Objective: This study aimed to develop a machine learning model for the diagnosis of chronic renal failure (CRF) with spleen-kidney qi deficiency (SKQD) syndrome by investigating facial chromatic biomarkers based on traditional Chinese medicine (TCM) theory.Materials and Methods: This cross-sectional study analyzed TCM-defined facial regions in 303 patients with CRF (166 SKQD and 137 non-SKQD) and 25 healthy controls using active appearance models and RGB/Lab color spaces. Key chromatic features were selected using Chi-square automatic interaction detection (CHAID) decision trees to construct a multibranch deep convolutional neural network (CNN), nomogram, and hybrid model. The model performances were compared using the DeLong test.Results: The SKQD group showed a higher glomerular filtration rate, albumin level, and facial R-value with a lower serum creatinine level (all P < 0.05), accompanied by a higher prevalence of shortness of breath with reluctance to speak, and cold extremities (P < 0.05) compared with the non-SKQD group. Chromatic analysis revealed elevated R/a values in the kidney region using the natural facial color region method (P < 0.05), and distinctively higher R-values in the bladder-uterus region and a-values in the right small intestine region using the Mingtang facial color region method (P < 0.05). The CHAID algorithm selected four diagnostic determinants, including the overall facial R-values. The CNN achieved superior discriminative performance (test area under the receiver operating characteristic curve = 0.74 vs. nomogram 0.68, DeLong test P < 0.001) with no added benefit from model integration (P > 0.05).Conclusions: Facial chromatic biomarkers effectively differentiated SKQD in patients with CRF when analyzed using TCM-defined regions. The superior performance of the CNN validates AI-driven TCM diagnostics as a clinically actionable tool for precise syndrome classification.

Background/Objectives: Effective self-management after lung transplantation is critical. The Health Belief Model is frequently used to predict and explain the health behaviour in chronic ill patients. The purpose of this study was to explore the status and association factors of self-management among lung transplantation recipients based on the Health Belief Model. Methods: A questionnaire survey was conducted on 123 lung transplantation recipients at the lung transplant unit of a general hospital from March 2022 to October 2023. The survey instruments included the Perceived Social Support Scale, the Champion Health Beliefs Model Scale, and the Self-Management Questionnaire for Lung Transplant Recipients. SPSS 25.0 was adopted to perform descriptive statistics, univariate analysis, and multivariate regression analysis. Results: Scoring indicators of self-management dimensions in lung transplantation recipients were lifestyle management (82.8%), communication with physicians (50.0%), cognitive symptom management (36.0%), and exercise (21.7%). Multiple linear regression analysis showed that the number of postoperative complications, perceived seriousness, perceived benefits, and health motivation explained 22.3% of the total variation in the exercise dimension; health motivation and social support explained 13.5% and 17.4% of the variation in cognitive symptom management dimension and communication with physicians dimension, respectively; and health motivation, social support, and perceived barriers explained 24.0% of the total variation in the lifestyle management dimension. Conclusions: Health motivation, perceived seriousness, perceived benefits and barriers, social support, and the number of postoperative complications were the main association factors of self-management behaviour among lung transplant recipients.

Lung transplant recipients (LTRs) face unique psychological distress post-transplantation, which may potentially impact their recovery, so establishing effective psychological coping mechanisms can significantly impact their recovery and overall quality of life. Self-psychological adjustment plays a critical role by mobilizing the recipient’s internal resources, thereby improving their psychological well-being more effectively. This study aims to evaluate the relevant systematic reviews to provide evidence-based support for psychological distress and self-psychological adjustment methods in LTRs. A method of overview of systematic reviews was conducted to synthesize findings from relevant studies. The Cochrane Library, PubMed, Embase, CINAHL, Web of Science, PsycINFO, and Chinese databases including China National Knowledge Infrastructure (CNKI), Wanfang data, Chinese Scientific Journals Full-text Database (VIP), and Sinomed were searched from the establishment of the database until January 30, 2024. In addition, the updated searches were completed on May 15, 2025. Two researchers independently screened and extracted data. We applied the AMSTAR 2 Scale to assess methodological quality of included reviews, and used the PRISMA 2020 and ENTRQ to assess reporting quality of included reviews. And the GRADE and CERQual frameworks were used to determine the certainty of the evidence. A total of 10 reviews were included, covering “psychological distress” and “self-psychological adjustment methods”. Common psychological distress identified included anxiety, depression, uncertainty about the future, adjustment disorders, sense of inadequacy, and fear of complications. Self-psychological adjustment methods were categorized into: (1) actively integrating into the society, (2) resuming daily activities, changing lifestyle and attitude, (3) accepting self, (4) seeking social support, (5) psychological interventions, such as mindfulness-based stress reduction (MBSR) intervention, music therapy. The AMSTAR 2 assessment indicated overall low methodological quality, with significant deficiencies in three key items (Item 2, 9 and 13). The reporting assessment results showed that most of the included reviews still needed to be improved in terms of reporting quality. The certainty of evidence ranged from moderate to very low, with notable inconsistencies between study findings and the actual situation. Currently, the methodological quality, reporting quality, and evidence quality of included reviews need to be improved. Self-psychological adjustment appears beneficial in alleviating psychological distress among LTRs. More high-quality, large-sample studies are still needed for further validation.

BACKGROUND:Acne is a chronic inflammatory and immune-mediated disease of the pilosebaceous unit (the skin structure consisting of a hair follicle and its associated sebaceous gland). It is characterised by non-inflammatory lesions (open and closed comedones) and inflammatory lesions (papules, pustules, nodules, and cysts). Lesions may be present on the face, thorax, and back, with variable severity. Acne exhibits a global distribution and has a growing prevalence. Acne vulgaris is the most common form. Acne gives rise to complications such as scars and can seriously affect people's mental health, especially those with severe acne. Acne has a huge impact on the quality of life and self-esteem of those affected. OBJECTIVES:To synthesise the existing evidence on the efficacy and safety of non-systemic pharmacological interventions and non-pharmacological interventions (physical therapy and complementary therapies) in the treatment of acne vulgaris and related skin complications. METHODS:We searched the Cochrane Database of Systematic Reviews, Epistemonikos, MEDLINE, and Embase to 2 December 2021, and checked the reference lists of included reviews. At least two authors were responsible for screening, data extraction, and critical appraisal. We excluded reviews with high risk of bias as assessed with the ROBIS tool. We evaluated the overall certainty of the evidence according to GRADE (as carried out by the authors of the included reviews or ourselves). We provide comprehensive evidence from the review data, including summary of findings tables, summary of results tables, and evidence maps. MAIN RESULTS:We retrieved and assessed a total of 733 records; however, only six reviews (five Cochrane reviews and one non-Cochrane review) with low risk of bias met the overview inclusion criteria. The six reviews involved 40,910 people with acne from 275 trials and 1316 people with acne scars from 37 trials. The age of the participants ranged from 10 to 59 years, with an average age range from 18 to 30 years. Four reviews included original trials involving only female participants and three reviews included original trials with only male participants. Main results for clinically important comparisons: Benzoyl peroxide versus placebo or no treatment: In two trials involving 1012 participants over 12 weeks, benzoyl peroxide may reduce the total (mean difference (MD) -16.14, 95% confidence interval (CI) -26.51 to -5.78), inflammatory (MD -6.12, 95% CI -11.02 to -1.22), and non-inflammatory lesion counts (MD -9.69, 95% CI -15.08 to -4.29) when compared to placebo (long-term treatment), but the evidence is very uncertain (very low-certainty evidence). Two trials including 1073 participants (time point: 10 and 12 weeks) suggested benzoyl peroxide may have little to no effect in improving participants' global self-assessment compared to placebo (long-term treatment), but the evidence is very uncertain (risk ratio (RR) 1.44, 95% CI 0.94 to 2.22; very low-certainty evidence). Very low-certainty evidence suggested that benzoyl peroxide may improve investigators' global assessment (RR 1.77, 95% CI 1.37 to 2.28; 6 trials, 4110 participants, long-term treatment (12 weeks)) compared to placebo. Thirteen trials including 4287 participants over 10 to 12 weeks suggested benzoyl peroxide may increase the risk of a less serious adverse event compared to placebo (long-term treatment), but the evidence is very uncertain (RR 1.46, 95% CI 1.01 to 2.11; very low-certainty evidence). Benzoyl peroxide versus topical retinoids: Benzoyl peroxide may increase the percentage change in total lesion count compared to adapalene (long-term treatment), but the evidence is very uncertain (MD 10.8, 95% CI 3.38 to 18.22; 1 trial, 205 participants, 12 weeks; very low-certainty evidence). When compared to adapalene, benzoyl peroxide may have little to no effect on the following outcomes (long-term treatment): percentage change in inflammatory lesion counts (MD -7.7, 95% CI -16.46 to 1.06; 1 trial, 142 participants, 11 weeks; very low-certainty evidence), percentage change in non-inflammatory lesion counts (MD -3.9, 95% CI -13.31 to 5.51; 1 trial, 142 participants, 11 weeks; very low-certainty evidence), participant's global self-assessment (RR 0.96, 95% CI 0.86 to 1.06; 4 trials, 1123 participants, 11 to 12 weeks; low-certainty evidence), investigators' global assessment (RR 1.16, 95% CI 0.98 to 1.37; 3 trials, 1965 participants, 12 weeks; low-certainty evidence), and incidence of a less serious adverse event (RR 0.77, 95% CI 0.48 to 1.25, 1573 participants, 5 trials, 11 to 12 weeks; very low-certainty evidence). Benzoyl peroxide versus topical antibiotics: When compared to clindamycin, benzoyl peroxide may have little to no effect on the following outcomes (long-term treatment): total lesion counts (MD -3.50, 95% CI -7.54 to 0.54; 1 trial, 641 participants, 12 weeks; very low-certainty evidence), inflammatory lesion counts (MD -1.20, 95% CI -2.99 to 0.59; 1 trial, 641 participants, 12 weeks; very low-certainty evidence), non-inflammatory lesion counts (MD -2.4, 95% CI -5.3 to 0.5; 1 trial, 641 participants, 12 weeks; very low-certainty evidence), participant's global self-assessment (RR 0.95, 95% CI 0.68 to 1.34; 1 trial, 240 participants, 10 weeks; low-certainty evidence), investigator's global assessment (RR 1.10, 95% CI 0.83 to 1.45; 2 trials, 2277 participants, 12 weeks; very low-certainty evidence), and incidence of a less serious adverse event (RR 1.27, 95% CI 0.98 to 1.64; 5 trials, 2842 participants, 10 to 12 weeks; low-certainty evidence). For these clinically important comparisons, no review collected data for the following outcomes: frequency of participants experiencing at least one serious adverse event or quality of life. No review collected data for the following comparisons: topical antibiotics versus placebo or no treatment, topical retinoids versus placebo or no treatment, or topical retinoids versus topical antibiotics. AUTHORS' CONCLUSIONS:This overview summarises the evidence for topical therapy, phototherapy, and complementary therapy for acne and acne scars. We found no high-certainty evidence for the effects of any therapy included. Randomised controlled trials and systematic reviews related to acne and acne scars had limitations (low methodological quality). We could not summarise the evidence for topical retinoids and topical antibiotics due to insufficient high-quality systematic reviews. Future research should consider pooled analysis of data on new emerging drugs for acne treatment (e.g. clascoterone) and focus more on acne complications.

Objective:To construct a diagnostic model for cardiac neurosis with rigid-deficiency symptoms using LASSO regression combined with Nomogram.Methods:A single-center prospective study was conducted to collect the clinical data of 141 patients with cardiac neurosis.Variables included in the analysis were age,ethnicity,marriage,education,mental/physical work,BMI,traditional Chinese medicine symptoms,and the scores of Chinese medicine five-state personality,the Hamilton Anxiety Inventory-14-item scale,the Hamilton Depression Inventory-24-item scale and the Symptom Checklist-90.The influencing factors significantly associated with the diagnosis of rigid-deficiency symptoms were screened by LASSO regression,incorporated into a binary multi-factor Logistic regression analysis to construct a diagnostic model,and the model was evaluated for predictive discrimination and calibration,internally validated using 10-fold cross-validation.Finally,the model was visualized by Nomogram,and the diagnostic threshold was determined according to the ROC curve.Results:A total of 70 patients with rigid deficiency syndrome and 71 patients with non-rigid deficiency syndrome were included.The LASSO regression screened the five most significant variables associated with the diagnosis of rigid-deficiency symptoms as female,age,fatigue,belching,and Shaoyang points in the five personality states.The model AUC was 0.85 and the H-L test was 2.94(P=0.982 4),suggesting good model differentiation and calibration,and the 10-fold cross-over internal validation results suggested an AUC of 0.82.Conclusion:In this study,the diagnostic model constructed by LASSO regression combined with Nomogram can help clinicians to rapidly diagnose patients with cardiac neurosis with rigid-deficiency symptoms,but the accuracy of the results needs to be further verified by large-sample clinical studies.

INTRODUCTION:Evidence of different smoking cessation interventions varies and has been assessed in many Cochrane reviews. We conducted an overview of these Cochrane reviews to summarize the effects of current interventions for smoking cessation. METHODS:Nine databases were searched from their inception to October 2024, with no restrictions on language. Two authors independently extracted data from the same studies simultaneously, double checking after extraction. A second round of examination was conducted on all the extracted contents by another author. We employed a measurement tool to assess systematic reviews (AMSTAR-2) to evaluate the methodological rigor of the included systematic reviews (SRs), synthesized the GRADE results as reported, and conducted a narrative synthesis. The research protocol was registered on PROSPERO (CRD42023388884). RESULTS:Seventy-one Cochrane reviews involving 3022 trials were included in this comprehensive analysis. The two predominant smoking cessation interventions were pharmacotherapy (24 SRs) and non-pharmacological therapy (31SRs). Overall, the methodological quality of all the reviews was good. Compared with placebo, the point effect size for each Cochrane review on relative risk (RR) regarding pharmacotherapies for prolonged abstinence rate ranged from 1.11 to 3.34, demonstrating high- or moderate-certainty evidence; whereas for non-pharmacological therapies, it varied from 0.79 to 25.38, but substantial heterogeneity was observed in most meta-analysis (I2>50%). Four studies investigating pharmacotherapies as interventions, adverse events were reported but no significant differences in outcomes were observed. CONCLUSIONS:Pharmacotherapy demonstrated some efficacy in promoting prolonged abstinence rate, while the effectiveness of different non-pharmacological interventions for smoking cessation varied widely, highlighting the need for further research on the integration of pharmacotherapy and non-pharmacological therapies.

To clarify and refine the specific elements of post-transplant recovery in lung transplant recipients, we explored the four dimensions of recovery: physiological, psychological, social, and habitual. This study is a scoping review. Two authors conducted a comprehensive electronic literature search to identify studies published from the establishment of the database to August 2022. Deductive coding was utilized to identify and categorize elements using a predefined list of the four components (physiological, psychological, social, and habitual recovery) based on the framework of post-transplant recovery proposed by Lundmark et al. Inductive coding was applied for concepts requiring further classification. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline. Systematic searching identified 8,616 potential records, of which 51 studies met the inclusion criteria. Ten subdimensions and their corresponding elements were identified and categorized into four dimensions of recovery following lung transplantation. The subdimensions included physiological recovery (including symptom experience, complications, physical function, and energy reserve), psychological recovery (encompassing affective distress, psychological adaptation, and transition from illness to health), social recovery (involving family adaptation and social adaptation), and habit recovery (focusing on health behavior).

Background and aims Cardiovascular disease (CVD) is associated with inflammation and abnormal lipid metabolism. However, a single inflammatory index or a single lipid index cannot accurately predict the prognosis of CVD independently because it is prone to be affected by various confounding factors. Methods This population-based cohort study included 6,554 participants from the China Health and Retirement Longitudinal Study (CHARLS) to investigate correlations. In the present study, the occurrence of CVD events such as stroke and heart disease was evaluated by considering self-reported diagnoses at the beginning of the study and during wave 4, and a restricted cubic spline model was used to investigate potential nonlinear relationships in addition to multivariate logistic regression models. Stratified analyses were performed to examine how sociodemographic characteristics may influence the results. Results Seven years of follow-up (2011–2018) revealed that 786 people (11.99%) developed CVD. According to the adjusted model, the high-sensitivity C-reactive protein (hs-CRP)-to-high-density lipoprotein cholesterol (HDL-C) ratio is a contributing factor to CVD risk (OR 1.31, 95% CI 1.05–1.64). In addition, a nonlinear relationship was observed between the hs-CRP/HDL-C ratio and the occurrence of new CVD, stroke, or cardiac issues ( P overall <0.05, Pnonlinear <0.05). Moreover, noteworthy associations between the hs-CRP/HDL-C ratio and age were detected in the stratified analysis ( P = 0.048), indicating that younger participants had more negative effects of a high hs-CRP/HDL-C ratio. Conclusions According to the present cohort study, a high hs-CRP/HDL-C ratio is a significant risk factor for CVD, new stroke, and heart problems. Early intervention in patients with increased hs-CRP/HDL-C ratios may further reduce the incidence of CVD, in addition to focusing on independent lipid markers or independent inflammatory markers.

Anthracyclines and trastuzumab are widely used to treat breast cancer but increase the risk of cardiomyopathy and heart failure. With the use of trastuzumab and anthracycline-containing medications, this study intends to evaluate the effectiveness and security of current treatments against cardiotoxicity. We conducted a systematic review of randomized controlled trials (RCTs), which used at least one angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), or beta-blocker (BB) to prevent cardiotoxicity of antineoplastic agents for breast cancer, in 4 databases (PubMed, Cochrane Library, EMBASE, Web of Science) from inception to 11 May 2022, without language restrictions. The outcome of interest was left ventricular ejection fraction (LVEF) and adverse events. Stata 15 and R software 4.2.1 were used to perform all statistical analyses. The Cochrane version 2 of the risk of bias tool was used to assess the risk of bias, and the grading of recommendations assessment, development, and evaluation (GRADE) assessment was used to appraise the quality of the evidence. Fifteen randomized clinical studies with a total of 1977 patients were included in the analysis. The included studies demonstrated statistically significant LVEF in the ACEI/ARB and BB treatment groups ( χ 2 = 184.75, I 2 = 88.6%, p = 0.000; SMD 0.556, 95% CI 0.299 to 0.813). In an exploratory subgroup analysis, the benefit of experimental agents on LVEF, whether anthracyclines or trastuzumab, was prominent in patients treated with ACEIs, ARBs, and BBs. Compared to placebo, ACEI/ARB and BB treatments in breast cancer patients protect against cardiotoxicity after trastuzumab and anthracycline-containing medication treatment, indicating a benefit for both.

Review question / Objective: We aim to systematically review all the current studies on the administration of smoking cessation clinics and clinical studies based on smoking cessation clinics in China.Background: Smoking is the leading preventable cause of death and chronic disease in China.Tobacco is a major cause of noncommunicable diseases, such as cardiovascular disease, cancer, chronic respiratory disease and diabetes.Tobacco dependence is a chronic fatal disease mainly caused by nicotine addiction.Smoking cessation clinic is an important approach to promote quitting smoking according to the WHO Framework Convention on Tobacco Control (FCTC).In China the first smoking cessation clinic was established in 1996, when China has became a party to the FCTC.With national financial support, smoking cessation clinics have been built in succession throughout the country, thus a comprehensive smoking cessation service system was initially build up in China.

对国内外等待肾移植病人健康教育需求内容及实施健康教育方式进行综述,以期加强对等待肾移植期间健康教育的重视,为临床等待肾移植病人健康教育支持项目的干预研究提供参考.

Review question / Objective: Participants/population: We will include recipients aged 12-65 years with no serious comorbidities, such as malignancy, psychiatric disorders, etc. Intervention(s), exposure(s): Illness perception is defined by the following attributes: identity (what the disease is), cause (what caused it), timeline (acute, chronic, cyclic), consequences (minor, moderate, severe), control (whether anything can be done about the disease) and emotional response (anxiety, worry).Cognitive appraisal (also called simply 'appraisal') is the subjective interpretation made by an individual to stimuli in the environment.It is a component in a variety of theories relating to stress, mental health, coping, and emotion.IB and CA must refer to cognitive representation of the disease.IB and CA should be analyzed separately.Comparator(s)/control: No treatment.Main Outcome (s) : a) Symptoms of anxiety or depression, such as AIMS scale、BDI scale, and so on.b) Quality of life, such as Qol scale.c) Coping Style, such as the COPE Inventory Scale.

目的 通过对现有证据的再次分析,评价流行性感冒(简称流感)的干预措施的现有证据等级及其有效性.方法 系统检索Cochrane图书馆中有关流感干预措施有效性及安全性的系统评价,检索时间为数据库建库至2021年10月31日.用AMSTAR-2量表评价纳入研究的方法学质量,运用GRADE对证据质量进行评价.结果 共纳入10篇系统评价,评价了 9种干预措施,共计153.项原始研究,涉及125 249例流感患者.AMSTAR-2量表评分7项研究为高质量,2项研究为中等质量,1项研究为低质量.GRADE证据评价主要结局指标中,高质量(维生素C)、中等质量(口服紫锥花制剂)证据研究各1项,其余为低或极低质量证据.主要结局指标报道情况为痊愈或痊愈率7项、死亡率1项和住院时间3项.结果 提示安替威胶囊(对照为安慰剂,疗程4天,RR=3.80,95％CI为 1.23～11.72,225例),感冒胶囊(对照为金刚烷胺,疗程2天,RR=5.17,95％CI为3.82～6.99,432例),不同剂量清开灵注射液(对照为林可霉素,疗程3天,每日120ml,RR=1.41,95％CI为 1.07～1.86,199例;每日 160ml,RR=1.41,95％CI为 1.08～1.86,202例;每日 200ml,RR=1.52,95％CI为1.15～2.00,181例),中成药膏剂(对照为青霉素或林可霉素,疗程2天,RR=2.10,95％CI为 1.20～3.67,60例)可提高流感患者痊愈率;防感颗粒(对照为对症治疗,MD=-1.24,95％CI为-1.71～-0.77,95例),葛根汤颗粒联合奥司他韦(对照为奥司他韦,MD=-0.59,95％CI为-0.76～-0.41,70例),自拟清瘟退热方联合奥司他韦(对照为奥司他韦,MD=-0.55,95％CI为-1.01～-0.09,60例)可缩短痊愈时间;痰热清联合奥司他韦(对照为奥司他韦,MD=-1.01,95％CI为-2.00～-0.02,54例)可能缩短住院时间.现有证据不支持其余干预措施可有效提高痊愈率、缩短痊愈时间或缩短住院时间,暂无可降低死亡率的干预措施.结论 维生素C、口服紫锥花制剂、非甾体类抗炎药、大蒜素胶囊在治疗流感患者时没有疗效.低和极低质量证据提示部分中药制剂可提高痊愈率、缩短痊愈时间.

Abstract Background Heart failure (HF) is a global public health problem with high morbidity and mortality. While machine learning (ML) has been perceived as a promising tool for HF research, a bibliometric analysis of this application is still lacking. This study aims to analyze the relevant papers from 2003 to 2023 and provide a comprehensive overview of this field in a visual way. Methods We systematically searched Web of Science Core Collection, PubMed, and preprint servers (arXiv, BioRxiv, and MedRxiv) to identify records from 2003 to 2023 on ML in HF research. After manual data cleansing, a Python approach based on the regular expression matching algorithm was used to automate text annotations, while three bibliometric analysis tools (CiteSpace, VOSviewer, and Bibliometrix) were used for the visualization of research trends, collaboration networks, and research hotspots. Results We analyzed 6,115 records (including 1,797 published papers) and observed a steady increase in annual publication rates since 2015, with a significant uptick after 2020. We identified 23 core journals in the field according to Bradford's law, and presented the top 10 journals with the highest citations, h-index, g-index, or m-index. The United States was the most productive country, followed by China and the United Kingdom. The most prolific institutions were Harvard Medical School and Mayo Clinic. Using text annotations, we identified 1,257 ML-related original HF research. In these studies, the main data modalities were ultrasound, electronic health records, and electrocardiograms. The most frequently applied ML methods were neural networks, followed by linear models and ensembles. The most common clinical goals were diagnosis, prediction, and classification. The main research topics included the classification of HF, AI-assisted medical diagnostic technologies, HF-related clinical prediction models, and HF-related bioinformatics research. Conclusions This bibliometric analysis revealed a significant growth in the application of ML in HF research over the past two decades. The current research landscape encompasses a wide range of ML techniques and applications, focusing on improving diagnosis, prognosis, classification, and precision treatment for HF patients.

Objective:To systematically evaluate the efficacy and safety of Gong Liu Ning as a complimentary therapy in treatment for uterine fibroids. Methods:Randomized controlled trials on Gong Liu Ning for uterine fibroids from China National Knowledge Infrastructure,Wanfang,China Science and Technology Journal Database,PubMed,Cochrane Library,Embase,Web of Science,Chinese Clinical Trial Registry,and Clinical Trials.gov were retrieved from inception to March 20,2023.The risk of bias tool was used to evaluate the quality of the selected studies after they met inclusion and exclusion criteria.The GRADE tool was used to evaluate the quality of evidence,and the RevMan5.3 software was used for data analysis. Results:Twenty studies with 1907 patients were analyzed.The meta-analysis results of 15 studies showed that Gong Liu Ning combined with mifepristone was more efficacious than those observed in controls taking only Western medicine(risk ratio[RR]=1.22,95％confidence interval[CI]=[1.11,1.33],P＜.001).Owing to the large heterogeneity,a random-effects model was used to merge the included studies.Gong Liu Ning combined with mifepristone was better in reducing the volume of uterine fibroids(mean difference[MD]=-4.09 cm3,95％CI[-5.16.-3.02],P＜.001),uterine volume(MD=-23.22 cm3,95％CI[-29.10,-17.33],P＜.001),and the levels of female hormones,including progesterone,estrogen,follicle-stimulating hormone,and luteinizing hormone(all P＜.001).Ten studies reported adverse events.The methodological quality of the included studies was not high,and a moderate risk of bias was observed. Conclusion:Compared with conventional Western medicine alone,the combined use of Gong Liu Ning has certain advantages in improving efficacy.It shows a certain advanced tendency to reduce the volume of uterine fibroids,uterine volume,and female hormones;however,more high-quality and rigorously designed studies are required for validation.

目的:目前针对抑郁症的随机对照试验(RCT)中普遍使用汉密尔顿量表(HAMD)评价抑郁程度.本研究旨在调查该评分细节报告的完整性,尤其是研究者对研究结果解释中临床意义的重视程度.方法:检索2020年10月至2022年10月发表于国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、临床试验注册系统(ChiCTR)、PUBMED、Cochrane、EMBASE、Web of Science、PROQUEST共9个数据库的以"针刺治疗抑郁症"为主题并报告HAMD结果的RCT.2名研究者独立提取了各研究对HAMD评分的报告细节以及对结果临床意义的报告和解释.结果:共检索到符合标准的RCT91项,超过95％的文献报道了均值、标准差及P值,但仅有3.3％的文献报道95％置信区间.93.4％的文献直接或间接地报道了HAMD值所代表的意义,73.6％报道了HAMD量表类型,19.8％文献报道HAMD的总分,34.1％的文献报道了HAMD具体的评价方法.统计学意义的报道在75％以上,纳入文献均报道了临床意义,但临床意义的解读仅基于统计学意义,并未结合临床实际有效值来判定.组间比较结果显示,学位论文各项报道的百分比均高于普通文献.国外研究报道的完整性普遍高于国内文献.结论:针刺治疗抑郁症随机对照试验的中文文献HAMD评分报道尚且不够完整.建议研究者在试验报告中参考高质量RCT结果,更详细地描述评分类指标的细节、合理解读其临床意义,以提高结局指标报道的质量.

Background and objective:Andrographis paniculata (AP) is a traditionally used herbaceous plant, whose main active constituent is andrographolide. Andrographolide derivative medications and herbal preparations of AP are often used to treat respiratory tract infections. This study aims to systematically evaluate the safety of andrographolide derivative medications and herbal preparations of AP based on clinical studies. Methods: English and Chinese databases were searched for all types of clinical studies that reported adverse drug reactions (ADRs) and adverse events (AEs) of andrographolide derivative medications and herbal preparations of AP. The ADRs and AEs were classified according to manifestations, and graded according to severity. Single-rate meta-analysis was performed for ADR incidence using R software. Results: A total of 262 studies were included, including 125 randomized controlled trials, 23 non-randomized controlled trials, 6 case series, and 108 case reports. In 9490 participants using andrographolide derivative injections, 383 (4.04%) reported ADRs. Meta-analysis showed that the ADR incidence of three most frequently used injections of andrographolide derivatives (andrographolide sulfonate, potassium sodium dehydroandrographolide succinate, and potassium dehydroandrographolide succinate) were 5.48% [95% CI (4.47%, 6.72%)], 3.69% [95% CI (2.59%, 4.94%)] and 5.33% [95% CI (3.68%, 7.72%)], respectively, which may be slightly higher than the actual ADR incidence, because only studies that reported the occurrence of ADRs or AEs were included, but studies without ADR and AE were not included. The ADRs of andrographolide derivative injections were mainly gastrointestinal, skin and subcutaneous tissue disorders, and anaphylaxis. Fifty-five patients experienced life-threatening anaphylactic shock, three patients died, and the causation attributed to the andrographolide derivative injection. Other ADRs were mild, moderate or medically significant. Nine herbal preparations of AP were tested in 10 studies, and the reported ADRs were mainly mild to moderate gastrointestinal, skin and subcutaneous tissue disorders. Except for five patients using andrographolide derivative injections eventually died, most of the ADRs were alleviated after drug withdrawal and symptomatic treatment. Conclusions: The ADRs of andrographolide derivative medications are few, but can be life-threatening, mainly gastrointestinal, skin and subcutaneous tissue disorders, and anaphylaxis. Injections of andrographolide derivatives should be used with caution. Herbal preparations of AP are essentially safe. Systematic Review Registration: [website], identifier [registration number].

To investigate adherence to immunosuppressive medication (IM) in kidney transplant recipients (KTRs) and analyze the associated factors using the Theory of Planned Behavior (TPB). Data were collected at Time1 (T1) and 3 months later (T2). T1: the elements of the TPB, past behavior, beliefs about medicines, perceived social support were measured. T2: IM adherence was measured. Structural equation modeling was applied to analyze the associated factors of medication adherence. A total of 246 KTRs were included. The average IM adherence score of KTRs’ was 4.86 ( SD = 1.63). Of the recipients, 39.43% had one aspect of non-adherence to IM. The model could explain 28.7% of the variance in adherence to IM ( R 2 = .287, p = .006). TPB is a useful tool for understanding adherence to IM in KTRs. Caregivers can provide effective interventions during follow-up, which should focus on improving medication beliefs as well as provision of other external support especially from outside.