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Objective: To compare the efficacy and safety of combining diosmin with Jiuhua hemorrhoid suppository versus diosmin alone for the treatment of hemorrhoid hemorrhage. Method: The Jiuhua hemorrhoid suppository study was conducted in 10 medical centers across China from April 1, 2019 to June 30, 2020. Patients with hemorrhoid bleeding were randomized in a ratio of 1 : 1 to either receive Jiuhua hemorrhoid suppository and diosmin tablets (the study group) or diosmin tablets alone (the control group). The suppository was used once a day after defecation or at bedtime after rinsing the anus with warm water. Diosmin tablets were administered only once a day (0.9 g). The primary endpoint of the study was the assessment of hemorrhoid bleeding relief 7 ± 2 days after treatment, classified as “very effective” “effective” and “ineffective”. The secondary endpoint included the evaluation of pain alleviation using the visual analogue scale (VAS, with scores ranging from 0 to 10) and edema (with scores ranging from 0 to 3). The safety of the two treatment regimens was evaluated 14 ± 2 days after drug administration. Results: The full analysis set (FAS) comprised 107 participants in the study group and 111 in the control group, while the per-protocol set (PPS) included 106 participants in the study group and 111 in the control group. In terms of hemorrhoid bleeding, the proportion of very effective and effective cases in the study group were significantly higher than that in the control group [106 (99.06 %) vs. 91 (81.98 %), P < 0.0001] in the FAS, and the PPS results [105 (99.06 %) vs. 91 (81.98 %), P < 0.0001] were comparable to the FAS results. The pain VAS scores at day 7 after treatment were comparable between the two groups (0.80 ± 1.17 vs. 0.80 ± 1.20, P = 0.2177). The majority of the participants in both groups had an edema score of 0 at day 7 after treatment [96 (89.72 %) vs. 99 (91.67 %), P = 0.3705]. Adverse events (AEs) occurred in 9 patients (8.4 %) in the study group and 3 patients (2.7 %) in the control group. In addition, 5 AEs in the study group and 1 AE in the control group were possibly in association with the study drug. Conclusion: Compared with the administration of diosmin oral tablets alone, the addition of Jiuhua hemorrhoid suppository to the tablets demonstrates enhanced efficacy in addressing hemorrhoid bleeding, with satisfactory patient adherence and acceptable safety.

Heat-balance thermal protection is non-ablating thermal protection for leading edge of hypersonic vehicle. Heat will be quickly transferred from high aerodynamic heating area to low aerodynamic heating area, where the energy will be released by radiation. The temperature of high aerodynamic heating area could be reduced to protect the designed structure from being burned down. Heat-balance thermal protection is summarized. The research on heat-pipe for heat-balance thermal protection is introduced.

The structural nestedness has important effects on the ecosystem's robustness, stability, and species diversity, but quantitative analysis tools are still lacking at present. According to the competitive and mutually beneficial interactions among ecosystems species, we designed a quantitative analysis tool of nestedness on ecosystems metrics by mapping the ecosystems into symbolic networks and calculating the network's competitive nestedness and mutualistic nestedness with an overlap metric, respectively. The results of the real system and network models show that in the competitive and mutualistic coupling network, the competitive nestedness reduces the biodiversity and robustness of the network, but the mutualistic nestedness has the opposite effect. Moreover, the larger the competitive nestedness in the pure structural case, the more unstable the ecological network tends to be. However, once the dynamical governing mechanism is considered, the competitive nestedness would make the system more stable. Our work enables us to understand more specifically the effects of the network structure on ecosystems and helps reveal the mechanism that how nestedness can be changed to increase network stability, species diversity, and robustness., (© 2023 Author(s). Published under an exclusive license by AIP Publishing.)