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Clinical Practice Guidelines and Experts’Consensuses for Treatment of Coronavirus Disease 2019(COVID-19)Patients with Chinese Herbal Medicine:A Systematic Review

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Chinese Journal of Integrative Medicine 2020年第10期26卷 786-793页

作者： LI Yu-xi LI Juan ZHANG Yue TIAN Yan-ping ZHANG Yong-gang JIN Rong-jiang GUO Yan Mike Clarke School of Acupuncture-Moxibustion and Tuina Chengdu University of Traditional Chinese MedicineChengdu(610032)China School of Health Preservation and Rehabilitation Chengdu University of Traditionai Chinese MedicineChengdu(610032)China west China Hospital Sichuan UniversityChengdu(610032)China Xiyuan Hospital China Academy of Chinese Medicine SciencesBeijing(100091)China northern Ireland Clinical trials Unit and methodology hub Centre for Public HealthQueen's University BelfastBelfastUK

Objective:To systematically review the clinical practice guidelines for the treatment of coronavirus disease 2019(COVID-19)patients with Chinese herbal medicine(CHM),summarize their recommendations and evaluate their ***:Electronic databases,websites of governments,academic associations or organizations for eligible guidelines were searched up to April *** were extracted to summarize recommendations for the use of Chinese herbal formulae and Chinese patent medicine(CPM)for COVID-19 *** methodological quality and reporting quality of the included guidelines were independently evaluated,using the Appraisal of Guidelines for research and Evaluation(AGREE)Ⅱtool and Reporting Items for Practice Guidelines in healthcare(RIGHT)statement,***:Totally 45 guidelines were identififi ed:42(93%)suggested specific CM formulae for treating COVID-19 patients;and 35(78%)assigned patients diagnosed with COVID-19 to 4 stages(early,development,critical and recovery).The recommended formulae and CPMs for each stage with diverse syndrome types have been *** of the included guidelines were of low methodological quality,with only one achieving moderate quality of AGREEⅡ.The frequency with which the 35 items in the Reporting Items for Practice Guidelines in Healthcare(RIGHT)checklist were reported averaged 36.5%across the 45 ***:This systematic review has summarized current recommendations for treating COVID-19 patients with CHM and shows that the general quality of present guidelines is quite *** development of future guidelines should include increased awareness of the features of good quality guidelines.

关键词： coronavirus disease 2019 COVID-19 Chinese medicine herbal medicine clinical practice guideline systematic review

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Cilostazol and isosorbide mononitrate for the prevention of progression of cerebral small vessel disease:baseline data and statistical analysis plan for the Lacunar Intervention Trial-2(LACI-2)(ISRCTN14911850)

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Stroke & Vascular Neurology 2023年第2期8卷 134-143页

作者： Philip M Bath Iris Mhlanga Lisa J Woodhouse Fergus Doubal Katherine Oatey Alan A Montgomery Joanna M Wardlaw LACI-Trial Investigators Stroke trials Unit University of NottinghamNottinghamUK Centre for Clinical Brain Sciences UK Dementia Research Institute CentreUniversity of EdinburghEdinburghUK Edinburgh Clinical trials Unit University of EdinburghEdinburghUK Nottingham Clinical trials Unit University of NottinghamNottinghamUK

Background Cerebral small vessel disease(SVD)causes lacunar strokes(25%of all ischaemic strokes),physical frailty and cognitive impairment and vascular and mixed *** is no specific treatment to prevent progression of *** The LACunar Intervention Trial-2 is an investigator-initiated prospective randomised open-label blinded-endpoint phase II feasibility study assessing cilostazol and isosorbide mononitrate for preventing SVD *** aimed to recruit 400 patients with clinically evident lacunar ischaemic stroke and randomised to cilostazol,isosorbide mononitrate,both or neither,in addition to guideline secondary ischaemic stroke prevention,in a partial factorial *** primary outcome is feasibility of recruitment and adherence to medication;key secondary outcomes include:drug tolerability;recurrent vascular events,cognition and function at 1 year after randomisation;and safety(bleeding,falls,death).Data are number(%)and median(IQR).Results The trial commenced on 5 February 2018 and ceased recruitment on 31 May 2021 with 363 patients randomised,with the following baseline characteristics:average age 64(56.0,72.0)years,female 112(30.9%),stroke onset to randomisation 79.0(27.0,244.0)days,hypertension 267(73.6%),median blood pressures 143.0(130.0,157.0)/83.0(75.0,90.0)mm Hg,current smokers 67(18.5%),educationally achieved end of school examinations(A-level)or higher 118(32.5%),modified Rankin scale 1.0(0.0,1.0),National Institutes Health stroke scale 1.0(1.4),Montreal Cognitive Assessment 26.0(23.0,28.0)and total SVD score on brain imaging 1.0(0.0,2.0).This publication summarises the baseline data and presents the statistical analysis *** The trial is currently in follow-up which will complete on 31 May 2022 with results expected in October *** registration number ISRCTN14911850.

关键词： nitrate initiated prevention

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Thermal ablation in colorectal liver metastases-the paradox of equipoise

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Hepatobiliary Surgery and Nutrition 2021年第2期10卷 276-278页

作者： Nalinie Joharatnam-Hogan Khurum Khan Department of Gastrointestinal Oncology University College London Hospitals NHS Foundation TrustLondonUK mrc Clinical trials Unit at UCL LondonUK UCL Cancer Institute LondonUK Department of Gastrointestinal Oncology North Middlesex University HospitalLondonUK

Approximately 25%of individuals with colorectal cancer(CRC)present with metastatic disease,and it is estimated that throughout the course of the disease,up to 50%of individuals may develop liver metastases,the majority of which are unresectable(1).However,thermal ablation is a treatment modality increasingly used to manage individuals with liver *** Takahashi et *** a comprehensive review of the various approaches to thermal ablation and summarised the recent evidence demonstrating an associated survival benefit supporting its use in the management of metastatic CRC(mCRC)(2).It is however critical to analyse the studies evaluated to ensure the strength of the evidence presented.

关键词： colorectal metastases liver

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多重结局的多元Meta分析和多重治疗的网状Meta分析:原理、概念及实例

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英国医学杂志中文版 2018年第12期21卷 725-735页

作者： Richard D Riley Dan Jackson Georgia Salanti Danielle L Burke Malcolm Price Jamie Kirkham Ian R White 孙至佳(译) 张岩(译) 刘雪晴(译) 杨智荣(校) 孙凤(校) research Institum for Primary Care and Health Sciences Keele University StaffordshireUK mrc Biestatistics Onit CambridgeUK Institute of Social and Preventive Medicine University of BernSwitzerland University of Ioannina School of Medicine Ioannina Greece Institute of Applied Health research University of BirminghamUK mrc north west hub for trials methodology research Department of Biostatistics University of LiverpoolLiverpool UK mrc Clinical trials Unit at UCL London UK 北京大学公共卫生学院流行病与卫生统计学系

英国国家健康与临床优选研究所(NICE)等组织需要对现有研究获得的证据进行整合来指导决策,需要确定关于多重疗效及安全性结局的最佳治疗。但是,相关的研究不一定对所有关注的治疗或结局都进行了直接比较,多元Meta分析及网状Meta分析为... 详细信息

英国国家健康与临床优选研究所(NICE)等组织需要对现有研究获得的证据进行整合来指导决策,需要确定关于多重疗效及安全性结局的最佳治疗。但是,相关的研究不一定对所有关注的治疗或结局都进行了直接比较,多元Meta分析及网状Meta分析为如何确定最佳治疗这一问题提供了思路,该方法不仅考虑了直接证据,还利用了关联或间接的证据。本文中,研究者描述了这些方法学的重要概念及假设,并阐述关联及间接证据如何产生,同时通过图表说明这些证据在涉及多重结局和多重治疗的真实临床案例中如何使用。

关键词：网状Meta分析最佳治疗多重实例临床案例证据研究所安全性

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临床研究的结局报告偏倚:系统综述中的评估和调整方法

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英国医学杂志中文版 2019年第6期22卷 345-349页

作者： Jamie J Kirkham Douglas G Altman An-Wen Chan Carrol Gamble Kerry M Dwan Paula R Williamson 周航宇(译) 王心雨(译) 冯国双(校) mrc north west hub for trials methodology research Department of BiostatisticsUniversity of LiverpoolLiverpool L69 3GLUK Centre for Statistics inMedicine Nuffield Departmentof OrthopaedicsRheumatology and Musculoskeletal SciencesUniversity of OxfordOxfordUK Department of Medicine Women's College Research InstituteWomen’s College HospitalUniversity of TorontoTorontoONCanada Cochrane Editorial Unit LondonUK 北京中医药大学东直门医院检验科国家儿童医学中心首都医科大学附属北京儿童医院大数据和工程研究中心北京

对临床研究进行系统综述的主要目的是通过纳入同一主题下的所有相关研究,对其研究结果进行无偏倚总结,从而产生评价某种治疗方式利弊的最佳证据。然而,有的研究可能并未提供所有结局的分析结果,或仅选择性地报告部分分析结果,这不仅导... 详细信息

对临床研究进行系统综述的主要目的是通过纳入同一主题下的所有相关研究,对其研究结果进行无偏倚总结,从而产生评价某种治疗方式利弊的最佳证据。然而,有的研究可能并未提供所有结局的分析结果,或仅选择性地报告部分分析结果,这不仅导致研究出版和报道的不必要浪费,还会给系统综述的结论带来潜在偏倚。在本文中,Kirkham等对结局报告偏倚提出了一种评估和调整的方法,并通过实例阐述如何识别系统综述中的缺失结局数据以及如何评估和调整结局报告偏倚。

关键词：系统综述临床研究偏倚最佳证据治疗方式

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A Measure for Assessing Functions of Time-Varying Effects in Survival Analysis

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Open Journal of Statistics 2014年第11期4卷 977-998页

作者： Anika Buchholz Willi Sauerbrei Patrick Royston Center for Medical Biometry and Medical Informatics Medical Center - University of Freiburg Freiburg Germany mrc Clinical trials Unit at University College London London UK

A standard approach for analyses of survival data is the Cox proportional hazards model. It assumes that covariate effects are constant over time, i.e. that the hazards are proportional. With longer follow-up times, though, the effect of a variable often gets weaker and the proportional hazards (PH) assumption is violated. In the last years, several approaches have been proposed to detect and model such time-varying effects. However, comparison and evaluation of the various approaches is difficult. A suitable measure is needed that quantifies the difference between time-varying effects and enables judgement about which method is best, i.e. which estimate is closest to the true effect. In this paper we adapt a measure proposed for the area between smoothed curves of exposure to time-varying effects. This measure is based on the weighted area between curves of time-varying effects relative to the area under a reference function that represents the true effect. We introduce several weighting schemes and demonstrate the application and performance of this new measure in a real-life data set and a simulation study.

关键词： Cox Model Measure of Distance Survival Analysis Time-Varying Effects

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Heat dissipating upper body compression garment:Thermoregulatory,cardiovascular, and perceptual responses

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Journal of Sport and Health Science 2019年第5期8卷 450-456页

作者： Iker Leoz-Abaurrea Nicholas Tam Roberto Aguado-Jiménez Department of Health Sciences Public University of NavarreNavarre 31500Spain UCT/mrc research Unit for Exercise Science and Sports Medicine Department of Human BiologyUniversity of Cape TownCape Town 7725South Africa

Purpose:The aim of the present study was to determine the effects of an upper body compression garment(UBCG)on thermoregulatory responses during cycling in a controlled laboratory thermoneutral environment(~23℃).A secondary aim was to determine the cardiovascular and perceptual responses when wearing the ***:Sixteen untrained participants(age:21.3±5.7 years;peak oxygen consumption(V02 peak):50.88±8.00 mL/min/kg;mean±SD)performed 2 cycling trials in a thermoneutral environment(~23℃)wearing either UBCG or control(Con)*** consisted of a 5-min rest on a cycle ergometer,followed by 4 bouts of cycling for 14-min at ~50%VO2 peak,with 1-min rest between each *** the end of these bouts there was 10-min of passive *** the entire protocol rectal temperature(Trec),skin temperature(Tskin),mean body temperature(Tbody),and heat storage(HS)were *** rate(HR),VO2,pH,hematocrit(Hct),plasma electrolytes,weight loss(Wloss),and perceptual responses were also ***:There were no significant differences between garments for Tskin,HS,HR,VO2,pH,Hct,plasma electrolyte concentration,Wloss,and perceptual responses during the *** did not differ between garment conditions during rest,exercise,or recovery although a greater reduction in Trec wearing UBCG(p=0.01)was observed during *** Tbody during recovery was found when wearing UBCG(36.82℃±0.30℃ vs.36.99℃±0.24℃).Conclusion:Wearing a UBCG did not benefit thermoregulatory,cardiovascular,and perceptual responses during exercise although it was found to lower Tbody during recovery,which suggests that it could be used as a recovery tool after exercise.

关键词： Body temperature Compression garment Cycling Heat dissipation Thermoregulation

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Therapies for Tau-associated neurodegenerative disorders:targeting molecules,synapses,and cells

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Neural Regeneration research 2023年第12期18卷 2633-2637页

作者： Miranda Robbins mrc Laboratory of Molecular Biology Cambridge Biomedical CampusFrancis Crick AveTrumpingtonCambridgeUKUniversity of CambridgeDepartment of ZoologyCambridgeUK

Advances in experimental and computational technologies continue to grow rapidly to provide novel avenues for the treatment of neurodegenerative disorders. Despite this, there remain only a handful of drugs that have shown success in late-stage clinical trials for Tau-associated neurodegenerative disorders. The most commonly prescribed treatments are symptomatic treatments such as cholinesterase inhibitors and N-methyl-D-aspartate receptor blockers that were approved for use in Alzheimer's disease. As diagnostic screening can detect disorders at earlier time points, the field needs pre-symptomatic treatments that can prevent, or significantly delay the progression of these disorders(Koychev et al., 2019). These approaches may be different from late-stage treatments that may help to ameliorate symptoms and slow progression once symptoms have become more advanced should early diagnostic screening fail. This mini-review will highlight five key avenues of academic and industrial research for identifying therapeutic strategies to treat Tau-associated neurodegenerative disorders. These avenues include investigating(1) the broad class of chemicals termed “small molecules”;(2) adaptive immunity through both passive and active antibody treatments;(3) innate immunity with an emphasis on microglial modulation;(4) synaptic compartments with the view that Tau-associated neurodegenerative disorders are synaptopathies. Although this mini-review will focus on Alzheimer's disease due to its prevalence, it will also argue the need to target other tauopathies, as through understanding Alzheimer's disease as a Tau-associated neurodegenerative disorder, we may be able to generalize treatment options. For this reason, added detail linking back specifically to Tau protein as a direct therapeutic target will be added to each topic.

关键词： Alzheimer's disease antibody frontotemporal dementia immunotherapy small molecules synapses tau therapeutics

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Rates and impact of hepatitis on human immunodeficiency virus infection in a large African cohort

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World Journal of Gastroenterology 2013年第10期19卷 1602-1610页

作者： Nimzing Gwamzhi Ladep Patricia Aladi Agaba Oche Agbaji Auwal Muazu Placid Ugoagwu Godwin Imade Graham Cooke Sheena McCormack Simon David Taylor-Robinson John Idoko Phyllis Kanki Section of Hepatology Department of MedicineImperial College LondonSt Mary's Hospital CampusLondon W2 1NYUnited Kingdom AIDS Prevention Initiative in Nigeria Jos University Teaching HospitalJos 930001Nigeria mrc Clinical trials Unit LondonLondon NW1 2DAUnited Kingdom National Agency for the Control of AIDS Central Business DistrictAbuja 905001Nigeria Immunology and Infectious Diseases Harvard School of Public HealthBostonMA 02115-5810United States

AIM:To determine the rates and impact of hepatitis B virus(HBV) and hepatitis C virus(HCV) infections on response to long-term highly active antiretroviral therapy(HAART) in a large human immunodeficiency virus(HIV) population in ***:HBV and HCV as well as HIV infections are endemic in sub Saharan *** was a retrospective cohort study of 19 408 adults who were recruited between June 2004 and December 2010 in the AIDS Prevention Initiative in Nigeria in Nigeria programme at Jos University Teaching *** assays,including HBV surface antigen(HBsAg) and hepatitis C antibody were used to categorise hepatitis status of the *** was determined using enzyme immunoassay(EIA)(Monolisa HBsAg Ultra3;Bio-Rad).HCV antibody was tested using third generation EIA(*** Diagnostic,Bioprobes srl,Milan,Italy).HIV RNA levels were measured using Roche COBAS Amplicor HIV-1 monitor test version 1.5(Roche Diagnostics,GmbH,Mannheim,Germany) with a detection limit of 400 copies/*** cytometry was used to determine CD4+ cell count(Partec,GmbH Munster,Germany).Comparison of categorical and continuous variables were achieved using Pearson's χ 2 and Kruskal Wallis tests respectively,on MedCalc for Windows,version 9.***.0.0(MedCalc Software,Mariakerke,Belgium).RESULTS:With an overall hepatitis screening rate of over 90% for each virus;HBV,HCV and HBV/HCV were detected in 3162(17.8%),1983(11.3%) and 453(2.5%) HIV infected adults *** rate of liver disease was low,but highest among HIV monoinfected patients(29,0.11%),followed by HBV coinfected patients(15,0.08%).Patients with HBV coinfection and triple infection had higher log 10 HIV RNA loads(HBV:4.6 copies/mL vs HIV only:4.5 copies/mL,P<0.0001) and more severe immune suppression(HBV:645,55.4%;HBV/HCV:97,56.7%) prior to initiation of HAART compared to HIV mono-infected patients(1852,48.6%)(P<0.0001).Of 3025 patients who were 4.4 years on HAART and whose CD4 cell counts results at baseline a

关键词： Human immunodeficiency virus Hepatitis B Hepatitis C Africa Liver disease

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Mononuclear cell therapy of neonatal hypoxic-ischemic encephalopathy in preclinical versus clinical studies:A systematic analysis of therapeutic efficacy and study design

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Neuroprotection 2023年第2期1卷 143-159页

作者： Alexander M.Scrutton Francesca Ollis Johannes Boltze School of Life Sciences University of WarwickCoventryUK Neurobiology Division MRC Laboratory of Molecular BiologyUniversity of CambridgeCambridgeUK

Background:Hypoxic-ischemic encephalopathy(HIE)is a devastating condition affecting around 8.5 in 1000 newborns *** hypothermia(TH)can reduce mortality and,to a limited extent,disability after ***,there is a need for new and effective treatment ***-based treatments using mononuclear cells(MNCs),which can be sourced from umbilical cord blood,are currently being *** promising preclinical results,there is currently no strong indicator for the clinical efficacy of the *** analysis aimed to provide potential explanations for this ***:A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis *** and clinical studies were retrieved from PubMed,Web of Science,Scopus,and *** using a predefined search strategy.A total of 17 preclinical and 7 clinical studies were *** analyzed overall MNC efficacy in preclinical trials,the methodological quality of preclinical trials,and relevant design features in preclinical versus clinical ***:There was evidence for MNC therapeutic efficacy in preclinical models of *** methodological quality of preclinical studies was not optimal,and statistical design quality was particularly ***,methodological quality was above the standard in other *** were significant differences in preclinical versus clinical study design including the use of TH as a baseline treatment(only in clinical studies)and much higher MNC doses being applied in preclinical ***:Based on the analyzed data,it is unlikely that therapeutic effect size is massively overestimated in preclinical *** is more plausible that the many design differences between preclinical and clinical trials are responsible for the so far lacking proof of the efficacy of MNC treatments in *** preclinical and clinical research is required

关键词： cell therapy hypoxic-ischemic encephalopathy mononuclear cells translational research treatment efficacy

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