol that implements a four-stage defense pipeline to ensure robust,precise synchronization even in hostile environments:(1)trust preprocessing that filters node participation using behavioral trust scoring;(2)anomaly isolation employing a lightweight autoencoder to detect and excise malicious nodes in real time;(3)reliability-weighted consensus that prioritizes high-trust nodes during time aggregation;and(4)convergence-optimized synchronization that dynamically adjusts parameters using theoretical stability bounds.We provide rigorous convergence analysis including a closed-form expression for convergence time,and validate the protocol through both simulations and realworld experiments on a controlled 16-node testbed.Under Sybil attacks with five malicious nodes within this testbed,iSTSP maintains synchronization error increases under 12%and achieves a rapid convergence.Compared to state-ofthe-art protocols like TPSN,SE-FTSP,and MMAR-CTS,iSTSP offers 60%faster detection,broader threat coverage,and more than 7 times lower synchronization error,with a modest 9.3%energy overhead over 8 h.We argue this is an acceptable trade-off for mission-critical deployments requiring guaranteed security.These findings demonstrate iSTSP’s potential as a reliable solution for secure WSN synchronization and motivate future work on large-scale IoT deployments and integration with energy-efficient communication protocols.
基金thank the staff of the accredited animal facility of the laboratory of anatomy,Histology and Embryology of Aristotle University of Thessaloniki’s veterinary school for their assistance in animal handling and care.
文摘BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increase re-tear rates.AIM To investigate the potential inhibitory effects of alpha-tocopherol(vitamin E)and OTR-4131 on muscle atrophy,fatty infiltration,and fibrosis in rotator cuff muscles following a massive RCT using a Wistar rat model,and establish a standardized methodology for evaluating potential therapeutic agents.METHODS This protocol outlines a controlled animal study using 40 male Wistar rats,randomized into five groups.The experimental groups will receive either systemic administration of alpha-tocopherol or local administration of OTR-4131 via intramuscular injection into the supraspinatus and infraspinatus muscles.Two sham groups will receive systemic and local saline injections respectively,while a control group will undergo no intervention.The interventions will be administered after surgical transection of the supraspinatus and infraspinatus tendons.Outcomes will be assessed via wet muscle weight measurements,muscle fiber diameter,fatty infiltration percentage,and fibrosis evaluation using histological methods.RESULTS The study anticipates that alpha-tocopherol and OTR-4131 will reduce muscle atrophy,fatty infiltration,and fibrosis compared to control and sham groups,supporting their potential protective role in rotator cuff muscle degeneration.CONCLUSION The results are expected to improve the understanding on the role of alpha-tocopherol and OTR-4131 in rotator cuff muscle protection after massive RCT and may serve as a foundation for further preclinical and clinical research aimed at improving rotator cuff repair outcomes.
文摘Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some suggestions and reference for promoting the timely marketing of drugs.Methods Based on the comparability protocol guidelines issued by the US FDA in October 2022,the regulatory status quo of PAC between China and the US was compared to explore the feasibility of implementing comparability protocols in China.Results and Conclusion According to the specific situation of post-approval of drug change supervision,some suggestions were put forward to optimize the PAC management procedure,such as establishing the communication pathways between holders and health authorities,publishing relevant guidance and strengthening training,so as to provide reference for the implementation of comparability protocols in China.
基金supported by the Fundamental Research Funds for the Central Universities(20822041H4082)。
文摘Developing highly active and stable oxygen evolution reaction(OER)catalysts necessitates the establishment of a comprehensive OER catalyst database.However,the absence of a standardized benchmarking protocol has hindered this progress.In this work,we present a systematic protocol for electrochemical measurements to thoroughly evaluate the activity and stability of OER electrocatalysts.We begin with a detailed introduction to constructing the electrochemical system,encompassing experimental setup and the selection criteria for electrodes and electrolytes.Potential contaminants originating from electrolytes,cells,and electrodes are identified and their impacts are discussed.We also examine the effects of external factors,such as temperature,magnetic fields,and natural light,on OER measurements.The protocol outlines operational mechanisms and recommended settings for various electrochemical techniques,including cyclic voltammetry(CV),potentiostatic electrochemical impedance spectroscopy(PEIS),Tafel slope analysis,and pulse voltammetry(PV).We summarize existing evaluation methodologies for assessing intrinsic activities and long-term stabilities of catalysts.Based on these discussions,we propose a comprehensive protocol for evaluating OER electrocatalysts’performance.Finally,we offer perspectives on advancing OER catalysts from laboratory research to industrial applications.
文摘The current recommendation to avoid non-steroidal anti-inflammatory drugs(NSAIDs)in the management of dengue virus disease(DVD)is scientifically considered of very low to low certainty,despite being widely adopted worldwide.The same recommendation,initially made during the coronavirus disease 2019(COVID-19)pandemic,was subsequently proven incorrect.In this clinical report,we present evidence,for the first time globally,from a real-life practice that NSAIDs may actually be lifesaving in the early management of DVD as they have proved to be in COVID-19.Moreover,we propose that the personalized immunemodulatory Kelleni’s protocol,which includes nitazoxanide as a key component,can be safely and effectively used to manage various separate or concomitant viral infections and co-infections,including DVD.Importantly,this article contributes to the current medical knowledge in the global pursuit of a safe and effective broad-spectrum antiviral protocol that can be used to early manage multiple highly infectious viruses.However,it’s crucial that sufficiently powered controlled randomized clinical trials be conducted to thoroughly assess and evaluate the safety of NSAIDs in the early management of DVD as well as the efficacy of nitazoxanide with or without NSAIDs in its management.
基金supported by grants from Pudong New Area Traditional Chinese Medicine Brand Multiplication Plan-Chronic Nephropathy(PDZY-2021-0302)Construction of He Liqun’s famous TCM studio(PDZY-2022-0703)+2 种基金Clinical Observation on the Efficacy of Guben Tongluo Formula in Treating Chronic Kidney Disease Phase 1-3(PW2022D-12)Pilot Project of Inheritance,Innovation and Development of Traditional Chinese Medicine in Pudong New Area(YC-2023-0602)Pudong New Area’s Peak and Plateau Discipline Development in Clinical Medicine for Novel and Special Diseases(2025-PWXZ-15).
文摘Introduction:With the incidence of chronic kidney disease(CKD)increasing year by year,it is particularly important to intervene in the early stage of CKD(stages 1–3).Unfortunately,the effective drug treatment methods for CKD(stages 1–3)are lacking.Guben Tongluo Formula(GTF)is the experience formula of Professor Liqun He,a famous traditional Chinese medicine(TCM)doctor in Shanghai.Our previous studies demonstrated that GTF might effectively alleviate CKD via multi-mechanisms.As the first angiotensin-2 receptor antagonist for treating hypertension,losartan potassium(LP)could effectively reduce blood pressure,decrease cardiovascular risk,and delay the occurrence of end-stage renal disease.Thus,we design this clinical protocol of GTF combining LP to observe the efficacy and safety of GTF and try to provide a novel drug treatment method for treating CKD(stages 1–3)patients.Methods and analysis:This is a multicenter randomized controlled clinical trial.160 participants will be enrolled in this trial and divided into LP group,GTF group,LP+GTF group,and placebo group randomly assigning 1:1:1:1 principle.LP group will receive general treatments combining LP,GTF group will receive general treatments combining GTF,and the GTF+LP group will receive general treatments combining GTF and LP.Placebo group will receive general treatments combining placebo treatment.The primary evaluation index will be the change of serum creatinine after treatment.Secondary evaluation indexes include changes in blood urea nitrogen,serum uric acid,estimated glomerular filtration rate,etc.;immune indicators and renal fibrosis indicators,as well as TCM symptoms.Besides,vital sign indicators and adverse events will be closely observed.Ethics and dissemination:The protocol has been approved by the Ethics Committee of Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine(reference number:2024-7th-HIRB-094)and other ethics committees at each center.With the implementation of this clinical trial,it would offer a TCM formula for the treatment of CKD(stages 1–3)and clarify the underlying mechanism of GTF for alleviating CKD.Trial registration:This trial is registered with ChiCTR2400090125 and registered on September 24,2024.
