1.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.
2.Strolling through the glorious years of Alveolar Surgery, bravely stepping onto the path of practice and innovation
Yiming WANG ; Yang XUE ; Jihong ZHAO ; Jian PAN ; Duohong ZOU ; Nianhui CUI ; Wei ZHANG ; Qizhang WANG ; Zhizheng LI ; Yuqiong ZHOU ; Kaijin HU
Chinese Journal of Stomatology 2024;59(4):301-311
This article summarizes and organizes relevant publications in journals, along with a review of medical history, systematically summarizing the development process of dental alveolar surgery in China. The initial establishment phase (1935—1952) marked the starting point of Chinese Alveolar Surgery. Despite the impact of wars, it laid the foundation for subsequent research and practice. During the early development phase (1953—1966), the "Chinese Journal of Stomatology" was founded, which promoted the development of Alveolar Surgery. Research focused on tooth extraction methods and complications. Tooth Transplantation and Preprosthetic Surgery gradually began to take off. The stagnant phase (1967—1977) occurred due to the interruption of international exchanges, leading to an almost complete halt in the development of Alveolar Surgery. Entering the rapid catch-up phase (1978—1985), Alveolar Surgery scholars in China began striving to overcome the stagnation of the previous decade. While some progress was made, no significant innovative achievements emerged. In the scientific development phase (1986—2010), clinical research, basic experiments, and paper writing in modern Chinese Alveolar Surgery began to adhere to scientific standards with the rise of experimental medicine. The exploration and innovation stage (2011—2023) is the current development phase, during which Chinese Aveolar Surgery has reached its peak, making substantial progress in technology, clinical practices, and basic research, gradually reaching or even surpassing international advanced levels. Looking back at the development history in China, we can find the wisdom and hard work of the older generation of Alveolar Surgery scholars. However, contemporary challenges and issues, such as standardizing technology, promoting clinical practices, and talent cultivation, need to be addressed by present-day Alveolar Surgery professionals as they forge ahead.
3.Effect of residual dental follicle after removal of impacted mandibular third molars on the periodontal health of adjacent second molars
Tingting LI ; Chaofan WANG ; Yu CAI ; Zhizheng LI ; Jihong ZHAO
Chinese Journal of Stomatology 2024;59(8):784-790
Objective:To investigate whether residual dental follicles in the alveolar socket after extraction of impacted mandibular third molars affect the periodontal health of adjacent mandibular second molars, in order to provide clinical reference for the management of residual dental follicles after third molar extraction.Methods:A total of 82 patients who underwent bilateral impacted mandibular third molar extraction at the Department of Oral Surgery, School and Hospital of Stomatology Wuhan University, from November 1, 2020, to November 30, 2022, were included in the study. Using a self-controlled method, each patient′s bilateral mandibular third molars were randomly divided into two groups: Group A underwent third molar extraction with thorough removal of residual dental follicle tissue, while Group B underwent third molar extraction without any treatment of the remaining dental follicle tissue. Operation time and adverse reactions were recorded. Clinical and radiographic examinations were performed at 6-month follow-up to evaluate the periodontal parameters and alveolar bone height of the bilateral mandibular second molars, and differences between the two groups were compared.Results:All patients had successful bilateral mandibular third molar extractions, and no serious complications occurred intraoperatively or postoperatively. There were no statistically significant differences in surgical time, postoperative pain, or facial swelling between the two groups ( P>0.05). At the 6-month follow-up, the probing depth on the distal aspect of the mandibular second molars in Group A [2.67 (2.00, 3.67) mm] was significantly less than that in Group B [4.00 (3.00, 5.00) mm] ( Z=-6.55, P<0.001). The clinical attachment loss on the distal aspect of the mandibular second molars in Group A [1.00 (0.00, 3.00) mm] was less than that in Group B [3.00 (2.00, 5.00) mm] ( Z=-5.99, P<0.001). The distance from the alveolar crest to the cementoenamel junction on the distal aspect of the mandibular second molars in Group A [(1.86±1.34) mm] was less than that in Group B [(3.04± 1.89) mm] ( t=-6.87, P<0.001). In patients aged≥20 years, the probability of recovery of alveolar bone height to normal level on the distal aspect of the mandibular second molars in Group A [42.3% (11/26)] was significantly higher than that in Group B [0 (0/26)] ( P<0.01), while there was no statistically significant difference between Group A [63.3% (19/30)] and Group B [46.7% (14/20)] in patients aged<20 years ( P>0.05). Conclusions:Residual dental follicles in the alveolar socket after extraction of impacted mandibular third molars adversely affect the periodontal health of adjacent teeth. Thorough removal of residual dental follicles during impacted mandibular third molar extraction is beneficial for the postoperative recovery of alveolar bone height of the distal aspect of the mandibular second molars, especially in patients aged≥20 years.
4.Clinical research on rhubarb powder modulated by different excipients to intervene solid constipation in cancer patients undergoing chemotherapy
Kun WANG ; Yanli HOU ; Hong JU ; Zhiqiang SONG ; Zhizheng ZHAO
Chinese Journal of Modern Nursing 2022;28(35):4954-4958
Objective:To explore the effects of different excipients and rhubarb powder in interfering with TCM solid constipation in cancer patients undergoing chemotherapy.Methods:Totally 120 tumor patients who developed solid constipation after chemotherapy during hospitalization from May 2019 to May 2021 in the Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences by convenience sampling and divided into an observation group and a control group according to the random number table, with 60 cases in each group. On the basis of the routine treatment and nursing protocol, patients in the control group received acupoint sticking with Kaisailu and rhubarb powder, and patients in the observation group were treated with sesame oil and rhubarb powder for acupoint sticking. The effective rate of treatment, the score of Cleveland Constipation Score (CCS), and the incidence of adverse reactions were compared between the two groups.Results:After the intervention, the total effective rate in the observation group was higher than in the control group, the CCS score and the incidence of adverse reactions were lower than those of the control group, with statistically significant differences ( P<0.05) . Conclusions:Acupoint sticking of rhubarb prepared with sesame oil can better relieve chemotherapy-induced constipation than that prepared with Kaisailu, and the adverse reactions rate is low.
5.Development of the triazole-fused pyrimidine derivatives as highly potent and reversible inhibitors of histone lysine specific demethylase 1 (LSD1/KDM1A).
Zhonghua LI ; Lina DING ; Zhongrui LI ; Zhizheng WANG ; Fengzhi SUO ; Dandan SHEN ; Taoqian ZHAO ; Xudong SUN ; Junwei WANG ; Ying LIU ; Liying MA ; Bing ZHAO ; Pengfei GENG ; Bin YU ; Yichao ZHENG ; Hongmin LIU
Acta Pharmaceutica Sinica B 2019;9(4):794-808
Histone lysine specific demethylase 1 (LSD1) has been recognized as an important modulator in post-translational process in epigenetics. Dysregulation of LSD1 has been implicated in the development of various cancers. Herein, we report the discovery of the hit compound (IC = 3.93 μmol/L) and further medicinal chemistry efforts, leading to the generation of compound (IC = 49 nmol/L, and = 16 nmol/L), which inhibited LSD1 reversibly and competitively with H3K4me2, and was selective to LSD1 over MAO-A/B. Docking studies were performed to rationalize the potency of compound . Compound also showed strong antiproliferative activity against four leukemia cell lines (OCL-AML3, K562, THP-1 and U937) as well as the lymphoma cell line Raji with the IC values of 1.79, 1.30, 0.45, 1.22 and 1.40 μmol/L, respectively. In THP-1 cell line, significantly inhibited colony formation and caused remarkable morphological changes. Compound induced expression of CD86 and CD11b in THP-1 cells, confirming its cellular activity and ability of inducing differentiation. The findings further indicate that targeting LSD1 is a promising strategy for AML treatment, the triazole-fused pyrimidine derivatives are new scaffolds for the development of LSD1/KDM1A inhibitors.
6.Diagnosis and treatment of 40 cases of gastritis cystica profunda
Shuai GONG ; Shiying YANG ; Hanbing XUE ; Yunjia ZHAO ; Yao ZHANG ; Yunjie GAO ; Haiying CHEN ; Hui DING ; Xiaobo LI ; Zhizheng GE
Chinese Journal of Digestive Endoscopy 2019;36(7):483-486
Objective To investigate the clinical,endoscopic and pathological features of gastritis cystica profunda (GCP).Methods A total of 40 patients with GCP confirmed by pathology who received endoscopic or surgical treatment at Renji Hospital,School of Medicine,Shanghai Jiaotong University from May 2013 to May 2018,were included in the retrospective analysis.The clinical data such as population composition,clinical manifestations,endoscopic findings and pathological results were summarized and analyzed.Results Among the 40 patients were predominantly males (75.0%,30/40),and the mean age of onset was 61.2 years.The most common sites were cardia (32.5%,13/40) and gastric antrum (30.0%,12/40).The clinical symptoms of the patients were atypical and it was difficult to diagnose GCP with routine endoscopy examination.The endoscopic findings were mostly type 0-Ⅱ (50.0%,20/40).GCP with neoplastic lesions accounted for 55% (22/40).Unconditional logistic regression analysis showed that male (P =0.013,OR =31.093,95% CI:2.079-464.976) and Helicobacter pylori infection (P =0.041,OR =10.225,95% CI:1.096-95.411) were risk factors for GCP with neoplastic lesions.Conclusion GCP commonly occurs in middle-aged and elderly men,and varies in different manifestations under white light endoscopy.GCP is not a benign lesion,but can also coexist with neoplastic lesions,which are mostly differentiated intramucosal cancer.
7.Impact of Liver Fibrosis and Fatty Liver on T1rho Measurements: A Prospective Study.
Shuangshuang XIE ; Qing LI ; Yue CHENG ; Yu ZHANG ; Zhizheng ZHUO ; Guiming ZHAO ; Wen SHEN
Korean Journal of Radiology 2017;18(6):898-905
OBJECTIVE: To investigate the liver T1rho values for detecting fibrosis, and the potential impact of fatty liver on T1rho measurements. MATERIALS AND METHODS: This study included 18 healthy subjects, 18 patients with fatty liver, and 18 patients with liver fibrosis, who underwent T1rho MRI and mDIXON collections. Liver T1rho, proton density fat fraction (PDFF) and T2* values were measured and compared among the three groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the T1rho values for detecting liver fibrosis. Liver T1rho values were correlated with PDFF, T2* values and clinical data. RESULTS: Liver T1rho and PDFF values were significantly different (p < 0.001), whereas the T2* (p = 0.766) values were similar, among the three groups. Mean liver T1rho values in the fibrotic group (52.6 ± 6.8 ms) were significantly higher than those of healthy subjects (44.9 ± 2.8 ms, p < 0.001) and fatty liver group (45.0 ± 3.5 ms, p < 0.001). Mean liver T1rho values were similar between healthy subjects and fatty liver group (p = 0.999). PDFF values in the fatty liver group (16.07 ± 10.59%) were significantly higher than those of healthy subjects (1.43 ± 1.36%, p < 0.001) and fibrosis group (1.07 ± 1.06%, p < 0.001). PDFF values were similar in healthy subjects and fibrosis group (p = 0.984). Mean T1rho values performed well to detect fibrosis at a threshold of 49.5 ms (area under the ROC curve, 0.855), had a moderate correlation with liver stiffness (r = 0.671, p = 0.012), and no correlation with PDFF, T2* values, subject age, or body mass index (p > 0.05). CONCLUSION: T1rho MRI is useful for noninvasive detection of liver fibrosis, and may not be affected with the presence of fatty liver.
Body Mass Index
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Fatty Liver*
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Fibrosis
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Healthy Volunteers
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Humans
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Liver Cirrhosis*
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Liver*
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Magnetic Resonance Imaging
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Prospective Studies*
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Protons
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ROC Curve
8.Review on Experiment research of traditional Chinese medicine on radiation-induced pulmonary injury
Yingxia PEI ; Qi ZHENG ; Zhizheng ZHAO ; Wei HOU ; Jie LI ; Huiting FAN ; Xin QI
International Journal of Traditional Chinese Medicine 2017;39(10):949-952
Radiation-induced pulmonary injury(RPI)refers to intrathoracic neoplasm after radiotherapy, radiation wild area normal lung tissue injury complicated by damage to the reaction. Traditional Chinese medicine was used for nourishing yin and clearing lung, heat-clearing and detoxifying, promoting blood circulation to remove blood stasis in reducing the adverse reaction of radiotherapy. TCM showed the advantage for radioactive lung injury. Based on the different mechanism of action and from the perspective of TCM treatment, the article reviewed the latest experiment research of TCM on radiation-induced pulmonary injury were summarized, and we discussed and pointed out the existing problems and prospect solution
9.Early Postoperative Cognitive Dysfunction after Sedation for Esophagogastroduodenoscopy
Rui WU ; Zhizheng GE ; Jun DAI ; Hanbing XUE ; Xiaobo LI ; Yunjia ZHAO
Chinese Journal of Gastroenterology 2014;(9):544-548
Background:It is commonly recommended that patients should refrain from driving for 24 hours after sedation for endoscopy,however,this recommendation has been queried recently. Aims:To investigate the effect of sedation on early postoperative cognitive function in patients undergoing endoscopy. Methods:One hundred adult patients undergoing sedative esophagogastroduodenoscopy ( EGD ) were randomly recruited, and another 100 adult patients undergoing conventional EGD were served as controls. All patients had an education level more than 9 years. Cognitive function was assessed by number connection test-A( NCT-A),number cancellation test and digit symbol test( DST)before propofol sedation or the beginning of endoscopic procedure and was reassessed when the discharge criteria were met. If the results obtained were inferior to those before EGD,a third assessment was taken 30 minutes later until the results recovered or being superior to the baseline levels. Results:All patients completed the first and second assessment,and 124 patients had taken the third assessment. When the discharge criteria were met,result of number cancellation test was inferior to that before EGD in sedation group( P =0. 000 ). Furthermore,the results were analyzed by grouping with age,number cancellation test in young patients and NCT-A in elderly patients were inferior to that before EGD,respectively(P=0. 000 and P =0. 025 ). In control group,none of the results were inferior to those before EGD. The results of the third assessment recovered or being superior to the baseline levels. Conclusions:Early postoperative cognitive dysfunction at discharge is common in patients undergoing endoscopy using propofol sedation,but the impairment will recover by a prolonged staying calm before discharge. The optimal time for discharge and resuming driving remains to be further studied.
10.Risk factors of rebleeding in patients with obscure gastrointestinal bleeding
Wei TAN ; Zhizheng GE ; Yunjie GAO ; Jun DAI ; Xiaobo LI ; Hanbing XUE ; Yunjia ZHAO
Chinese Journal of Digestive Endoscopy 2012;29(11):604-608
ObjectiveTo investigate the long-term (>1 year) rebleeding rate after capsule endoscopy (CE)-guided intervention in patients with obscure gastrointestinal bleeding (OGIB) and to identify the risk factors of rebleeding.MethodsA total of 307 consecutive patients who underwent CE for OGIB in our hospital from June 2002 to October 2010 were enrolled.Follow-up data were obtained by reviewing medical records,CE database and contacting the patients or their relatives by telephone.We evaluated the rebleeding rates and analyzed risk factors predictive of rebleeding by means of COX ratio hazard model.ResultsThe medium follow-up was 52 months (range13-112 months).Significant lesions were found in 202 patients (65.8%).The overall rebleeding rate after interventional therapy induced by CE findings was 28.0% (86/307).CE positive patients had higher rebleeding rate than CE negative patients (37.6% vs 9.5%,log-rank test,P=0.000),while specific therapy could prevent rebleeding,compared with nonspecific therapy (32.9% vs 23.0%,P=0.042).95.3% (82/86) rebleeding occurred within 24 months after CE.Multivariate analysis performed by using COX proportional hazards model showed that age over 50 years,CE positive findings,lowest hemoglobin (Hb) level 3 months before CE ≤7 g/dl,receiving nonspecific therapy after CE,hypertension,administration of anticoagulants,antiplatelet medicine or NSAIDs after CE were six risk factors associated with rebleeding.Conclusion Clinicians should be aware of these risk factors for OGIB rebleeding,which can reduce the occurrence of rebleeding and improve OGIB patients' prognosis.Those high risk OGIB patients should be followed up for at least 24 months after CE.

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