29 results on '"Liu, Zhao-Lan"'
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2. Development and multiple visualization methods for the therapeutic effects prediction model of five-flavor Sophora Flavescens enteric-coated capsules in the treatment of active ulcerative colitis: A study on model development and result visualization
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Bu, Zhi-Jun, Huang, Zhi-Rui, Chen, Yun-Ru, Su, You-Zhu, Jin, Yuan-Yuan, Zhang, Yu-Huan, Wu, Qiu-Ju, Wang, Xue-Hui, Wang, Yu, Liu, Jian-Ping, and Liu, Zhao-Lan
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- 2023
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3. An evidence mapping of systematic reviews and meta-analysis on traditional Chinese medicine for ulcerative colitis
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Sun, Yu-Xin, Wang, Xiao, Liao, Xing, Guo, Jing, Hou, Wen-Bin, Wang, Xin, Liu, Jian-Ping, and Liu, Zhao-Lan
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- 2021
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4. Performance of ChatGPT on Chinese Master's Degree Entrance Examination in Clinical Medicine.
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Li, Ke-Cheng, Bu, Zhi-Jun, Shahjalal, Md., He, Bai-Xiang, Zhuang, Zi-Fan, Li, Chen, Liu, Jian-Ping, Wang, Bin, and Liu, Zhao-Lan
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CHATGPT ,LANGUAGE models ,MASTER'S degree ,MEDICAL education examinations ,CLINICAL medicine - Abstract
Background: ChatGPT is a large language model designed to generate responses based on a contextual understanding of user queries and requests. This study utilised the entrance examination for the Master of Clinical Medicine in Traditional Chinese Medicine to assesses the reliability and practicality of ChatGPT within the domain of medical education. Methods: We selected 330 single and multiple-choice questions from the 2021 and 2022 Chinese Master of Clinical Medicine comprehensive examinations, which did not include any images or tables. To ensure the test's accuracy and authenticity, we preserved the original format of the query and alternative test texts, without any modifications or explanations. Results: Both ChatGPT3.5 and GPT-4 attained average scores surpassing the admission threshold. Noteworthy is that ChatGPT achieved the highest score in the Medical Humanities section, boasting a correct rate of 93.75%. However, it is worth noting that ChatGPT3.5 exhibited the lowest accuracy percentage of 37.5% in the Pathology division, while GPT-4 also displayed a relatively lower correctness percentage of 60.23% in the Biochemistry section. An analysis of sub-questions revealed that ChatGPT demonstrates superior performance in handling single-choice questions but performs poorly in multiple-choice questions. Conclusion: ChatGPT exhibits a degree of medical knowledge and the capacity to aid in diagnosing and treating diseases. Nevertheless, enhancements are warranted to address its accuracy and reliability limitations. Imperatively, rigorous evaluation and oversight must accompany its utilization, accompanied by proactive measures to surmount prevailing constraints. [ABSTRACT FROM AUTHOR] more...
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- 2024
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5. Acupuncture for ulcerative colitis: a systematic review and meta-analysis of randomized clinical trials
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Wang, Xiao, Zhao, Nan-qi, Sun, Yu-xin, Bai, Xue, Si, Jiang-tao, Liu, Jian-ping, and Liu, Zhao-lan
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- 2020
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6. Medical nutrition therapy for pregnant women with gestational diabetes mellitus—A retrospective cohort study
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Shi, Mai, Liu, Zhao-Lan, Steinmann, Peter, Chen, Jie, Chen, Che, Ma, Xiao-Tao, and Han, Su-Hui
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- 2016
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7. Evaluating the implementation of evidence-based TCM Clinical Practice Guidelines for Cerebral Infarction
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Zhou, Li, Chen, Ying, Liu, Jianping, Liu, Zhao-lan, and Gao, Ying
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- 2014
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8. Acupuncture and Doxylamine–Pyridoxine for Nausea and Vomiting in Pregnancy: A Randomized, Controlled, 2 × 2 Factorial Trial.
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Wu, Xiao-Ke, Gao, Jing-Shu, Ma, Hong-Li, Wang, Yu, Zhang, Bei, Liu, Zhao-Lan, Li, Jian, Cong, Jing, Qin, Hui-Chao, Yang, Xin-Ming, Wu, Qi, Chen, Xiao-Yong, Lu, Zong-Lin, Feng, Ya-Hong, Qi, Xue, Wang, Yan-Xiang, Yu, Lan, Cui, Ying-Mei, An, Chun-Mei, and Zhou, Li-Li more...
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MORNING sickness ,ACUPUNCTURE points ,ACUPUNCTURE ,SMALL for gestational age ,PLACEBOS ,PREGNANCY complications - Abstract
An effective and safe treatment for nausea and vomiting of pregnancy (NVP) is lacking. This randomized controlled trial, which was conducted at 13 tertiary hospitals in China during 2020 to 2022, sought to assess the efficacy and safety of acupuncture, doxylamine–pyridoxine, and their combination in women with moderate to severe NVP. Visual Abstract. Acupuncture and Doxylamine–Pyridoxine for Nausea and Vomiting in Pregnancy: An effective and safe treatment for nausea and vomiting of pregnancy (NVP) is lacking. This randomized controlled trial, which was conducted at 13 tertiary hospitals in China during 2020 to 2022, sought to assess the efficacy and safety of acupuncture, doxylamine–pyridoxine, and their combination in women with moderate to severe NVP. Background: An effective and safe treatment for nausea and vomiting of pregnancy (NVP) is lacking. Objective: To assess the efficacy and safety of acupuncture, doxylamine–pyridoxine, and a combination of both in women with moderate to severe NVP. Design: Multicenter, randomized, double-blind, placebo-controlled, 2 × 2 factorial trial. (ClinicalTrials.gov: NCT04401384) Setting: 13 tertiary hospitals in mainland China from 21 June 2020 to 2 February 2022. Participants: 352 women in early pregnancy with moderate to severe NVP. Intervention: Participants received daily active or sham acupuncture for 30 minutes and doxylamine–pyridoxine or placebo for 14 days. Measurements: The primary outcome was the reduction in Pregnancy-Unique Quantification of Emesis (PUQE) score at the end of the intervention at day 15 relative to baseline. Secondary outcomes included quality of life, adverse events, and maternal and perinatal complications. Results: No significant interaction was detected between the interventions (P = 0.69). Participants receiving acupuncture (mean difference [MD], −0.7 [95% CI, −1.3 to −0.1]), doxylamine–pyridoxine (MD, −1.0 [CI, −1.6 to −0.4]), and the combination of both (MD, −1.6 [CI, −2.2 to −0.9]) had a larger reduction in PUQE score over the treatment course than their respective control groups (sham acupuncture, placebo, and sham acupuncture plus placebo). Compared with placebo, a higher risk for births with children who were small for gestational age was observed with doxylamine–pyridoxine (odds ratio, 3.8 [CI, 1.0 to 14.1]). Limitation: The placebo effects of the interventions and natural regression of the disease were not evaluated. Conclusion: Both acupuncture and doxylamine–pyridoxine alone are efficacious for moderate and severe NVP. However, the clinical importance of this effect is uncertain because of its modest magnitude. The combination of acupuncture and doxylamine–pyridoxine may yield a potentially larger benefit than each treatment alone. Primary Funding Source: The National Key R&D Program of China and the Project of Heilongjiang Province "TouYan" Innovation Team. [ABSTRACT FROM AUTHOR] more...
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- 2023
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9. Systematic review of randomized controlled trials of traditional Chinese medicine treatment of non-acute bronchial asthma complicated by gastroesophageal reflux
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ZHAO, Yu-hao, LIU, Zhao-lan, LI, Lan-hua, JIANG, Sheng-hua, and SHI, Cheng-he
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- 2012
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10. Use of Artificial Intelligence in Peer Review Among Top 100 Medical Journals.
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Li, Zhi-Qiang, Xu, Hui-Lin, Cao, Hui-Juan, Liu, Zhao-Lan, Fei, Yu-Tong, and Liu, Jian-Ping
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- 2024
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11. Effect of Health Education Based on Integrative Therapy of Chinese and Western Medicine for Adult Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study.
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Shi, Mai, Liu, Zhao-lan, Zhu, Yan-bo, Xu, Mei-yan, Duan, Xue-ying, Shi, Hui-mei, Jiang, Bo, Zhang, Xiao-mei, and Yu, Xiao-han
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TYPE 2 diabetes treatment ,HEALTH education evaluation ,TREATMENT effectiveness ,GLYCOSYLATED hemoglobin ,MEDICINE ,CHINESE medicine ,QUALITY of life ,REGRESSION analysis ,STATISTICAL sampling ,T-test (Statistics) ,TIME ,INTEGRATIVE medicine ,BODY mass index ,RANDOMIZED controlled trials ,CONTROL groups ,DATA analysis software ,DESCRIPTIVE statistics ,ADULTS - Abstract
Objective: To investigate the effects of health education based on integrative therapy of Chinese and Western medicine for type 2 diabetes mellitus (T2DM) from the aspects of knowledge, attitude and practice (KAP), health-related quality of life (HRQoL), body mass index (BMI) and glucose control. Methods: Patients were individually randomized into intervention group (receiving integrative education, n=120) and control group (receiving usual education, n=120). The primary outcome was the changes in glycosylated hemoglobin A1c (HbA1c) levels after 3, 6, 9 and 12 months from baseline. Hierarchical linear models (HLMs) were used to assess within-group changes in outcomes over time and between-group differences in patterns of change. Secondary outcomes were KAP scores, HRQoL scores and BMI after 6 and 12 months, paired-sample t test was used to assess within-group changes in outcomes in 6 and 12 months, independent-sample t test was used to assess between-group differences in patterns of change. Results: HbA1c decreased statistically from baseline to 3 months, from 3 to 6 months, from 6 to 9 months and from 9 to 12 months in the intervention group (all P<0.01); and decreased significantly from baseline to 3 months, and from 3 to 6 months in the control group P<0.01). There was a significant between-group difference from baseline to 3 months ( P=0.044), from 6 to 9 months ( P<0.01) and from 9 to 12 months ( P<0.01). Significant improvements in the intervention group along with significant between-group differences were found in KAP and HRQoL scores respectively (all P<0.05). The number in the intervention group of normal weight increased from 56 at baseline to 81 (6 months), 94 (12 months), the number in the control group were 63 (baseline), 69 (6 months), 70 (12 months), the χ of hierarchical analysis of BMI were 6.93 ( P=0.075), 10.31 ( P=0.016), 15.53 ( P<0.01), respectively. Conclusion: Health education based on integrative therapy of Chinese and Western medicine is beneficial to the control of T2DM and should be recommended for T2DM. [ABSTRACT FROM AUTHOR] more...
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- 2018
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12. Studies on the co-colour reaction of platinum(IV) and palladium(II) with 4,4′-bis(dimethylamino)thiobenzophenone.
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Liu, Zhao-Lan, Chang, Wen-Bao, Hong, Jian, and Ci, Yun-Xiang
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- 1991
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13. Effectiveness of family involvement in newly diagnosed type 2 diabetes patients: a follow-up study.
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Shi, Mai, Xu, Mei-Yan, Liu, Zhao-Lan, Duan, Xue-Ying, Zhu, Yan-Bo, Shi, Hui-Mei, Jiang, Bo, Zhang, Xiao-Mei, and Yu, Xiao-Han
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PEOPLE with diabetes , *TYPE 2 diabetes diagnosis , *FAMILY medicine , *FOLLOW-up studies (Medicine) , *HEALTH education , *QUALITY of life , *BLOOD sugar analysis , *HYPOGLYCEMIC agents , *TYPE 2 diabetes & psychology , *FAMILIES & psychology , *COMPARATIVE studies , *GLYCOSYLATED hemoglobin , *HEALTH attitudes , *HEALTH surveys , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL cooperation , *MEDICAL personnel , *TYPE 2 diabetes , *PATIENT education , *QUESTIONNAIRES , *RESEARCH , *SOCIAL support , *SOCIOECONOMIC factors , *EVALUATION research , *BODY mass index , *RANDOMIZED controlled trials , *PATIENTS' families - Abstract
Objective: To investigate the effects of family-involvement on health education for T2DM from the aspects of knowledge, attitude and practice (KAP), health-related quality of life (HRQoL), body mass index (BMI) and glucose control.Methods: A follow-up study was performed and patients with newly diagnosed T2DM were divided into family-involved group (FIG, n=60) and single-involved group (SIG, n=60). Hierarchical linear models were used to assess within-group changes and between-group differences in the glycosylated hemoglobin A1c (HbA1c), KAP, SF-36 and BMI.Results: Significant improvements in FIG along with significant differences between-group were seen for HbA1c levels (9.73, 8.92, 5.55, 5.79, 5.30 vs. 10.05, 9.53, 6.36, 8.41, 6.58) in baseline, M3, M6, M12, M24 compared with SIG, respectively (all P≤0.001). Significant improvements in FIG along with significant differences between-group were seen for KAP (16.23, 46.98, 48.93 vs. 16.65, 29.07, 37.62), SF-36 (78.04, 92.68, 92.34 vs. 74.96, 77.03, 78.25), and BMI (24.74, 23.46, 22.96 vs. 24.00, 23.45, 23.50) in baseline, M12 and M24, respectively (all P≤0.05).Conclusion: Family involvement is beneficial to the control of T2DM and should be suggested for T2DM newly diagnosed.Practice Implications: Health education should encourage the family to participate in the whole process to improve the efficacy of education. [ABSTRACT FROM AUTHOR] more...- Published
- 2016
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14. Catalytic behaviour of iron(II)-oxime complexes in the chemiluminescence reaction of luminol with hydrogen peroxide
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Ci, Yun-Xiang, Tie, Jian-Ke, Yao, Feng-Ji, Liu, Zhao-Lan, Lin, Sa, and Zheng, Wei-Qing
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- 1993
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15. Five-Flavor Sophora flavescens Enteric-Coated Capsules for Ulcerative Colitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
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Hou, Wen Bin, Sun, Wei Jia, Zhang, Xiao Wen, Li, Yuan Xi, Zheng, You You, Sun, Yu Xin, Liu, Jian Ping, and Liu, Zhao Lan
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ULCERATIVE colitis , *FLAVORING essences , *DRUG efficacy , *MEDICINE , *MEDICINAL plants , *HERBAL medicine , *META-analysis , *CONFIDENCE intervals , *PHARMACEUTICAL encapsulation , *SYSTEMATIC reviews , *ANTI-inflammatory agents , *TREATMENT duration , *CONTROLLED release preparations , *DESCRIPTIVE statistics , *DRUG side effects , *CHINESE medicine , *PATIENT safety , *DRUG administration , *DRUG dosage , *EVALUATION - Abstract
Background. Ulcerative colitis (UC), a chronic inflammatory bowel disease, is characterized by abdominal pain, diarrhea, and mucopurulent bloody stool. In recent years, the incidence and prevalence of UC have been increasing consistently. Five-flavor Sophora falvescens enteric-coated capsule (FSEC), a licensed Chinese patent medicine, was specifically used to treat UC. This review was aimed to assess the effectiveness and safety of FSEC for the treatment of UC. Methods. Six electronic databases were searched from inception to March 2021. Randomized clinical trials (RCTs) comparing FSEC or FSEC plus conventional Western medicine with conventional Western medicine in participants with UC were included. Two authors screened all references, assessed the risk of bias, and extracted data independently. Binary data were presented as risk ratios (RRs) with 95% confidence intervals (CIs) and metric data as mean difference (MD) with 95% CI. The overall certainty of the evidence was assessed by GRADE. Results. We included 15 RCTs (1194 participants, 763 in the FSEC group and 431 in the control group). The treatment duration ranged from 42 to 64 days. Twelve trials compared FSEC with conventional Western medicine, and two trials compared FSEC plus conventional medicine with conventional medicine. Another trial compared FSEC plus mesalazine with compound glutamine enteric capsules plus mesalazine. FSEC showed a higher clinical effective rate (improved clinical symptoms, colonoscopy results, and stools) (RR 1.12, 95% CI 1.05 to 1.20; 729 participants; 8 trials; low-quality evidence) as well as the effective rate of traditional Chinese medicine (TCM) syndromes (RR 1.10, 95% CI 1.01 to 1.20; 452 participants; 5 trials; low-quality evidence) compared to mesalazine. There was no significant difference in the adverse events between FSEC and control groups. Conclusions. FSEC may show effectiveness in UC treatment compared to conventional medicine, and the use of FSEC may not increase the risk of adverse events. Due to the limited number of clinical trials and low methodological quality of the included trials, our findings must be interpreted with discretion. [ABSTRACT FROM AUTHOR] more...
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- 2022
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16. Chinese Patent Medicine as Adjuvant for Mild-to-Moderate Active Ulcerative Colitis: A Network Meta-Analysis of Randomized Controlled Trials.
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Sun, Yu-Xin, Yang, Guo-Yan, Karamacoska, Diana, Wang, Xiao, Li, Yuan-Xi, Hou, Wen-Bin, Zheng, You-You, Liu, Jian-Ping, and Liu, Zhao-Lan
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ULCERATIVE colitis , *DRUG efficacy , *ONLINE information services , *RELATIVE medical risk , *HERBAL medicine , *META-analysis , *MEDICAL databases , *INFORMATION storage & retrieval systems , *MEDICAL information storage & retrieval systems , *COMBINATION drug therapy , *CONFIDENCE intervals , *SYSTEMATIC reviews , *PATENTS , *DESCRIPTIVE statistics , *MEDLINE , *CHINESE medicine , *MESALAMINE , *EVALUATION ,DISEASE relapse prevention - Abstract
Objective. To evaluate the effectiveness and safety of Chinese patent medicine for mild-to-moderate active ulcerative colitis (UC) using network meta-analysis (NMA). Methods. We systematically searched PubMed, Cochrane library, Embase, Sino-Med, China National Knowledge Infrastructure (CNKI), Wanfang, and Chinese Scientific Journal Database (VIP) databases to October, 2020. We included randomized controlled trials (RCTs) on Chinese patent medicine for mild-to-moderate active UC. The main analysis was complemented by network subanalyses and standard pairwise comparisons. Statistical heterogeneity, inconsistencies, and ranking probability were also evaluated. Results. The databases search identified 3222 citations, of which 33 RCTs involving 2971 patients met the inclusion criteria. A total of 15 Chinese patent medicines were analyzed. The overall quality of the included studies was low. Pairwise meta-analysis showed that Chinese patent medicine was superior to Mesalazine in improving disappearances of clinical symptoms, recurrence rate, and Mayo score. Based on decreases in adverse events, results from NMA showed that Xilei powder plus Mesalazine was more effective than other drugs. Other NMA results indicated that Danshen freeze-dried powder plus Mesalazine (RR: 0.13; 95% CI, 0.02–0.78) and Kangfuxin lotion plus Mesalazine (RR: 0.24; 95% CI, 0.07–0.57) were superior to Mesalazine in decreasing recurrence rate. Another NMA result indicated that Kangfuxin lotion plus Mesalazine (RR: 0.00; 95% CI, 0.00–0.02) and Zhi Kang capsule plus Mesalazine (RR: 0.00; 95% CI, 0.00–0.02) were superior to Mesalazine in increasing the disappearance of tenesmus. Conclusion. In the probability sorting, Xilei powder combined with Mesalazine ranked first for having the fewest adverse events, Maintaining Intestines Antidiarrheal Pills combined with Mesalazine ranked first for having the lowest recurrence rate, Xilei powder combined with Mesalazine ranked first for improving disappearance rate of mucopurulent bloody stool/abdominal pain, and Kangfuxin lotion combined with Mesalazine ranked first for improving the disappearance rate of diarrhea/tenesmus. However, there is a lack of direct comparisons among Chinese patent medicines for UC. More multiarm RCTs are needed in the future to provide direct comparative evidence. [ABSTRACT FROM AUTHOR] more...
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- 2021
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17. Development and Validation of an Interpretable Machine Learning Model for Early Prognosis Prediction in ICU Patients with Malignant Tumors and Hyperkalemia.
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Bu ZJ, Jiang N, Li KC, Lu ZL, Zhang N, Yan SS, Chen ZL, Hao YH, Zhang YH, Xu RB, Chi HW, Chen ZY, Liu JP, Wang D, Xu F, and Liu ZL
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- Humans, Female, Male, Middle Aged, Prognosis, Aged, Hospital Mortality, Algorithms, Hyperkalemia diagnosis, Hyperkalemia mortality, Machine Learning, Intensive Care Units statistics & numerical data, Neoplasms mortality, Neoplasms complications
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This study aims to develop and validate a machine learning (ML) predictive model for assessing mortality in patients with malignant tumors and hyperkalemia (MTH). We extracted data on patients with MTH from the Medical Information Mart for Intensive Care-IV, version 2.2 (MIMIC-IV v2.2) database. The dataset was split into a training set (75%) and a validation set (25%). We used the Least Absolute Shrinkage and Selection Operator (LASSO) regression to identify potential predictors, which included clinical laboratory indicators and vital signs. Pearson correlation analysis tested the correlation between predictors. In-hospital death was the prediction target. The Area Under the Curve (AUC) and accuracy of the training and validation sets of 7 ML algorithms were compared, and the optimal 1 was selected to develop the model. The calibration curve was used to evaluate the prediction accuracy of the model further. SHapley Additive exPlanations (SHAP) and Local Interpretable Model-agnostic Explanations (LIME) enhanced model interpretability. 496 patients with MTH in the Intensive Care Unit (ICU) were included. After screening, 17 clinical features were included in the construction of the ML model, and the Pearson correlation coefficient was <0.8, indicating that the correlation between the clinical features was small. eXtreme Gradient Boosting (XGBoost) outperformed other algorithms, achieving perfect scores in the training set (accuracy: 1.000, AUC: 1.000) and high scores in the validation set (accuracy: 0.734, AUC: 0.733). The calibration curves indicated good predictive calibration of the model. SHAP analysis identified the top 8 predictive factors: urine output, mean heart rate, maximum urea nitrogen, minimum oxygen saturation, minimum mean blood pressure, maximum total bilirubin, mean respiratory rate, and minimum pH. In addition, SHAP and LIME performed in-depth individual case analyses. This study demonstrates the effectiveness of ML methods in predicting mortality risk in ICU patients with MTH. It highlights the importance of predictors like urine output and mean heart rate. SHAP and LIME significantly enhanced the model's interpretability., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.) more...
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- 2024
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18. Effectiveness and Safety of Chinese Herbal Injections Combined with SOX Chemotherapy Regimens for Advanced Gastric Cancer: a Bayesian Network Meta-Analysis.
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Bu ZJ, Wan SR, Steinmann P, Yin ZT, Tan JP, Li WX, Tang ZY, Jiang S, Ye MM, Xu JY, Zheng YY, Wang XH, Liu JP, and Liu ZL
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Background: Randomized controlled trials (RCTs) have demonstrated that combining Chinese herbal injections (CHIs) with oxaliplatin plus tegafur (SOX) chemotherapy regimens improves clinical effectiveness and reduces adverse reactions in patients with advanced gastric cancer (AGC). These RCTs highlight the potential applications of CHIs and their impact on AGC patient prognosis. However, there is insufficient comparative evidence on the clinical effectiveness and safety of different CHIs when combined with SOX. Therefore, we performed a network meta-analysis to rank the clinical effectiveness and safety of different CHIs when combined with SOX chemotherapy regimens. This study aimed to provide evidence for selecting appropriate CHIs in the treatment of patients with AGC. Methods: We searched eight databases from their inception until March 2023. Surface Under the Cumulative Ranking Curve (SUCRA) probability values were used to rank the treatment measures, and the Confidence in Network Meta-Analysis (CINeMA) software assessed the grading of evidence. Results: A total of 51 RCTs involving 3,703 AGC patients were identified. Huachansu injections + SOX demonstrated the highest clinical effectiveness (SUCRA: 78.17%), significantly reducing the incidence of leukopenia (93.35%), thrombocytopenia (80.19%), and nausea and vomiting (95.15%). Shenfu injections + SOX improved Karnofsky's Performance Status (75.59%) and showed a significant reduction in peripheral neurotoxicity incidence (88.26%). Aidi injections + SOX were most effective in reducing the incidence of liver function damage (75.16%). According to CINeMA, most confidence rating results were classified as "low". Conclusion: The combination of CHIs and SOX shows promising effects in the treatment of AGC compared to SOX alone. Huachansu and Shenfu injections offer the greatest overall advantage among the CHIs, while Aidi injections are optimal for reducing the incidence of liver damage. However, further rigorous RCTs with larger sample sizes and additional pharmacological studies are necessary to reinforce these findings., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).) more...
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- 2024
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19. Comparative effectiveness and safety of Chinese medicine belly button application for childhood diarrhea: a Bayesian network meta-analysis of randomized controlled trials.
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Bu ZJ, Liu YN, Shahjalal M, Zheng YY, Liu CJ, Ye MM, Xu JY, Peng XY, Wang XH, Chen X, Liu JP, Liu HL, and Liu ZL
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Background: Chinese medicine belly button application (CMBBA) has been used to treat childhood diarrhea (CD) in several randomized controlled trials (RCTs), but its effectiveness and combination strategy still need to be clarified. Therefore, we aimed to evaluate the effectiveness, safety, and the optimal combination strategy of CMBBA in treating CD., Methods: Up until January 2023, we searched for studies that met our inclusion criteria in six databases, including PubMed, the Cochrane Library, Chinese SinoMed, CNKI, VIP, and Wanfang. Heterogeneity was quantified using I
2 statistics. A methodological evaluation was performed using the Cochrane Risk Bias Tool 2.0. The Confidence in Network Meta-Analysis online software was employed to evaluate evidence grading. A minimally contextualized framework was used to provide a comprehensive conclusion for the network meta-analysis. This study protocol was registered with PROSPERO., Results: We analyzed data from 33 RCTs that included 4,490 children with diarrhea. In terms of clinical effectiveness, CMBBA plus montmorillonite powder plus anti-infectives may be the most effective treatment option for children with diarrhea and concurrent infection according to a minimally contextualized framework. Either exclusive use of CMBBA or CMBBA in combination with modern medicine was beneficial in reducing the time to diarrhea disappearance (MD = -1.33 days, 95% CI: -1.59 to -1.08, Z = -10.103, p < 0.001) compared to modern medicine exclusively, and the difference was statistically significant. The combined usage of CMBBA could shorten the recovery time of dehydration by an average of 0.74 days (MD = -0.74 days, 95% CI: -1.10 to -0.37, Z = -3.931.103, p < 0.001). While some studies have reported mild allergic reactions and mild abdominal pain after CMBBA use, these symptoms can be cured in a relatively short period of time., Conclusions: The combination of CMBBA, montmorillonite powder, and anti-infectives may provide superior clinical effectiveness for children with diarrhea and concurrent infection. To treat CD, CMBBA can be used effectively and safely. However, the findings must be interpreted with cautiously due to the limited number of clinical trials and the low quality of the studies. In addition, the choice of treatment plan should also be based on the specific conditions of each patient., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42022380694., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Bu, Liu, Shahjalal, Zheng, Liu, Ye, Xu, Peng, Wang, Chen, Liu, Liu and Liu.) more...- Published
- 2023
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20. Chinese herbal injections versus intrapleural cisplatin for lung cancer patients with malignant pleural effusion: A Bayesian network meta-analysis of randomized controlled trials.
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Xu YF, Chen YR, Bu FL, Huang YB, Sun YX, Li CY, Sellick J, Liu JP, Qin DM, and Liu ZL
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Background: Malignant pleural effusion (MPE) is a common complication in patients with advanced lung cancer that can severely compromise the quality of life and limit life expectancy. Randomized controlled trials (RCTs) have shown that Chinese herbal injections (CHIs) may be beneficial in improving quality of life. This network meta-analysis (NMA) aims to explore several CHIs used for lung cancer patients with MPE., Methods: Seven databases were systematically searched for eligible RCTs from inception to November 2021. The primary outcome was the clinical effective rate. Secondary outcomes were the improvement rate of Karnofsky performance status (KPS) score and incidence of adverse events (AEs). The Cochrane risk of bias 2 tool was used to assess the quality of included studies. Data analysis was performed using STATA 16.0 and R software 4.1.0. Both pairwise meta-analysis and Bayesian NMA were conducted. Competing interventions were ranked using the surface under the cumulative ranking (SUCRA) probabilities. Evidence grading was evaluated using the Confidence in Network Meta-Analysis online software (https://cinema.ispm.unibe.ch/)., Results: A total of 44 studies involving 2,573 patients were included. The combined Huachansu injection (HCS) with intrapleural cisplatin (cis-diamminedichloro-platinum, DDP) had the highest probability of improving the clinical effective rate (SUCRA, 84.33%). The Kangai injection (KA) combined with DDP had the most improvement rate of KPS score (SUCRA, 80.82%), while the Fufangkushen injection (FFKS) alone was more likely to reduce AEs including gastrointestinal reactions (SUCRA, 89.92%), leukopenia (SUCRA, 91.85%), and chest pain (SUCRA, 98.17%). FFKS combined with DDP ranked the best in reducing the incidence of fever (SUCRA, 75.45%)., Conclusions: Our NMA showed that CHIs alone or combined with DDP could improve clinical effectiveness and quality of life and reduce AEs, compared to DDP alone. HSC and KA, combined with DDP, may be the most effective considering clinical effective rate and improvement of KPS score, respectively. FFKS, either used alone or in combination therapy with DDP, may be the best in reducing AEs. However, high-quality RCTs with larger sample sizes are needed to further support the evidence., Systematic Review Registration: PROSPERO https://www.crd.york.ac.uk/prospero/, identifier CRD42021285275., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Xu, Chen, Bu, Huang, Sun, Li, Sellick, Liu, Qin and Liu.) more...
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- 2022
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21. WITHDRAWN: Herbal medicines for viral myocarditis.
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Liu ZL, Liu ZJ, Liu JP, and Kwong JS
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- Astragalus propinquus, Biomarkers blood, China, Creatine Kinase, MB Form blood, Drug Combinations, Drugs, Chinese Herbal adverse effects, Electrocardiography drug effects, Humans, L-Lactate Dehydrogenase blood, Myocarditis virology, Phytotherapy adverse effects, Randomized Controlled Trials as Topic, Drugs, Chinese Herbal therapeutic use, Myocarditis drug therapy, Phytotherapy methods, Virus Diseases drug therapy
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- 2016
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22. Chinese herbal medicine for menopausal symptoms.
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Zhu X, Liew Y, and Liu ZL
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- Drugs, Chinese Herbal adverse effects, Estazolam therapeutic use, Female, Fluoxetine therapeutic use, Hormone Replacement Therapy, Hot Flashes drug therapy, Humans, Menopause, Middle Aged, Quality of Life, Randomized Controlled Trials as Topic, Time Factors, Drugs, Chinese Herbal therapeutic use, Sweating drug effects
- Abstract
Background: Chinese herbal medicine (CHM) usage is expected to increase as women suffering from menopausal symptoms are seeking alternative therapy due to concerns from the adverse effects (AEs) associated with hormone therapy (HT). Scientific evidence for their effectiveness and safety is needed., Objectives: To evaluate the effectiveness and safety of CHM in the treatment of menopausal symptoms., Search Methods: We searched the Gynaecology and Fertility Group's Specialised Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), MEDLINE, Embase, CINAHL, AMED, and PsycINFO (from inception to March 2015). Others included Current Control Trials, Citation Indexes, conference abstracts in the ISI Web of Knowledge, LILACS database, PubMed, OpenSIGLE database, and China National Knowledge Infrastructure database (CNKI, 1999 to 2015). Other resources included reference lists of articles as well as direct contact with authors., Selection Criteria: Randomised controlled trials (RCTs) comparing the effectiveness of CHM with placebo, HT, pharmaceutical drugs, acupuncture, or another CHM formula in women over 18 years of age, and suffering from menopausal symptoms., Data Collection and Analysis: Two review authors independently assessed 864 studies for eligibility. Data extractions were performed by them with disagreements resolved through group discussion and clarification of data or direct contact with the study authors. Data analyses were performed in accordance with Cochrane Collaboration guidelines., Main Results: We included 22 RCTs (2902 women). Participants were from different ethnic backgrounds with the majority of Chinese origin.When CHM was compared with placebo (eight RCTs), there was little or no evidence of a difference between the groups for the following pooled outcomes: hot flushes per day (MD 0.00, 95% CI -0.88 to 0.89; 2 trials, 199 women; moderate quality evidence); hot flushes per day assessed by an overall hot flush score in which a difference of one point equates to one mild hot flush per day (MD -0.81 points, 95% CI -2.08 to 0.45; 3 RCTs, 263 women; low quality evidence); and overall vasomotor symptoms per month measured by the Menopause-Specific Quality of Life questionnaire (MENQOL, scale 0 to 6) (MD -0.42 points; 95% CI -1.52 to 0.68; 3 RCTs, 256 women; low quality evidence).In addition, results from individual studies suggested there was no evidence of a difference between the groups for daily hot flushes assessed by severity (MD -0.70 points, 95% CI -1.00, -0.40; 1 RCT, 108 women; moderate quality evidence); or overall monthly hot flushes scores (MD -2.80 points, 95% CI -8.93 to 3.33; 1 RCT, 84 women; very low quality evidence); or overall daily night sweats scores (MD 0.07 points, 95% CI -0.19 to 0.33, 1 RCT, 64 women; low quality evidence); or overall monthly night sweats scores (MD 1.30 points, 95% CI -1.76 to 4.36, 1 RCT, 84 women; very low quality evidence). However one study using the Kupperman Index reported that overall monthly vasomotor symptom scores were lower in the CHM group (MD -4.79 points, 95% CI -5.52 to -4.06; 1 RCT, 69 women; low quality evidence).When CHM was compared with hormone therapy (HT) (10 RCTs), only two RCTs reported monthly vasomotor symptoms using MENQOL. It was uncertain whether CHM reduces vasomotor symptoms (MD 0.47 points, 95% CI -0.50 to 1.44; 2 RCTs, 127 women; very low quality evidence).Adverse effects were not fully reported in the included studies. Adverse events reported by women taking CHM included mild diarrhoea, breast tenderness, gastric discomfort and an unpleasant taste. Effects were inconclusive because of imprecise estimates of effects: CHM versus placebo (RR 1.51; 95% CI 0.69 to 3.33; 7 trials, 705 women; I² = 40%); CHM versus HT (RR 0.96; 95% CI 0.66 to 1.39; 2 RCTs, 864 women; I² = 0%); and CHM versus specific conventional medications (such as Fluoxetine and Estazolam) (RR 0.20; 95% CI 0.03 to 1.17; 2 RCTs, 139 women; I² = 61%)., Authors' Conclusions: We found insufficient evidence that Chinese herbal medicines were any more or less effective than placebo or HT for the relief of vasomotor symptoms. Effects on safety were inconclusive. The quality of the evidence ranged from very low to moderate; there is a need for well-designed randomised controlled studies. more...
- Published
- 2016
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23. A cross-sectional study of the clinical characteristics of hospitalized children with community-acquired pneumonia in eight eastern cities in China.
- Author
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Wang XF, Liu JP, Shen KL, Ma R, Cui ZZ, Deng L, Shang YX, Zhao DY, Wang LB, Wan LY, Sun YQ, Li YN, Jiang ZY, Xu H, Li XM, Wu ZQ, Liu ZL, Hu YH, Huang Y, He CH, Zhang H, Jiang YH, Liu H, and Wang Z
- Subjects
- Adolescent, Anti-Bacterial Agents therapeutic use, Child, Child, Preschool, China, Community-Acquired Infections drug therapy, Community-Acquired Infections microbiology, Cross-Sectional Studies, Drugs, Chinese Herbal therapeutic use, Female, Hospitals, Humans, Infant, Male, Pneumonia, Bacterial drug therapy, Pneumonia, Bacterial microbiology, Treatment Outcome, Community-Acquired Infections epidemiology, Hospitalization statistics & numerical data, Medicine, Chinese Traditional methods, Pneumonia, Bacterial epidemiology
- Abstract
Background: Community-acquired pneumonia in children is common in China. To understand current clinical characteristics and practice, we conducted a cross-sectional study to analyze quality of care on childhood pneumonia in eight eastern cities in China., Methods: Consecutive hospital records between January 1, 2010 and December 31, 2010 were collected from 13 traditional Chinese medicine (TCM) and western medicine (WM) hospitals in February, May, August, and November (25 cases per season, 100 cases over the year), respectively. A predesigned case report form was used to extract data from the hospital medical records., Results: A total of 1298 cases were collected and analyzed. Symptoms and signs upon admission at TCM and WM hospitals were cough (99.3% vs. 98.6%), rales (84.8% vs. 75.0%), phlegm (83.3% vs. 49.1%), and fever (74.9% vs. 84.0%) in frequency. Patients admitted to WM hospitals had symptoms and signs for a longer period prior to admission than patients admitted to TCM hospitals. Testing to identify etiologic agents was performed in 1140 cases (88.4%). Intravenous antibiotics were administered in 99.3% (595/598) of cases in TCM hospitals and in 98.6% (699/700) of cases in WM hospitals. Besides, Chinese herbal extract injection was used more frequently in TCM hospitals (491 cases, 82.1%) than in WM hospitals (212 cases, 30.3%) (p < 0.01). At discharge, 818 cases (63.0%) were clinically cured, with a significant difference between the cure rates in TCM (87.6%) and WM hospitals (42.0%) (OR = 9.8, 95% confidence interval (CI): 7.3 ~ 12.9, p < 0.01). Pathogen and previous medical history were more likely associated with the disappearance of rales (OR = 7.2, 95% CI: 4.8 ~ 10.9). Adverse effects were not reported from the medical records., Conclusions: Intravenous use of antibiotics is highly prevalent in children with community-acquired pneumonia regardless of aetiology. There was difference between TCM and WM hospitals with regard to symptom profile and the use of antibiotics. Intravenous use of herbal injection was higher in TCM hospitals than in WM hospitals. Most of the cases were diagnosed based on clinical signs and symptoms without sufficient confirmation of aetiology. Audit of current practice is urgently needed to improve care. more...
- Published
- 2013
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24. Herbal medicines for viral myocarditis.
- Author
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Liu ZL, Liu ZJ, Liu JP, and Kwong JS
- Subjects
- Astragalus propinquus, Biomarkers blood, China, Creatine Kinase, MB Form blood, Drug Combinations, Drugs, Chinese Herbal adverse effects, Electrocardiography drug effects, Humans, L-Lactate Dehydrogenase blood, Myocarditis virology, Phytotherapy adverse effects, Randomized Controlled Trials as Topic, Drugs, Chinese Herbal therapeutic use, Myocarditis drug therapy, Phytotherapy methods, Virus Diseases drug therapy
- Abstract
Background: Herbal medicines are used as treatment for viral diseases such as viral myocarditis, and numerous clinical trials have been conducted to investigate their efficacy. Despite this wealth of evidence, the role of herbal medicines in the treatment of viral myocarditis has yet to be established. This is an update of a review published in 2012., Objectives: To assess the benefits and harms of herbal medicines on clinical (e.g. mortality, incidence of complications) and indirect outcomes (e.g. cardiac function, biochemical response) in patients with viral myocarditis, irrespective of the patients' age, gender or type (including acute and chronic viral myocarditis)., Search Methods: We searched CENTRAL (2013, Issue 1) on The Cochrane Library, MEDLINE (Ovid, 1946 to January Week 4 2013), EMBASE (Ovid, 1980 to 2013 Week 04) and LILACS (Bireme) on 1 February 2013. We previously searched The Chinese Biomedical Database (1979 to 2011), China National Knowledge Infrastructure (1979 to 2011), Chinese VIP Information (1989 to 2011), Chinese Academic Conference Papers Database and Chinese Dissertation Database (1980 to 2011), AMED (June 2011) and the Cochrane Complementary Medicine Field Trials Register (June 2011). We handsearched Chinese journals and conference proceedings. No language restrictions were applied., Selection Criteria: Randomised controlled trials of herbal medicines (with a minimum duration of seven days of treatment) compared with placebo, no intervention, or conventional interventions were included. Trials of herbal medicine plus a conventional drug versus the drug alone were also included. We included only trials that reported an adequate description of allocation sequence generation., Data Collection and Analysis: Two review authors independently extracted data and evaluated trial quality. Information on adverse effects was collected from the trial reports., Main Results: We did not identify any new trials with the updated search in February 2013. The 2011 update of this review included twenty randomised controlled trials involving 2177 people. All the trials were conducted and published in China. The controls included anti-arrhythmic drugs, corticosteroids, and antiviral therapies such as ribavirin or interferon. Combining the risk of bias for random sequence generation, allocation concealment, selective reporting, and incomplete outcome data, we assessed the included trials as being at a high risk of bias. Thirteen different herbal medicines were tested in the included trials. One of the trials reported outcomes on mortality. The trials reported electrocardiogram results, levels of myocardial enzymes, cardiac function, and adverse effects.Compared with supportive therapy, Astragalus membranaceus injection did not show a significant reduction in the number of patients that died of cardiac failure.A meta-analysis showed a significant effect ofAstragalus membranaceus injection plus supportive therapy on the number of participants with an abnormal electrocardiogram (RR 0.28, 95% CI 0.13 to 0.61), ST-T changes (RR 0.72, 95% CI 0.54 to 0.95), creatine phosphate kinase (CPK) levels (MD -21.54, 95% CI -33.80 to -9.28), and lactate dehydrogenase (LDH) levels (MD -30.33, 95% CI -46.78 to -13.88).Shengmai injection plus supportive therapy showed a significant effect on the number of patients with an abnormal electrocardiogram (RR 0.11, 95% CI 0.01 to 0.86), CPK levels (MD -103.90, 95% CI -114.97 to -92.83), LDH levels (MD -34.60, 95% CI -51.25 to -17.95), and on myocardial enzyme CK-MB levels (MD -10.87, 95% CI -14.50 to -7.24). Shengmai decoction plus supportive therapy showed a significant effect on improving quality of life measured by the SF-36 (MD 40.20, 95% CI 18.13 to 62.27) compared to supportive therapy. Data on adverse events were only available from six of the included trials and no serious adverse effects were reported., Authors' Conclusions: Since no new trials were identified in the updated search in 2013, the conclusions remain the same as they were in 2012. There is no evidence of benefit of herbal medicine on all cause mortality. Some herbal medicines may lead to improvement of ventricular premature beat, electrocardiogram, levels of myocardial enzymes, and cardiac function in viral myocarditis. However, these findings should be interpreted with care, due to the risk of bias of the included studies, small sample size, and limited number of trials on individual herbs. Further robust trials are needed to explore the use of herbal medicines for viral myocarditis. more...
- Published
- 2013
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25. Herbal medicines for fatty liver diseases.
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Liu ZL, Xie LZ, Zhu J, Li GQ, Grant SJ, and Liu JP
- Subjects
- Drugs, Chinese Herbal therapeutic use, Humans, Non-alcoholic Fatty Liver Disease, Randomized Controlled Trials as Topic, Fatty Liver drug therapy, Phytotherapy methods, Plants, Medicinal
- Abstract
Background: Fatty liver disease is potentially a reversible condition that may lead to end-stage liver disease. Since herbal medicines such as Crataegus pinnatifida and Salvia miltiorrhiza have increasingly been used in the management of fatty liver disease, a systematic review on herbal medicine for fatty liver disease is needed., Objectives: To assess the beneficial and harmful effects of herbal medicines for people with alcoholic or non-alcoholic fatty liver disease., Search Methods: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 3, 2012), MEDLINE, EMBASE, and Science Citation Index Expanded to 1 March 2012. We also searched the Chinese BioMedical Database, Traditional Chinese Medical Literature Analysis and Retrieval System, China National Knowledge Infrastructure, Chinese VIP Information, Chinese Academic Conference Papers Database and Chinese Dissertation Database, and the Allied and Complementary Medicine Database to 2 March 2012., Selection Criteria: We included randomised clinical trials comparing herbal medicines with placebo, no treatment, a pharmacological intervention, or a non-pharmacological intervention such as diet or lifestyle, or Western interventions in participants with fatty liver disease., Data Collection and Analysis: Two review authors extracted data independently. We used the 'risk of bias' tool to assess the risk of bias of the included trials. We assessed the following domains: random sequence generation, allocation concealment, blinding, incomplete outcome data, selective outcome reporting, and other sources of bias. We presented the effects estimates as risk ratios (RR) with 95% confidence intervals (CI) or as mean differences (MD) with 95% CI, depending on the variables of the outcome measures., Main Results: We included 77 randomised clinical trials, which included 6753 participants with fatty liver disease. The risks of bias (overestimation of benefits and underestimation of harms) was high in all trials. The mean sample size was 88 participants (ranging from 40 to 200 participants) per trial. Seventy-five different herbal medicine products were tested. Herbal medicines tested in the randomised trials included single-herb products (Gynostemma pentaphyllum, Panax notoginseng, and Prunus armeniaca), proprietary herbal medicines commercially available, and combination formulas prescribed by practitioners. The most commonly used herbs were Crataegus pinnatifida,Salvia miltiorrhiza,Alisma orientalis,Bupleurum Chinense,Cassia obtusifolia, Astragalus membranaceous, and Rheum palmatum. None of the trials reported death, hepatic-related morbidity, quality of life, or costs. A large number of trials reported positive effects on putative surrogate outcomes such as serum aspartate aminotransferase, alanine aminotransferase, glutamyltransferase, alkaline phosphatases, ultrasound, and computed tomography scan. Twenty-seven trials reported adverse effects and found no significant difference between herbal medicines versus control. However, the risk of bias of the included trials was high.The outcomes were ultrasound findings in 22 trials, liver computed tomography findings in eight trials, aspartate aminotransferase levels in 64 trials, alanine aminotransferase activity in 77 trials, and glutamyltransferase activities in 44 trials. Six herbal medicines showed statistically significant beneficial effects on ultrasound, four on liver computed tomography, 42 on aspartate aminotransferase activity, 49 on alanine aminotransferase activity, three on alkaline phosphatases activity, and 32 on glutamyltransferase activity compared with control interventions., Authors' Conclusions: Some herbal medicines seemed to have positive effects on aspartate aminotransferase, alanine aminotransferase, ultrasound, and computed tomography. We found no significant difference on adverse effects between herbal medicine and control groups. The findings are not conclusive due to the high risk of bias of the included trials and the limited number of trials testing individual herbal medicines. Accordingly, there is also high risk of random errors. more...
- Published
- 2013
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26. Chinese herbal medicines for hypertriglyceridaemia.
- Author
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Liu ZL, Li GQ, Bensoussan A, Kiat H, Chan K, and Liu JP
- Subjects
- Gemfibrozil therapeutic use, Humans, Randomized Controlled Trials as Topic, Drugs, Chinese Herbal therapeutic use, Hypertriglyceridemia drug therapy, Hypolipidemic Agents therapeutic use
- Abstract
Background: Hypertriglyceridaemia is associated with many diseases including atherosclerosis, diabetes, hypertension and chylomicronaemia. Chinese herbal medicines have been used for a long time as lipid-lowering agents., Objectives: To assess the effects and safety of Chinese herbal medicines for hypertriglyceridaemia., Search Methods: We searched a number of databases including The Cochrane Library, MEDLINE, EMBASE and several Chinese databases (all until May 2012)., Selection Criteria: Randomised controlled trials in participants with hypertriglyceridaemia comparing Chinese herbal medicines with placebo, no treatment, and pharmacological or non-pharmacological interventions., Data Collection and Analysis: Two review authors independently extracted data and assessed the risk of bias. Any disagreement was resolved by discussion and a decision was achieved based on consensus. We assessed trials for risk of bias against key criteria: random sequence generation, allocation concealment, blinding of participants, incomplete outcome data, selective outcome reporting and other sources of bias., Main Results: We included three randomised trials with 170 participants. Ninety participants were randomised to the Chinese herbal medicines groups and 80 to the comparator groups with numbers ranging from 50 to 60 participants per trial. The duration of treatment varied from four to six weeks. All the included trials were conducted in China and published in Chinese. Overall, the risk of bias of included trials was unclear. There were no outcome data in any of the trials on death from any cause, cardiovascular or cerebrovascular events, health-related quality of life, or costs.Three different herbal medicines, including Zhusuan Huoxue decoction, Huoxue Huayu Tongluo decoction, and Chushi Huayu decoction were evaluated. All three trials investigating Chinese herbal medicines treatment alone (two studies) or in combination with gemfibrozil (one study) reported results on serum triglyceride (TG) in favour of the herbal treatment. We did not perform a meta-analysis due to significant clinical heterogeneity between the studies.No relevant differences in adverse effects occurred and no serious adverse events were noted., Authors' Conclusions: The present systematic review suggests that Chinese herbal medicines may have positive effects on hypertriglyceridaemia. The trials did not report serious adverse effects following Chinese herbal medicines treatment. However, based on an unclear risk of bias in included studies and lack of patient-important long-term outcomes, no definite conclusion could be reached. more...
- Published
- 2013
- Full Text
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27. Herbal medicines for viral myocarditis.
- Author
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Liu ZL, Liu ZJ, Liu JP, and Kwong JS
- Subjects
- Astragalus propinquus, Biomarkers blood, China, Creatine Kinase, MB Form blood, Drug Combinations, Drugs, Chinese Herbal adverse effects, Electrocardiography drug effects, Humans, L-Lactate Dehydrogenase blood, Myocarditis virology, Phytotherapy adverse effects, Randomized Controlled Trials as Topic, Drugs, Chinese Herbal therapeutic use, Myocarditis drug therapy, Phytotherapy methods, Virus Diseases drug therapy
- Abstract
Background: Herbal medicines are being used as a treatment for viral diseases such as viral myocarditis and numerous clinical trials have been conducted to investigate their efficacy. Despite this wealth of evidence, the role of herbal medicines in the treatment of viral myocarditis is yet to be established. This is an update of the review published in 2010., Objectives: To assess the effects of herbal medicines on clinical (for example mortality, incidence of complications) and indirect outcomes (for example cardiac function, biochemical response) in patients with viral myocarditis., Search Methods: We searched CENTRAL (The Cochrane Library 2011, Issue 2), MEDLINE (January 1966 to June 2011), EMBASE (January 1998 to June 2011), Chinese Biomedical Database (1979 to 2011), China National Knowledge Infrastructure (1979 to 2011), Chinese VIP Information (1989 to 2011), Chinese Academic Conference Papers Database and Chinese Dissertation Database (1980 to 2011), AMED (June 2011), LILACS (June 2011), and the Cochrane Complementary Medicine Field Trials Register. We handsearched Chinese journals and conference proceedings. No language restrictions were applied., Selection Criteria: Randomised controlled trials of herbal medicines (with a minimum of seven days treatment duration) compared with placebo, no intervention, or conventional interventions were included. Trials of herbal medicine plus conventional drug versus drug alone were also included. Only trials that reported an adequate description of allocation sequence generation were included., Data Collection and Analysis: Two review authors independently extracted data and evaluated trial quality. Adverse effects information was collected from the trials., Main Results: Twenty randomised controlled trials involving 2177 people were included. All trials were conducted and published in China. The controls included anti-arrhythmic drugs, corticosteroids, and antiviral therapies such as ribavirin or interferon. Combining the risk of bias on random sequence generation, allocation concealment, selective reporting, and incomplete outcome data, the included trials were assessed to be at high risk of bias. Thirteen different herbal medicines were tested in the included trials. None of the trials reported outcomes on mortality. The trials reported electrocardiogram results, level of myocardial enzymes, cardiac function, and adverse effects.A meta-analysis showed a significant effect of Astragalus membranaceus injection plus supportive therapy on the number of patients with an abnormal electrocardiogram (RR 0.28, 95% CI 0.13 to 0.61), ST-T changes (RR 0.72, 95% CI 0.54 to 0.95), creatine phosphate kinase (CPK) levels (MD -21.54, 95% CI -33.80 to -9.28), and lactate dehydrogenase (LDH) levels (MD -30.33, 95% CI -46.78 to -13.88).Shengmai injection plus supportive therapy showed a significant effect on the number of patients with an abnormal electrocardiogram (RR 0.11, 95% CI 0.01 to 0.86), CPK levels (MD -103.90, 95% CI -114.97 to -92.83), LDH levels (MD -34.60, 95% CI -51.25 to -17.95), and on myocardial enzyme CK-MB levels (MD -10.87, 95% CI -14.50 to -7.24). Shengmai decoction plus supportive therapy showed a significant effect on improving quality of life measured by the SF-36 (MD 40.20, 95% CI 18.13 to 62.27) compared to supportive therapy. Data on adverse events were only available from six of the included trials and no serious adverse effects were reported., Authors' Conclusions: Some herbal medicines may lead to improvement of ventricular premature beat, electrocardiogram, level of myocardial enzymes, and cardiac function in viral myocarditis. However, these findings should be interpreted with care due to the high risk of bias of the included studies, small sample size, and limited number of trials on individual herbs. Further robust trials are needed to explore the use of herbal medicines in viral myocarditis. more...
- Published
- 2012
- Full Text
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28. Chinese herbal medicines for hypercholesterolemia.
- Author
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Liu ZL, Liu JP, Zhang AL, Wu Q, Ruan Y, Lewith G, and Visconte D
- Subjects
- Humans, Randomized Controlled Trials as Topic, Drugs, Chinese Herbal therapeutic use, Hypercholesterolemia drug therapy
- Abstract
Background: Hypercholesterolemia is an important key contributory factor for ischemic heart disease and is associated with age, high blood pressure, a family history of hypercholesterolemia, and diabetes. Chinese herbal medicines have been used for a long time as lipid-lowering agents., Objectives: To assess the effects of Chinese herbal medicines on hypercholesterolemia., Search Strategy: We searched the following databases: The Cochrane Library (issue 8, 2010), MEDLINE (until July 2010), EMBASE (until July 2010 ), Chinese BioMedical Database (until July 2010), Traditional Chinese Medical Literature Analysis and Retrieval System (until July 2010), China National Knowledge Infrastructure (until July 2010), Chinese VIP Information (until July 2010), Chinese Academic Conference Papers Database and Chinese Dissertation Database (until July 2010), and Allied and Complementary Medicine Database (until July 2010)., Selection Criteria: We considered randomized controlled clinical trials in hypercholesterolemic participants comparing Chinese herbal medicines with placebo, no treatment, and pharmacological or non-pharmacological interventions., Data Collection and Analysis: Two review authors independently extracted data and assessed the risk of bias. We resolved any disagreements with this assessment through discussion and a decision was achieved based by consensus. We assessed trials for the risk of bias against key criteria: random sequence generation, allocation concealment, blinding of participants, incomplete outcome data, selective outcome reporting and other sources of bias., Main Results: We included 22 randomized trials (2130 participants). The mean treatment duration was 2.3 ± 1.3 months (ranging from one to six months). Twenty trials were conducted in China and 18 trials were published in Chinese. Overall, the risk of bias of included trials was high or unclear. Five different herbal medicines were evaluated in the included trials, which compared herbs with conventional medicine in six comparisons (20 trials), or placebo (two trials). There were no outcome data in any of the trials on cardiovascular events and death from any cause. One trial each reported well-being (no significant differences) and economic costs. No serious adverse events were observed. Xuezhikang was the most commonly used herbal formula investigated. A significant effect on total cholesterol (two trial, 254 participants) was shown in favor of Xuezhikang when compared with inositol nicotinate (mean difference (MD) -0.90 mmol/L, 95% confidence interval (CI) -1.13 to -0.68) ., Authors' Conclusions: Some herbal medicines may have cholesterol-lowering effects. Our findings have to be interpreted with caution due to high or unclear risk of bias of the included trials. more...
- Published
- 2011
- Full Text
- View/download PDF
29. Herbal medicines for viral myocarditis.
- Author
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Liu ZL, Liu ZJ, Liu JP, Yang M, and Kwong J
- Subjects
- Astragalus propinquus, Drug Combinations, Drugs, Chinese Herbal adverse effects, Humans, Myocarditis virology, Phytotherapy adverse effects, Randomized Controlled Trials as Topic, Drugs, Chinese Herbal therapeutic use, Myocarditis drug therapy, Phytotherapy methods, Virus Diseases drug therapy
- Abstract
Background: Herbal medicines are being used for treating viral diseases including viral myocarditis, and many controlled trials have been done to investigate their efficacy., Objectives: To assess the effects of herbal medicines on clinical and indirect outcomes in patients with viral myocarditis., Search Strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library Issue 3, 2009, MEDLINE (January 1966 - July 2009), EMBASE (January 1998 - July 2009), Chinese Biomedical Database (1979 - 2009), China National Knowledge Infrastructure (1979 - 2009), Chinese VIP Information (1989 - 2009), Chinese Academic Conference Papers Database and Chinese Dissertation Database (1980 - 2009), AMED (1985 - 2009), LILACS accessed in July 2009 and the trials register of the Cochrane Complementary Medicine Field. We handsearched Chinese journals and conference proceedings. No language restrictions were applied., Selection Criteria: Randomised controlled trials of herbal medicines (with a minimum of seven days treatment duration) compared with placebo, no intervention, or conventional interventions were included. Trials of herbal medicine plus conventional drug versus drug alone were also included. Only trials that reported adequate description of allocation sequence generation were included., Data Collection and Analysis: Two review authors independently extracted data and evaluated trial quality. Adverse effects information was collected from the trials., Main Results: Fourteen randomised trials involving 1463 people were included. All trials were conducted and published in China. Quality of the trials was assessed to be low. No trial had diagnosis of viral myocarditis confirmed histologically, and only a few trials attempted to establish viral aetiology. Nine different herbal medicines were tested in the included trials. The trials reported electrocardiogram results, level of myocardial enzymes, cardiac function, symptoms, and adverse effects.Astragalus membranaceus (either as an injection or granules) showed significant positive effects in symptom improvement, normalisation of electrocardiogram results, CPK levels, and cardiac function. Shengmai injection also showed significant effects in symptom improvement. Shengmai decoction triggered significant improvement in quality of life measured by SF-36. No serious adverse effects were reported., Authors' Conclusions: Some herbal medicines may lead to improvement of symptoms, ventricular premature beat, electrocardiogram, level of myocardial enzymes, and cardiac function in viral myocarditis. However, interpretation of these findings should be taken with care due to the low methodological quality, small sample size, and limited number of trials on individual herbs. Further robust trials are needed to explore the use of herbal medicines in viral myocarditis. more...
- Published
- 2010
- Full Text
- View/download PDF
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