1.Evaluation of GRADE Clinical Research Evidence of Chinese Patent Medicine Combined with Western Medicine in Treatment of Hypertension with Dyslipidemia
Jiaheng WANG ; Yukun LI ; Liangyu CUI ; Yilan ZHENG ; Zhiwei ZHAO ; Cong REN ; Tianyue JING ; Tong YIN ; Liying WANG ; Xuejie HAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):95-105
		                        		
		                        			
		                        			ObjectiveTo evaluate the effect of antihypertensive and lipid-regulating Chinese patent medicine combined with conventional Western medicine in the treatment of hypertension with dyslipidemia. To carry out the evidence synthesis of clinical research and provide evidence-based evidence support for clinical decision-making. MethodThe databases including China National Knowledge Infrastructure (CNKI),Wanfang Data Knowledge Service Platform (WF),VIP,SinoMed,Embase,PubMed,Web of Science (WOS),and the Cochrane Library were searched for randomized controlled trials (RCT) of all listed Chinese patent medicines in the treatment of hypertension with dyslipidemia from the establishment of the databases to April 15,2023. The literature was screened and extracted,and the risk of bias tool 2.0 (RoB2) was used to assess the quality and risk of bias of the methodology. Revman 5.4.1 software was used to analyze the outcome indicators. Grading of Recommendations Assessment,Development and Evaluation (GRADE) was applied to assess the quality of evidence formed by clinical research data. The inclusion and recommendation of Chinese patent medicines in the National Drug Catalogue for Basic Medical Insurance,Work-related Injury Insurance and Maternity Insurance (2022) and domestic guidelines and consensus were searched to form a bubble chart. ResultA total of 15 studies were included. The evaluation of the methodological quality of each study showed that the risk of bias stemmed from the lack of blinding and allocation concealment,and low sample size. The comprehensive analysis of clinical studies showed that Dengzhan Shengmai capsules combined with rosuvastatin and amlodipine besylate,Yindan Xinnaotong capsules combined with simvastatin and levamlodipine tablets,Xiaoshuan Tongluo capsules combined with nifedipine controlled release tablets and pravastatin sodium tablets,Xinshubao capsules combined with atorvastatin calcium tablets and irbesartan,Wenyading capsules combined with enalapril,and Jiangzhining tablets combined with conventional Western medicines were all superior to conventional Western medicines used in the control group in improving systolic blood pressure (SBP),diastolic blood pressure (DBP),cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),and high density lipoprotein cholesterol (HDL-C). There was no significant difference in the incidence of adverse reactions between the two groups. The GRADE evaluation of the main outcome indicators showed that the evidence quality of SBP and incidence of adverse reactions was graded as B,that of DBP as C,and that of total TC,TG,LDL-C,and HDL-C as D. The evaluation of Chinese patent medicines covered by medical insurance and recommended by guidelines and consensus showed that Yindan Xinnaotong soft capsules,Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules belonged to class B drugs of medical insurance,and were recommended for 7,6 and 3 times in the guidelines and consensus,respectively. ConclusionCompared with simple medicine treatment,Chinese patent medicine combined with conventional Western medicine has more advantages in improving blood pressure and blood lipid,and shows higher safety. Among them,Yindan Xinnaotong soft capsules,Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules have stronger clinical applicability and economy. All the trials included in this article adhered to the principle of randomization and reported the outcome measures. However,the quality of evidence in related clinical studies was low. In terms of trial design,large-sample,multi-center,blinded randomized controlled trials based on the consolidated standards of reporting trials (CONSORT) statement are still needed for comprehensive trial designs and reporting,to further improve the GRADE quality evaluation and guideline formulation under the guidance of evidence-based medicine,so as to provide higher quality evidence-based research evidence for clinical decision-making. 
		                        		
		                        		
		                        		
		                        	
2.GRADE Clinical Study Evidence Evaluation and Expert Consensus on Antihypertensive Chinese Patent Medicines Combined with Western Medicines for Treatment of Hypertension
Liangyu CUI ; Yukun LI ; Tianyue JING ; Yu WANG ; Cong REN ; Tong YIN ; Zhiwei ZHAO ; Jiaheng WANG ; Chenge SUN ; Dasheng LIU ; Zhizheng XING ; Xuejie HAN ; Liying WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):106-115
		                        		
		                        			
		                        			ObjectiveTo evaluate the quality of research and evidence related to antihypertensive Chinese patent medicines combined with western medicines for the treatment of hypertension, synthesize and update the evidence, form expert consensus, and provide evidence for clinical decision-making. MethodThe databases of China National Knowledge Infrastructure (CNKI), WanFang Data Knowledge Service Platform (WanFang), Vip Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Service System (Sinomed), National Library of Medicine (PubMed), Cochrane Library, Web of Science, and US Clinical Trials Registry were searched for randomized controlled trials of antihypertensive Chinese medicine combined with western medicine for the treatment of hypertension from database construction to July 31, 2022. The quality of the literature was evaluated using the bias risk assessment tool in Cochrane Handbook 6.3. Evidence synthesis of main outcome indicators was performed using R software. The Grading of Recommendations Assessment, Development, and Evaluation profiler (GRADEprofiler) 3.6 was employed to evaluate the quality of evidence. Expert consensus was formed based on the Delphi method after two rounds of voting. Result64 pieces of literature were included, and the results of literature quality evaluation and risk of bias showed that 70.31% (45/64) of the studies indicated some risks, and 29.69% (19/64) indicated high risks. Compared with conventional western medicines, the combination of Chinese patent medicines with western medicines can significantly lower systolic pressure (SBP) and diastolic pressure (DBP), increase the effective rate of antihypertensive, reduce the incidence of adverse reactions, endothelin-1, and traditional Chinese medicine syndrome scores. Egger's test showed that Songling Xuemaikang capsules reduced SBP and DBP. Tianma Gouteng granules reduced SBP and DBP and increased the effective rate of antihypertensive, and Xinmaitong capsules reduced SBP and increased the effective rate of antihypertensive, without significant publication bias. Songling Xuemaikang capsules increased the effective rate of antihypertensive, and Xinmaitong capsules decreased DBP, with significant publication bias. The results of the GRADE evidence quality evaluation showed that most evidence was at grades B and C. Finally, four strong recommendations and 14 weak recommendations were formed. ConclusionCompared with conventional western medicines for the treatment of hypertension, antihypertensive Chinese patent medicines combined with western medicines have advantages in reducing blood pressure and improving drug use safety, but they are mostly weak recommendations in terms of efficacy, and more high-quality evidence is needed. 
		                        		
		                        		
		                        		
		                        	
3.Clinical Evidence Mapping of Chinese Patent Medicines Combined with Western Medicine in Treatment of Hypertension
Yukun LI ; Liangyu CUI ; Zhiwei ZHAO ; Cong REN ; Tong YIN ; Yu WANG ; Liying WANG ; Xuejie HAN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(10):116-123
		                        		
		                        			
		                        			ObjectiveTo systematically collect, analyze, and evaluate the randomized controlled trials (RCT) of Chinese patent medicine combined with western medicine in the treatment of hypertension, map the evidence, and provide reference for the future clinical research and formulation of guidelines and policies. MethodThe relevant articles were retrieved from China Biology Medicine disc, China National Knowledge Infrastructure (CNKI), VIP, Wanfang Data, PubMed, Embase, and Cochrane Library with the time interval from inception to December 31, 2022. The RCT of Chinese patent medicines combined with western medicine in the treatment of hypertension were included. The research characteristics and methodological quality were analyzed and evaluated. ResultA total of 330 RCTs of treating hypertension with Chinese patent medicines combined with Western medicine were included in this study, all of which were published in Chinese. These RCTs involved 88 Chinese patent medicines and 37 788 patients, and 46% of RCT had the sample size ≥100 patients. Eighty-seven percent of RCT showed the study period within 3 months. All the interventions in the RCTs were Chinese patent medicine + western medicine vs western medicine. Among the evaluation indicators, blood pressure, response rate, TCM syndrome score, endothelial cell function, and safety were mainly concerned. In terms of methodological quality, most articles did not mention the generation of random sequences, allocation concealment, or blinding method. The blinding evaluation of outcomes showed low risks of bias, and there was insufficient information to judge whether there was selective bias or other bias. ConclusionThere were many Chinese patent medicines used in combination with western medicine in the treatment of hypertension, and they were mainly taken orally. The existing RCT had problems such as small sample size, unclear clinical value positioning, imperfect design failing to reflect the value of Chinese patent medicines, unreasonable measurement indicators, and non-standard measurement methods. Future research should solve the above problems, improve the research quality, value, and authenticity, and enhance the reliability and extension of evidence. 
		                        		
		                        		
		                        		
		                        	
4.The Research Status and Thinking of Objectification of Diagnosis by Integrating Prior Knowledge and Information Technology
Chenge SUN ; Yukun LI ; Zhiwei ZHAO ; Linshuang WANG ; Liangyu CUI ; Tong YIN ; Liying WANG ; Xuejie HAN ; Dasheng LIU
World Science and Technology-Modernization of Traditional Chinese Medicine 2024;26(6):1654-1659
		                        		
		                        			
		                        			In order to solve the problem of strong subjectivity and difficulty in quantification,clinical objectification mainly adopts the techniques of image processing,computer vision and machine learning.The acquisition and processing of prior knowledge is a key link in the objectification of inspection,as well as an important elaboration of the quantification of subjective judgment and macro performance in objectification research.However,there is still a lack of in-depth summary and parametric processing of prior knowledge.Based on the analysis of the current research status of objectification of inspection,this paper uses data mining technology to summarize the experience of TCM inspection.Moreover,the observation information can be transformed into quantifiable digital features through natural language processing and representation learning.Meanwhile,the application of deep learning can realize automatic diagnosis and analysis of observation images to improve accuracy and efficiency,and promote the process of TCM modernization.
		                        		
		                        		
		                        		
		                        	
5.Standard on classification of Traditional Chinese Medicine ancient books
Huamin ZHANG ; Weina ZHANG ; Hongtao LI ; Yanping WANG ; Xuejie HAN ; Yuqi LIU ; Lin TONG ; Bing LI ; Sihong LIU ; Hongyan CHEN ; Zongxin WANG ; Hao QIU
International Journal of Traditional Chinese Medicine 2023;45(1):1-7
		                        		
		                        			
		                        			The standardization of classification methods of Traditional Chinese Medicine(TCM) ancient books can provide a clear and reliable reference for all kinds of TCM ancient books collection units, which can also promote the sharing and utilization of TCM ancient books. We studied and investigated the classification methods of TCM ancient books in past dynasties. The standard on classification of TCM ancient books was formulated by compared with the classification table of Zhongguo Zhongyi Guji Zongmu, and referred to the classification table of Zhonghua Guji Zongmu. This standard specified three-level categories and classification principles of TCM ancient books, and mainly composed of basic categories, three-level category table, classification principles and examples, and instructions for use.
		                        		
		                        		
		                        		
		                        	
6. Subacute dynamic silica dust inhalation induced changes of pathology and cytokines in mouse organs
Dandan LI ; Tingyu ZHANG ; Lin LI ; Mingming HAN ; Xuejie HAO ; Zhifeng YANG ; Haidong ZHANG ; Rui WANG
China Occupational Medicine 2020;47(02):172-177
		                        		
		                        			
		                        			 OBJECTIVE: To investigate the effects of subacute dynamic silica dust inhalation on the histopathology of major organs and the cytokine changes in lung tissues. METHODS: Male Kunming specific pathogen free mice were randomly divided into control group and dust exposure groups of 3, 14 and 28 d, with 7 mice in each group.The mice of the 3 exposure groups were given for 3, 12 and 24 days with silica dust at a concentration of 1 000.00 mg/m~3 using the self-made automatic dust inhalation device, 6 hours per day and 6 days per week. Rats in the control group were not treated with dust. After the end of treatment, rats were sacrificed. The organ coefficients of the liver, kidney, spleen and lung were calculated. The pathological changes of the organs were observed by hematoxylin-eosin staining method. The pulmonary fibrosis of lung tissues was evaluated by Masson staining method. Sirius scarlet picric acid staining was used to observe the collagen fiber area ratio in lung tissues. Enzyme-linked immunosorbent assay was used to detect the levels of interleukin(IL)-1β, tumor necrosis factor(TNF)-α, transforming growth factor(TGF)-β1 and matrix metalloproteinase 2(MMP-2) in lung tissues. Colorimetric method was used to detect the level of hydroxyproline(HYP) in lung tissues. RESULTS: After the exposure to silica dust, the histology of liver, spleen and kidney tissues were not significantly changed in the mice of the 3 dust exposure groups. The lung organ coefficients increased in the mice of dust exposure groups of 3, 14 and 28 d compared with the control group(P<0.05). The spleen coefficient of mice in dust exposure groups of 3 and 14 d were higher than that in control group(P<0.05). Among the dust exposure groups, the score of pulmonary fibrosis and HYP level in lung tissues were increased with the prolonged dust exposure time(P<0.05). The collagen fiber area ratio of collagenⅠand Ⅲ, and the levels of IL-1β, TGF-β1 and MMP-2 in lung tissues increased in the 3 dust exposure groups compared with the control group(P<0.05). The collagen fiber area ratio of collagen Ⅲ, and the level of IL-1β in lung tissues of the 14 and 28 d of dust exposure group increased(P<0.05), and the TGF-β1 level decreased(P<0.05), when compared with the 3 d group. The collagen fiber area ratio of collagen Ⅰ in lung tissues of 14 d group and the level of MMP-2 in the 28 d group were higher than that of the 3 d group(P<0.05). The level of TNF-α in lung tissues of 14 d group was higher than that of the control group(P<0.05), and while in 28 d group it was lower than those of the other 3 group(P<0.05). CONCLUSION: Subacute dynamic inhalation of silica dust can cause acute lung injury in mice. There is no obvious pathological change in liver, kidney and spleen. The pathological changes of lung tissue are inflammation and fibrosis, and the degree of fibrosis increases with the extension of dust exposure time, and cytokines also changed. 
		                        		
		                        		
		                        		
		                        	
7.Research progress of intestinal microflora therapy in glucose control of type 2 diabetes mellitus patients
Shujing HU ; Hongmei DUAN ; Hongxia LIU ; Xuejie GUO ; Han WANG ; Shasha WANG ; Mengxi HAN
Chinese Journal of Modern Nursing 2020;26(20):2690-2693
		                        		
		                        			
		                        			At present, diabetes mellitus has become an increasingly serious disease which affects public health in the word. Clinical treatment of diabetes is mainly based on oral hypoglycemic drugs, insulin injections and lifestyle interventions (diet and exercise) . The new intervention method targeting intestinal microflora opens up new ideas for diabetes treatment. This article reviews the application of new intestinal microbial therapy (probiotic treatment, oral prebiotics/synbiotics, fecal microbiota transplantation) and treatment by regulating intestinal microflora (bariatric surgery, antibiotic therapy and traditional Chinese medicine) in diabetes. This article also summarized the nursing intervention based on intestinal microbial therapy so as to improve the understanding of the relationship between intestinal microflora and diabetes, and provide a reference for treatment and nursing care for type 2 diabetes.
		                        		
		                        		
		                        		
		                        	
8.Comparison of two methods for hemodynamic assessment in children with tetralogy of Fallot after radical surgery
YANG Fan ; WANG Jianming ; GU Jiangrong ; YAO Junping ; ZHU Xiaoli ; ZHANG Xuejie ; HAN Zhe
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2019;26(4):326-331
		                        		
		                        			
		                        			Objective To explore the hemodynamic assessment after radical surgery in children with tetralogy of Fallot (TOF) by both echocardiography and Mostcare monitor. Methods Clinical data of 63 children with TOF who underwent radical surgery in our hospital from February 2016 to June 2018 were retrospectively analyzed, including 34 males and 29 females, aged 6-24 (9.82±5.77) months. There were 19 patients undergoing transannular patch reconstruction of the right ventricular outflow tract (a transannular patch group) while 44 patients retained the pulmonary valve annulus (a non-transannular patch group) . The echocardiography and Mostcare monitor parameters were recorded and brain natriuretic peptide was tested at the time points of 0, 8, 12, 24 and 48 hours after operation (T 0, T 1, T 2, T 4) to analyze their correlations and the change trend at different time points after radical surgery. Results The left ventricular ejection fraction at T 1 (43.49%±3.82%) was lower than that at T 0 (48.29%±4.55%), T 2 (45.83%±3.69%), T 3 (53.76%±4.43%) and T 4 (60.54%±3.23%, P<0.05). The cardiac index at T 1 (1.85±0.35 L·min−1·m−2) was lower than that at T 0 (2.11±0.38 L·min−1·m−2), T 2 (2.07±0.36 L·min−1·m−2), T 3 (2.42±0.37 L·min−1·m−2) and T 4 (2.82±0.42 L·min−1·m−2, P<0.05). The cardiac circulation efficiency at T1 (0.19±0.05) was lower than that at T 0 (0.22±0.06), T 2 (0.22±0.05), T 3 (0.28±0.06) and T 4 (0.34±0.06, P<0.05). The right ventricular two-chambers view fraction area change at T 1 (23.17%±3.11%) was lower than that at T 0 (25.81%±3.74%), T 2 (25.38%±3.43%), T 3 (30.60%±4.50%) and T 4 (36.94%±5.85%, P<0.05). The pulse pressure variability was the highest at T 0 (18.76%±3.58%), followed by T 1 (14.81%±3.32%), T 2 (12.44%±2.94%), T 3 (10.39%±2.96%) and T 4 (9.18%±1.92%, P<0.05). The blood brain natriuretic peptide was higher at T 1 (846.67±362.95 pg/ml) than that at T 0 (42.60±18.06 pg/ml), T 2 (730.95±351.09 pg/ml), T 3 (510.98±290.39 pg/ml) and T 4 (364.41±243.56 pg/ml, P<0.05). There was no significant difference in left ventricular ejection fraction, cardiac circulation efficiency and heart index between the two groups (P>0.05). The right ventricular two-chambers view fraction area change of the transannular patch group was significantly lower than that of the nontransannular patch group at each time point (P<0.05). The blood brain natriuretic peptide and pulse pressure variability of the transannular patch group were significantly higher than those of the non-transannular patch group (P<0.05). Left ventricular ejection fraction was positively correlated with cardiac index (r=0.637, P=0.001) and cardiac circulation efficiency (r=0.462, P=0.001) while was significantly negatively correlated with blood brain natriuretic peptide (r=–0.419, P=0.001). Conclusion Both methods can accurately reflect the state of cardiac function. Mostcare monitor has a good consistency with echocardiography. Using transannular patch to recontribute right ventricular outflow tract in operation has more influence on right ventricular systolic function. The Mostcare monitor can guide the hemodynamic management after surgery in real time, continuously and accurately.
		                        		
		                        		
		                        		
		                        	
9.The add-on effect of a Chinese herbal formula for patients with resistant hypertension: study protocol for a pilot cohort study.
Ya YUWEN ; Yuqi LIU ; Yanping WANG ; Jingang DAI ; Dasheng LIU ; Yuexi WANG ; Xuejie HAN
Journal of Integrative Medicine 2015;13(2):122-8
		                        		
		                        			
		                        			Despite a recent American Heart Association (AHA) consensus statement emphasizing the importance of resistant hypertension (RH), its control is still a challenge for conventional medicine. The Chinese herbal formula, Qutan Huayu Fang, has been used effectively to assist antihypertensive agents in blood pressure control, but its effect for RH patients is still unclear. This pilot study aims to explore the effects of taking the formula in addition to antihypertensive medication in the management of RH.
		                        		
		                        		
		                        		
		                        	
10.Study on Clinical Functions of Consensus-based Clinical Practice Guidelines in Traditional Chinese Medicine
Ya YUWEN ; Yanping WANG ; Weixia LIU ; Wei YANG ; Xueyao ZHAO ; Xingfang LIU ; Mengyu LIU ; Liying WANG ; Xuejie HAN
World Science and Technology-Modernization of Traditional Chinese Medicine 2015;(2):329-332
		                        		
		                        			
		                        			This study was aimed to explore clinical functions of consensus-based clinical practice guidelines (CB CPGs) in traditional Chinese medicine (TCM). Under the guidance of the State Administration of TCM, 42 TCM hospitals in China had conducted a questionnaire survey for 73 CB CPGs and 2993 questionnaires had been included and analyzed. According to the category of good, general and bad, the proportion of the good in improving safety performance was 69.43%, controlling cost was 58.57%, regulating medical behavior was 55.50%, improving clinical effectiveness was 46.74%. It was concluded that the CB CPGs had played a good role in improving safety performance and controlling cost in TCM clinical practice.
		                        		
		                        		
		                        		
		                        	
            

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