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Journal of Orthopaedic Surgery and... Aug 2023Hip joint-preserving treatment options for osteonecrosis of the femoral head (ONFH) have been a research hotspot in recent years. The combination of Chinese and Western... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Hip joint-preserving treatment options for osteonecrosis of the femoral head (ONFH) have been a research hotspot in recent years. The combination of Chinese and Western medicine has been used in clinical practice to treat early- and mid-stage ONFH. However, there is still a lack of high-quality evidence to verify the effectiveness and safety of this approach.
OBJECTIVE
To systematically evaluate the clinical efficacy and safety of the combination of traditional Chinese medicine (TCM) with Western medicine in the treatment of early- and mid-stage ONFH.
METHODS
Multiple electronic databases were searched to identify the randomized controlled trials (RCTs) examining the use of TCM in the treatment of ONFH. Based on the inclusion and exclusion criteria, eligible studies were selected, and the quality of the studies was evaluated using the risk of bias assessment tool recommended by the Cochrane system Evaluator manual 5.1.0. The meta-analysis of the included data was performed using Review Manager 5.4.1 software and Stata 17.0 software.
RESULTS
A total of 47 RCTs involving 3266 subjects were included in the meta-analysis. The results are observed: (1) Harris score: TCM + Western medicine versus Western medicine (SMD = 1.25, 95% Cl: 1.02 to 1.48, P < 0.00001), TCM + physiotherapy versus physiotherapy (SMD = 2.26, 95% Cl: 1.42 to 3.10, P < 0.00001), and TCM + hip preservation surgery versus hip preservation surgery (SMD = 1.28, 95% Cl: 1.03 to 1.53, P < 0.00001); (2) Visual analogue scale score: TCM + Western medicine versus Western medicine (SMD = -3.99, 95% Cl: -7.41 to -0.57, P = 0.02), TCM + physiotherapy versus physiotherapy (SMD = -0.99, 95% Cl: -1.44 to -0.54, P < 0.0001), and TCM + hip preservation surgery versus hip preservation surgery (SMD = -1.08, 95% Cl: -1.75 to -0.40, P = 0.002); (3) Imaging improvement: TCM + physiotherapy versus physiotherapy (RR = 1.42, 95% Cl: 1.15 to 1.76, P = 0.001) and TCM + hip preservation surgery versus hip preservation surgery (RR = 1.21, 95% Cl: 1.11 to 1.31, P < 0.0001); and (4) Occurrence of adverse reaction: TCM + Western medicine versus Western medicine (RR = 0.73, 95% Cl: 0.28 to 1.92, P = 0.53), TCM + physiotherapy versus physiotherapy (RR = 0.46, 95% Cl: 0.03 to 7.33, P = 0.58), and TCM + hip preservation surgery versus hip preservation surgery (RR = 1.11, 95% Cl: 0.36 to 3.45, P = 0.86).
CONCLUSION
TCM combined with Western medicine is an effective and safe approach for the treatment of ONFH. However, due to the low quality and quantity of the included studies, additional large-scale, high-quality studies are required to verify the above conclusions.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/#recordDetails , CRD42023392030.
Topics: Humans; Femur Head; Femur Head Necrosis; Medicine, Chinese Traditional; Treatment Outcome
PubMed: 37580744
DOI: 10.1186/s13018-023-04086-9 -
The International Journal on Drug Policy Apr 2022Opioid use disorder (OUD) is a global public health concern. The standard of care for OUD involves treatment using medications such as buprenorphine, methadone, or... (Review)
Review
BACKGROUND
Opioid use disorder (OUD) is a global public health concern. The standard of care for OUD involves treatment using medications such as buprenorphine, methadone, or naltrexone. No known review exists to assess the contextual factors associated with medication for opioid use disorder (MOUD) in the Arab World. This systematic review serves as an implementation science study to address this research gap and improve the uptake of MOUD in the Arab World.
METHODS
Systematic searches of Medline, PsycINFO, and EMBASE, and a citation analysis, were used to identify peer-reviewed articles with original data on MOUD in the Arab World. Quality assessment was conducted using the CASP appraisal tools, and main findings were extracted and coded according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.
RESULTS
652 research articles were identified, and 10 met inclusion criteria for final review. Four studies considered health-systems aspects of MOUD administration, such as cost-effectiveness, the motivations for and impact of national MOUD policies, the types of social, political, and scientific advocacy that led to the adoption of MOUD in Arab countries, and the challenges limiting its wide-scale adoption in the Arab World. Six papers considered MOUD at individual and group patient levels by evaluating patient quality of life, addiction severity, patient satisfaction, and patient perspectives on opioid agonist therapy.
CONCLUSION
Despite financial and geographic barriers that limit access to MOUD in the Arab World, this review found MOUD to be cost-effective and associated with positive health outcomes for OUD patients in the Arab World. MOUD can be successfully established and scaled to the national level in the Arab context, and strong coalitions of health practitioners can lobby to establish MOUD programs in Arab countries. Still, the relative novelty of MOUD in this context precludes an abundance of research to address its long-term delivery in the Arab World.
Topics: Analgesics, Opioid; Arab World; Buprenorphine; Humans; Methadone; Opiate Substitution Treatment; Opioid-Related Disorders; Pharmaceutical Preparations; Quality of Life
PubMed: 35182841
DOI: 10.1016/j.drugpo.2022.103617 -
Journal of Ethnopharmacology Jan 2024Condyloma acuminatum (CA) is a common sexually transmitted disease. Previous studies using randomized controlled trials (RCTs) have revealed that Paiteling (PTL), a... (Meta-Analysis)
Meta-Analysis
ETHNOPHARMACOLOGICAL RELEVANCE
Condyloma acuminatum (CA) is a common sexually transmitted disease. Previous studies using randomized controlled trials (RCTs) have revealed that Paiteling (PTL), a Chinese patent medicine formula, can effectively relieve CA symptoms. However, the evidence needs to be more cohesive and there is a need for a clear summary of the existing RCTs to assess the overall efficacy and safety profile of PTL.
AIMS OF THE STUDY
This study aimed to conduct a comprehensive review and meta-analysis of RCTs, to examine the efficacy of PTL and physical therapies in CA.
MATERIAL AND METHODS
A literature search was conducted in multiple databases, including PubMed, MEDLINE, Cochrane Library, etc. up to December 1, 2022. Revman 5.4 and Stata 15.0 was used for data statistics and sensitivity analyses.
RESULTS
31 trials with a total of 2868 patients were included in this review. The results showed that PTL plus physical therapies were significantly more effective than physical therapies used alone (RR = 1.60, 95% CI [1.38, 1.86]; P < 0.00001). Subgroup analysis showed that the type of physical therapies, gender, and wart location might be the primary sources of heterogeneity. Additionally, PTL can reduce recurrence rates (RR = 0.27, 95% CI [0.19, 0.39]; P < 0.00001), improve the negative conversion rate of HPV (RR = 1.15, 95% CI [1.02, 1.30]; P = 0.02), and improve immune function. No severe adverse reactions or physical injuries were observed, making it a better choice for women planning to become pregnant.
CONCLUSION
Compared with physical therapies, PTL can effectively eliminate CA symptoms and reduce the recurrence rates with safety ensured. However, due to the heterogeneity and methodological shortcomings, large sample sizes and high-quality rigorous RTCs are still needed to strengthen this clinical evidence.
Topics: Female; Humans; Nonprescription Drugs; Medicine, East Asian Traditional
PubMed: 37517567
DOI: 10.1016/j.jep.2023.116894 -
Molecules (Basel, Switzerland) Sep 2023Traditional Chinese medicine (TCM) is a class of natural drugs with multiple components and significant therapeutic effects through multiple targets. It also originates... (Review)
Review
Traditional Chinese medicine (TCM) is a class of natural drugs with multiple components and significant therapeutic effects through multiple targets. It also originates from a wide range of sources containing plants, animals and minerals, and among them, plant-based Chinese medicine also includes fungi. Fungal traditional Chinese medicine is a medicinal resource with a long history and widespread application in China. Accumulating evidence confirms that polysaccharide is the main pharmacodynamic material on which fungal TCM is based. The purpose of the current systematic review is to summarize the extraction, isolation, structural identification, biological functions, quality control and medicinal and edible applications of polysaccharides from fungal TCM in the past three years. This paper will supplement and deepen the understanding and application of polysaccharides from fungal TCM, and propose some valuable insights for further research and development of drugs and functional foods.
Topics: Animals; Medicine, Chinese Traditional; Drugs, Chinese Herbal; Polysaccharides; Quality Control; China
PubMed: 37836659
DOI: 10.3390/molecules28196816 -
Nutrients Jun 2023Bercht. & J. Presl has been widely used due to the presence of different bioactive compounds. This review summarizes the latest advances and perspectives of the plant... (Review)
Review
Bercht. & J. Presl has been widely used due to the presence of different bioactive compounds. This review summarizes the latest advances and perspectives of the plant species; it is a systematic literature review on aspects of botany, traditional uses, phytochemistry, pharmacology, and toxicology as therapeutic potential. In addition, 120 compounds are described, including alkaloids, flavonoids, terpenoids, steroids, amino acids, aromatics, and aliphatics. As for the therapeutic potential, it is described in extracts and compounds in the antitumor, anti-inflammatory, antioxidant, antimicrobial, antispasmodic, anticoagulant, and analgesic aspects, as well as the effects on the central nervous system. The toxicity of the genus stands out, especially the potential for organ toxicity. Therefore, this review evidenced the knowledge related to the traditional use based on the scientific research of , highlighting an overview of bioactive compounds and biological and toxicological activities in order to provide a scientific basis for future studies on the value of this species for the development of new natural products.
Topics: Brugmansia; Phytotherapy; Medicine, Traditional; Plant Extracts; Alkaloids; Phytochemicals; Ethnopharmacology
PubMed: 37447241
DOI: 10.3390/nu15132912 -
Frontiers in Psychology 2019In recent years, research on the family role and entrepreneurship has increased noticeably, consolidating itself as a valid and current subject of study. This paper...
In recent years, research on the family role and entrepreneurship has increased noticeably, consolidating itself as a valid and current subject of study. This paper presents a systematic analysis of academic research, applying bibliometric indicators, and cluster analysis, which define the state of research about the relationship between family role and entrepreneurship. For this purpose, using three well-accepted databases among the research community: Scopus, Web of Science, Business Source, a total of 92 articles were selected and analyzed, published between 1989 and 2019 (until March). A cluster analysis shows five main areas of literature development: (1) cultural dimension and geneder issue; (2) family business and succession; (3) parental role models and entrepreneurial intentions; (4) entrepreneurship and self-employment; (5) family support and women entrepreneurs. Findings also show how this is a relatively recent field of study, with a multidisciplinary character.
PubMed: 31998192
DOI: 10.3389/fpsyg.2019.02939 -
Annals of Palliative Medicine Oct 2021To clarify the efficacy and safety of traditional Chinese medicine (TCM) bath in the treatment of psoriasis vulgaris, meta-analysis and systematic evaluation were... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To clarify the efficacy and safety of traditional Chinese medicine (TCM) bath in the treatment of psoriasis vulgaris, meta-analysis and systematic evaluation were adopted to comprehensively evaluate the published articles.
METHODS
Combing the terms "traditional Chinese medicine bath" and "psoriasis vulgaris", the articles were searched for in the databases of China Knowledge Network (CNKI), Baidu scholar, Wanfang, Chinese Biomedical Literature Database (CBM), Weipu Database, Medline, Embase, Chinese Medical Citation Index (CMCI), and PubMed. The quality of articles was evaluated using the RevMan 5.3 software provided by the Cochrane system.
RESULTS
A total of 13 articles were included. From the funnel chart drawn, it could be seen that the circles and the midline of most articles were not symmetrical, and the publication was biased, so the conclusions obtained were relatively credible. The heterogeneity analysis of TCM bath in treatment of psoriasis vulgaris showed that 13 articles reporting the total effective rate (TER) and the TERs of the two groups displayed obvious differences [P<0.05, 95% confidence interval (CI): 2.9 to 4.77]; there were 8 articles reporting the incidence of adverse reactions, and the incidence of adverse reactions between the two groups was greatly different (P<0.05, 95% CI: 0.22 to 0.77); and there were 9 articles reporting the psoriasis area and severity index, and the overall efficacy was greatly different between the two groups (P<0.05, 95% CI: -5.38 to -1.88).
DISCUSSION
The TER of the meta-analysis of treatment in this study was higher in the experimental group; the incidence of adverse reactions was lower in the experimental group; and the area and severity of psoriasis were lower in the experimental group, so it was concluded that the TCM bath had a significant effect on the treatment of psoriasis vulgaris.
Topics: China; Combined Modality Therapy; Humans; Medicine, Chinese Traditional; Psoriasis
PubMed: 34763428
DOI: 10.21037/apm-21-2386 -
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