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BMC Complementary and Alternative... Mar 2017As the etiology of chronic fatigue syndrome (CFS) is unclear and the treatment is still a big issue. There exists a wide range of literature about acupuncture and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
As the etiology of chronic fatigue syndrome (CFS) is unclear and the treatment is still a big issue. There exists a wide range of literature about acupuncture and moxibustion (AM) for CFS in traditional Chinese medicine (TCM). But there are certain doubts as well in the effectiveness of its treatment due to the lack of a comprehensive and evidence-based medical proof to dispel the misgivings. Current study evaluated systematically the effectiveness of acupuncture and moxibustion treatments on CFS, and clarified the difference among them and Chinese herbal medicine, western medicine and sham-acupuncture.
METHODS
We comprehensively reviewed literature including PubMed, EMBASE, Cochrane library, CBM (Chinese Biomedical Literature Database) and CNKI (China National Knowledge Infrastructure) up to May 2016, for RCT clinical research on CFS treated by acupuncture and moxibustion. Traditional direct meta-analysis was adopted to analyze the difference between AM and other treatments. Analysis was performed based on the treatment in experiment and control groups. Network meta-analysis was adopted to make comprehensive comparisons between any two kinds of treatments. The primary outcome was total effective rate, while relative risks (RR) and 95% confidence intervals (CI) were used as the final pooled statistics.
RESULTS
A total of 31 randomized controlled trials (RCTs) were enrolled in analyses. In traditional direct meta-analysis, we found that in comparison to Chinese herbal medicine, CbAM (combined acupuncture and moxibustion, which meant two or more types of acupuncture and moxibustion were adopted) had a higher total effective rate (RR (95% CI), 1.17 (1.09 ~ 1.25)). Compared with Chinese herbal medicine, western medicine and sham-acupuncture, SAM (single acupuncture or single moxibustion) had a higher total effective rate, with RR (95% CI) of 1.22 (1.14 ~ 1.30), 1.51 (1.31-1.74), 5.90 (3.64-9.56). In addition, compared with SAM, CbAM had a higher total effective rate (RR (95% CI), 1.23 (1.12 ~ 1.36)). In network meta-analyses, similar results were recorded. Subsequently, we ranked all treatments from high to low effective rate and the order was CbAM, SAM, Chinese herbal medicine, western medicine and sham-acupuncture.
CONCLUSIONS
In the treatment of CFS, CbAM and SAM may have better effect than other treatments. However, the included trials have relatively poor quality, hence high quality studies are needed to confirm our finding.
Topics: Acupuncture Therapy; Drugs, Chinese Herbal; Fatigue Syndrome, Chronic; Humans; Medicine, Chinese Traditional; Moxibustion; Treatment Outcome
PubMed: 28335756
DOI: 10.1186/s12906-017-1647-x -
Frontiers in Endocrinology 2023Through a comprehensive analysis of the clinical randomized controlled trials of traditional Chinese medicine (TCM) combined with conventional western medicine (CWM) in... (Meta-Analysis)
Meta-Analysis
Efficacy and safety of traditional Chinese medicines combined with conventional Western medicines in the treatment of type 2 diabetes mellitus: a network meta-analysis of randomized controlled trials.
AIMS/HYPOTHESIS
Through a comprehensive analysis of the clinical randomized controlled trials of traditional Chinese medicine (TCM) combined with conventional western medicine (CWM) in treating type 2 diabetes(T2DM) in the past ten years, the clinical efficacy and safety of different TCMs combined with CWM were explored. This study aimed to provide specific suggestions for clinical guidance on treating T2DM.
METHODS
A literature search was conducted in CNKI, WanFang, VIP, CBM, PubMed, Embase, and Web of Science. The search time was limited from 2010 to the present time. The literature type was a controlled clinical trial study of TCM combined with CWM intervention in treating T2DM. The outcome indices of the efficacy evaluation included fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), adverse reactions, and clinical efficacy. Stata 15 and RevMan 5.4 software were used to conduct a network meta-analysis and a traditional meta-analysis.
RESULTS
The results showed that shenqi jiangtang granule combined with sulfonylurea, shenqi jiangtang granules combined with metformin and jinlida granules combined with insulin had significant effects on reductions in FBG, 2hPG and clinical efficacy compared with western medicines alone, which included fasting blood glucose [MD=-2.17, 95%CI=(-2.50, -1.85)], blood sugar at 2 hours after a meal [MD=-1.94, 95%CI=(-2.23, -1.65)], and clinical curative effect [OR= 1.73, 95%CI=(0.59, 2.87)].
CONCLUSIONS
TCM combined with CWM has a very significant effect on treating T2DM compared with CWM alone. According to the network meta-analysis, the best intervention measures of different TCMs for different outcome indicators were obtained.
SYSTEMATIC REVIEW REGISTRATION
identifier 42022350372.
Topics: Humans; Diabetes Mellitus, Type 2; Medicine, Chinese Traditional; Network Meta-Analysis; Blood Glucose; Randomized Controlled Trials as Topic
PubMed: 37223050
DOI: 10.3389/fendo.2023.1134297 -
Forensic Science International Dec 2023Vertebrate scavengers frequently affect forensic casework by feeding on human remains or by scattering body parts and bones. Therefore, animal activity can influence... (Review)
Review
Vertebrate scavengers frequently affect forensic casework by feeding on human remains or by scattering body parts and bones. Therefore, animal activity can influence complete recovery of bodies, trauma analysis, and the estimation of the postmortem interval (PMI), potentially hampering identification of the deceased and elucidation of the perimortem circumstances. Experimental research is well suited to investigate scavengers and their impact on carcasses over time, generating knowledge on the forensic relevance of certain scavenger species or communities. However, there are currently no systematised standards to conduct these investigations with a forensic focus, impeding comparison and synthesis of the studies. In our work, we performed a systematic literature review and found 79 publications featuring terrestrial experiments on vertebrate scavenging and/or scattering within a forensic context. We extracted 21 variables describing the study environment, experimental design and the specimens. The results show that there is considerable inconsistency in the study designs and that some of the variables are insufficiently reported. We point out research questions and areas that require attention in future studies, stressing the importance of infrequently mentioned or applied variables. Furthermore, we recommend guidelines to include and report a list of variables in forensic scavenging and scattering experiments. These guidelines will help standardising future research in the field, facilitating inter-study consolidation of results and conclusions, and consequently, inform forensic casework.
Topics: Animals; Humans; Postmortem Changes; Feeding Behavior; Forensic Anthropology; Cadaver; Autopsy
PubMed: 37931469
DOI: 10.1016/j.forsciint.2023.111862 -
Asian Journal of Surgery Nov 2023
Meta-Analysis
Topics: Humans; East Asian People; Exercise Therapy; Medicine, Chinese Traditional; Osteoarthritis, Knee
PubMed: 37349176
DOI: 10.1016/j.asjsur.2023.06.044 -
BMJ Open Nov 2014Worldwide, an estimated 125 million girls and women live with female genital mutilation/cutting (FGM/C). We aimed to systematically review the evidence for physical... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Worldwide, an estimated 125 million girls and women live with female genital mutilation/cutting (FGM/C). We aimed to systematically review the evidence for physical health risks associated with FGM/C.
DESIGN
We searched 15 databases to identify studies (up to January 2012). Selection criteria were empirical studies reporting physical health outcomes from FGM/C, affecting females with any type of FGM/C, irrespective of ethnicity, nationality and age. Two review authors independently screened titles and abstracts, applied eligibility criteria, assessed methodological study quality and extracted full-text data. To derive overall risk estimates, we combined data from included studies using the Mantel-Haenszel method for unadjusted dichotomous data and the generic inverse-variance method for adjusted data. Outcomes that were sufficiently similar across studies and reasonably resistant to biases were aggregated in meta-analyses. We applied the instrument Grading of Recommendations Assessment, Development and Evaluation to assess the extent to which we have confidence in the effect estimates.
RESULTS
Our search returned 5109 results, of which 185 studies (3.17 million women) satisfied the inclusion criteria. The risks of systematic and random errors were variable and we focused on key outcomes from the 57 studies with the best available evidence. The most common immediate complications were excessive bleeding, urine retention and genital tissue swelling. The most valid and statistically significant associations for the physical health sequelae of FGM/C were seen on urinary tract infections (unadjusted RR=3.01), bacterial vaginosis (adjusted OR (AOR)=1.68), dyspareunia (RR=1.53), prolonged labour (AOR=1.49), caesarean section (AOR=1.60), and difficult delivery (AOR=1.88).
CONCLUSIONS
While the precise estimation of the frequency and risk of immediate, gynaecological, sexual and obstetric complications is not possible, the results weigh against the continuation of FGM/C and support the diagnosis and management of girls and women suffering the physical risks of FGM/C.
TRIAL REGISTRATION NUMBER
This study is registered with PROSPERO, number CRD42012003321.
Topics: Causality; Circumcision, Female; Female; Female Urogenital Diseases; Humans; Internationality; Obstetric Labor Complications; Pregnancy; Risk
PubMed: 25416059
DOI: 10.1136/bmjopen-2014-006316 -
International Journal of Nursing Studies Jan 2021An increasing number of qualitative research articles have reported on relatives' experiences of providing care for individuals displaying suicidal behaviour. To... (Review)
Review
BACKGROUND
An increasing number of qualitative research articles have reported on relatives' experiences of providing care for individuals displaying suicidal behaviour. To contribute more fully to theory and practice, these reported experiences must be synthesized.
OBJECTIVES
To identify original qualitative studies of relatives' experiences of providing care for individuals with non-fatal suicidal behaviour and to systematically review and synthesize this research using a meta-ethnographic approach.
DESIGN
Systematic review and meta-ethnography.
DATA SOURCES
Literature searches were undertaken in six bibliographic databases (PubMed, CINAHL, Embase, PsycINFO, Web of Science and Scopus) and limited to peer-reviewed original studies. Eligible studies reported relatives' experiences of providing care for individuals with suicidal behaviour, published in English or a Scandinavian language.
REVIEW METHODS
One reviewer screened the titles, abstracts and full texts and then collaborated with another reviewer on excluding ineligible studies. A two-step strategy was used while reviewing publications: 1) appraising study quality, and 2) classifying study findings according to degree of data interpretation. This strategy was used for each study by two independent reviewers who subsequently reached a shared decision on inclusion. Noblit and Hare's methodology for translation and synthesis was followed in developing a novel theoretical interpretation of relatives' experiences. The concept of moral career was adopted in producing this synthesis.
RESULTS
Of 7,334 publications screened, 12 studies were eligible for inclusion. The synthesis conveyed relatives' moral career as comprising four stages, each depicting relatives' different perspectives on life and felt identities. First, relatives negotiated conventional ideas about normalcy and positioned themselves as living abnormal family lives in the stage from normal to abnormal. The first career movement could be mediated by social interactions with professionals in the stage feeling helpful or feeling unhelpful. For some relatives, this negotiated perspective of abnormality got stuck in an impasse. They did not interact with their surroundings in ways that would enable them to renegotiate these fixed views, and this stage was named stuck in abnormality. For other relatives, career movement took place as relatives re-positioned themselves as negotiating an alternative perspective of normalcy in the stage from abnormal to normal.
CONCLUSIONS
Interactions with other people facing similar difficulties enabled relatives to shift perspectives and alleviated experiences of distress.
Topics: Anthropology, Cultural; Emotions; Humans; Morals; Qualitative Research; Suicidal Ideation
PubMed: 33161331
DOI: 10.1016/j.ijnurstu.2020.103793 -
Contrast Media & Molecular Imaging 2022Lung carcinoma is a serious disorder that negatively influences the quality of life of sufferers. Despite the growing number of investigations into the management and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Lung carcinoma is a serious disorder that negatively influences the quality of life of sufferers. Despite the growing number of investigations into the management and prognosis of lung carcinoma, few research studies have been conducted to demonstrate the association between TCM constitution and lung carcinoma.
METHODS
We searched PubMed, EMBASE, Science Net, Cochrane Library, China National Knowledge Infrastructure, VIP database, Wanfang database, and China Biomedical Literature Database for Chinese and English versions until January 31, 2021. We also manually searched for Chinese lung cancer, Chinese physical medicine, Chinese medical trial registries, and unpublished surveys or references. The literature was screened against inclusive and exclusive criteria, and two investigators' results were independently summarized. The primary outcome was a ratio of body type. Single-group rates were meta-analyzed using Stata 14.0 statistical software, bias was estimated by funnel plotting, and sources of heterogeneity were evaluated by subgroup and sensitivity examinations.
RESULTS
18 randomized controlled trials were totally included to compare the single-group ratio and 95% confidence interval of nine constitution types of lung cancer, namely, mild constitution (ES = 0.12, 95% CI (0.08, 0.15), < 0.0001), Qi deficiency constitution (ES = 0.20, 95% CI (0.15, 0.26), < 0.0001), Qi depression constitution (ES = 0.09, 95% CI (0.07, 0.12), < 0.0001), damp-heat constitution (ES = 0.05, 95% CI (0.03, -0.06), < 0.0001), phlegm dampness constitution (ES = 0.05, 95% CI (0.03, -0.06), < 0.0001), special constitution (ES = 0.01, 95% CI (0.01, 0.02), =0.993), blood stasis constitution (ES = 0.05, 95% CI (0.04, 0.07), < 0.0001), Yang deficiency constitution (ES = 0.16, 95% CI (0.12, 0.19), < 0.0001), and Yin deficiency constitution (MD = 0.15, 95% CI (0.11, 0.18), < 0.0001).
CONCLUSION
This study showed that Qi deficiency, Yang deficiency, and Yin vacuity were the predominant types of physical conditions of lung cancer cases.
Topics: Body Constitution; Carcinoma; Humans; Lung; Lung Neoplasms; Medicine, Chinese Traditional; Quality of Life
PubMed: 36072639
DOI: 10.1155/2022/5660231 -
Journal of Ethnopharmacology Jun 2022Aconitum carmichaelii, belonging to the Ranunculaceae family, is a widely used traditional herbal plant in Asian countries, especially in China. The lateral ("Fuzi") and... (Review)
Review
Aconitum carmichaelii Debeaux: A systematic review on traditional use, and the chemical structures and pharmacological properties of polysaccharides and phenolic compounds in the roots.
ETHNOPHARMACOLOGICAL RELEVANCE
Aconitum carmichaelii, belonging to the Ranunculaceae family, is a widely used traditional herbal plant in Asian countries, especially in China. The lateral ("Fuzi") and mother ("Chuanwu") roots are the two main plant parts used in Traditional Chinese Medicine (TCM), where they are used in the treatment of acute myocardial infarction, heart failure, rheumatoid arthritis, and as analgesics.
AIM OF THE STUDY
In order to further guide the research direction and application of A. carmichaelii, this study aims to give a systematic and in-depth overview on the phytochemical and pharmacological studies of non-alkaloid natural products with focus on polysaccharides and phenolic compounds.
MATERIALS AND METHODS
A comprehensive search in the literature was conducted based on the databases Google Scholar, SciFinder (American Chemical Society), Springer Link, PubMed Science, Science Direct and China National Knowledge Internet, Wanfang Data, in addition to books, doctoral and master's dissertations, and official website. The main keywords were: "Aconitum carmichaelii", "Aconiti Lateralis Radix Praeparata", "Fuzi", "Chuanwu", "Aconiti Radix", "monkshood" and "Bushi".
RESULTS
A. carmichaelii is known for the use of its different root parts, including "Fuzi" and "Chuanwu". Different types of polysaccharides, both neutral and acidic, and 39 phenolic compounds like flavonoids, phenylpropanoids, lignans, neolignans, and benzoic acid derivatives have been isolated and identified from the roots. Pharmacological studies of the isolated polysaccharides have demonstrated various biological effects such as hypoglycemic, hypolipidemic, cardiovascular, immunomodulatory, anti-tumor, and neuropharmacological activities. Studies on pharmacological effects of the phenolic compounds isolated from the roots are however limited.
CONCLUSIONS
This review shows that polysaccharides could be one of the active components in the roots of A. carmichaelii, and they are promising for future applications due to their pharmacological properties. In addition, polysaccharides are generally non-toxic, biocompatible, and biodegradable. This review also sheds light on new research directions for A. carmichaelii. A more detailed structural characterization of polysaccharides from different root parts of A. carmichaelii, and their structure-activity relationships are required. Additionally, their pharmacological properties as immunomodulators in the intestinal system should be investigated. Further, more knowledge about the pharmacological effects and molecular mechanisms of the phenolic compounds that have been identified are needed.
Topics: Aconitum; Drugs, Chinese Herbal; Medicine, Chinese Traditional; Phenols; Phytochemicals; Plant Roots; Polysaccharides
PubMed: 35240238
DOI: 10.1016/j.jep.2022.115148 -
Journal of Ethnopharmacology Jan 2015Polygonum multiflorum Thunb., which is known as Heshouwu ( in Chinese) in China. It is traditionally valued and reported for hair-blacking, liver and kidney-tonifying... (Review)
Review
ETHNOPHARMACOLOGICAL RELEVANCE
Polygonum multiflorum Thunb., which is known as Heshouwu ( in Chinese) in China. It is traditionally valued and reported for hair-blacking, liver and kidney-tonifying and anti-aging effects as well as low toxicity. The aim of this review is to provide comprehensive information on the botany, traditional uses, phytochemistry, pharmacological research and toxicology of Polygonum multiflorum, based on the scientific literature. Moreover, trends and perspectives for future investigation of this plant are discussed. It will build up a new foundation for further study on Polygonum multiflorum.
MATERIALS AND METHODS
A systematic review of the literature on Polygonum multiflorum was performed using several resources, including classic books on Chinese herbal medicine and various scientific databases, such as PubMed, SciFinder, the Web of Science, Science Direct, China Knowledge Resource Integrated (CNKI).
RESULTS
Polygonum multiflorum is widely distributed throughout the world and has been used as a traditional medicine for centuries in China. The ethnomedical uses of Polygonum multiflorum have been recorded in many provinces of China and Japan for nine species of adulterants in six families. More than 100 chemical compounds have been isolated from this plant, and the major components have been determined to be stilbenes, quinones, flavonoids and others. Crude extracts and pure compounds of this plant are used as effective agents in pre-clinical and clinical practice due to their anti-aging, anti-hyperlipidaemia, anti-cancer and anti-inflammatory effects and to promote immunomodulation, neuroprotection, and the curing of other diseases. However, these extracts can also lead to hepatotoxicity, nephrotoxicity and embryonic toxicity. Pharmacokinetic studies have demonstrated that the main components of Polygonum multiflorum, such as 2,3,5,4'-tetrahydroxystilbene-2-O-β-d-glucopyranoside and emodin are distributed among many organs and tissues.
CONCLUSION
Therapeutic potential of Polygonum multiflorum has been demonstrated in the conditions like Alzheimer׳s disease, Parkinson׳s disease, hyperlipidaemia, inflammation and cancer, which is attributed to the presence of various stilbenes, quinones, flavonoids, phospholipids and other compounds in the drug. On the other hand, the adverse effects (hepatotoxicity, nephrotoxicity, and embryonic toxicity) of this plant were caused by the quinones, such as emodin and rhein. Thus more pharmacological and toxicological mechanisms on main active compounds are necessary to be explored, especially the combined anthraquinones (Emodin-8-O-β-d-glucopyranoside, Physcion-8-O-β-d-glucopyranoside, etc.) and the variety of stilbenes.
Topics: Animals; Ethnopharmacology; Humans; Medicine, Chinese Traditional; Phytochemicals; Phytotherapy; Plant Extracts; Polygonum
PubMed: 25449462
DOI: 10.1016/j.jep.2014.11.009 -
Social Science & Medicine (1982) Oct 2021In a context of increasing international dialogue around the appropriate means and ends of newborn screening programmes, it is critical to explore the perspectives of... (Review)
Review
In a context of increasing international dialogue around the appropriate means and ends of newborn screening programmes, it is critical to explore the perspectives of those directly impacted by such screening. This meta-ethnography uses a systematic review process to identify qualitative studies that focus on parents' experiences of newborn screening published in English-language academic journals from 2000 to 2019 (n = 36). The included studies represent a range of moments, outcomes, and conditions that illuminate discrete elements of the newborn screening journey. We draw on these varied studies to construct a diagram of possible newborn screening pathways and through so-doing identify a critical window of time between the signalling of a positive newborn screen and the end of the screening process. During this critical window of time, families navigate complex emotional reactions, information, and decisions. From an in-depth analysis of this data, we develop the concept of "absorptive capacity" as a lens through which to understand parents' responses to new and emerging information. Alongside this, we identify how the "concertinaing of time" - the various ways that parents experience the expansion and compression of time throughout and beyond the screening pathway - affects their absorptive capacities. This study underscores the need to move away from viewing newborn screening as a discrete series of clinical events and instead understand it as a process that can have far-reaching implications across time, space, and family groups. Using this understanding of screening as a starting point, we make recommendations to facilitate communication and support for screened families, including the antenatal provision of information to parents and accommodations for the fluctuations in parents' absorptive capacities across the screening trajectory.
Topics: Anthropology, Cultural; Communication; Female; Humans; Infant, Newborn; Neonatal Screening; Parents; Pregnancy; Qualitative Research
PubMed: 34534781
DOI: 10.1016/j.socscimed.2021.114367