Routine Treatment Group Research Articles

Efficacy and Safety of Canagliflozin in STEMI Patients with Type 2 Diabetes after PCI: A Retrospective Study

Objective: To assess the effectiveness and safety of canagliflozin in the management of ST segment elevation myocardial infarction (STEMI) patients with type 2 diabetes mellitus (T2DM) post-percutaneous coronary intervention (PCI). Methods: A retrospective analysis on data of patients diagnosed with STEMI and T2DM who underwent PCI treatment at our hospital was performed from June 2020 to September 2023. The patients were divided into two groups based on the exposure factor: the canagliflozin and conventional treatment groups and the canagliflozin and routine treatment groups. Various parameters, such as demographic characteristics, cardiac function indicators, and insulin-related factors, were collected and compared postprocedure. In addition, evaluation of the insulin sensitivity index (ISI), lipid profile parameters, and safety outcomes was conducted. A balanced baseline characteristics of patients was achieved via propensity score matching (PSM) at a 1:1 ratio. Statistical analyses were performed through t-tests, nonparametric tests, and chi-square tests. Results: This work included data on 156 patients, including 63 and 93 patients in the canagliflozin and routine treatment groups, respectively. Later, each group comprised 63 patients after 1:1 matching by PSM. After treatment, the canagliflozin treatment group exhibited notably reduced levels of N-terminal B-type natriuretic peptide, cardiac troponin T (cTnT), and creatine kinase-MB and a significantly higher level of left ventricular ejection fraction in comparison with the routine treatment group (p < 0.05). In addition, following treatment, the canagliflozin treatment group exhibited a significant decrease in homeostatic model assessment (HOMA)-insulin resistance levels and a significant increase in HOMA-β levels (p < 0.05). Conversely, the groups manifested no significant variances in terms of major adverse cardiovascular events, hypoglycemia, diabetic ketoacidosis, acute kidney injury, and urinary tract infection (p > 0.05). Conclusion: The concurrent administration of canagliflozin following PCI improves cardiac function, insulin sensitivity, and lipid profile in patients with STEMI and T2DM, which ultimately lowers the likelihood of cardiovascular incidents. Canagliflozin demonstrates favorable clinical safety profiles in such individuals and displays promising prospects for clinical utility.

Effect of Long-Term Tai Chi Therapy on the Immune-Inflammatory Pathway in Patients with Schizophrenia with Antipsychotic-Stabilized.

The primary objective of this study was to explore the influence of prolonged (24weeks) supplementary Tai Chi therapy on cognitive capabilities and immune-inflammatory pathways in subjects diagnosed with schizophrenia. A total of 90 individuals who have been clinically diagnosed with schizophrenia were assigned to two treatment groups, namely the Tai Chi treatment (TT) group and the routine treatment (RT) group. Following a 24-week duration of intervention, the data obtained from 32 patients in the TT group and 30 patients in the RT group were meticulously analyzed. At the commencement of the investigation and upon completion of the 24-week intervention, blood samples were gathered, and clinical evaluations were executed. In plasma, the identification of nine cytokines (IL-10, IFN-γ, IL-5, GM-CSF, TNF-α, IL-13, IL-4, IL-2, and IL-12) was conducted using the multiple primer suspension chip method. The clinical evaluations encompassed CGI, WHOQUOL-BREF, SOFS, PSS, BPRS, SAPS, SANS, and RBANS. In comparison to the RT group, the patients in the TT group demonstrated decreased levels of TNF-α and IL-5 (P < 0.05). Moreover, they encountered more pronounced advancements in SAPS, SANS, PSS, SOFS, and RBANS scores (P < 0.05). Additionally, a positive connection was detected between the plasma TNF-α level in the TT group and both the SANS score and the SPFS score (P < 0.05). Tai Chi has been shown to improve clinical symptoms in patients with schizophrenia as an add-on therapy, potentially through its effects on immunomodulatory pathways.

Study of electronic biofeedback combined with nursing intervention in the treatment of vascular cognitive impairment-no dementia.

To investigate the effects of electronic biofeedback combined with nursing intervention and conventional drug treatment on cognitive function in patients with vascular cognitive impairment-no dementia (VCIND). A total of 102 patients with VCIND treated in the Department of Neurology from January 2021 to May 2022 were enrolled and divided into the routine treatment group and biofeedback group according to different treatment methods. The routine treatment group was given conventional drug therapy and nursing intervention; for the biofeedback group, electronic biofeedback therapy was added, based on the routine treatment group. The Montreal Cognitive Assessment, (MoCA), Alzheimer's Disease Assessment Scale-Cognitive Subscale, (ADAS-cog), and Hamilton Depression Scale (HAMD) were checked before treatment, 2weeks after treatment, and 3months after treatment. At 3months of treatment, the scores of the MoCA and ADAS-cog scales in the biofeedback group were better than those in the routine treatment group, while no difference was detected in the HAMD scores before and after treatment and between the two groups. Electronic biofeedback therapy for VCIND can significantly improve the MoCA score, reduce the ADAS-cog score and improve the cognitive level of patients and can be used as a complementary treatment for VCIND.

Role of clinical pharmacists in multidisciplinary collaborative management of blood glucose in COVID-19 patients with hyperglycemia

BackgroundDuring the ongoing global pandemic of COVID-19, the association between hyperglycemia and COVID-19 infection has emerged as a notable concern. Therefore, finding effective methods to manage hyperglycemia in patients with COVID-19 is crucial. ObjectiveTo introduce the clinical pharmacists participating in multidisciplinary collaborative whole hospital blood glucose management mode, and to explore its effect on blood glucose control in patients with coronavirus disease 2019 infection and complicated with hyperglycemia. MethodsPatients with COVID-19 treated at Nanjing Drum Tower Hospital from December 2022 to January 2023 were assigned to routine diagnosis and treatment group and whole hospital blood glucose management group according to the blood glucose management plan received by patients. The groups were compared in regards to their adherence to management advice, blood glucose levels, fluctuation, inflammation-related indicators, medical service-related indicators, and incidence of hypoglycemia and adverse events. ResultsAfter 5 days of glucose management, both groups showed a decrease in fasting and postprandial blood glucose. Postprandial blood glucose in the whole hospital glucose management group was significantly lower than the routine group (P < 0.05). The whole hospital glucose management group showed a significant increase in compliance rate, improved inflammation-related indicators, and higher detection rates for hemoglobin and islet function (P < 0.05). Implementation rates for medical orders and treatment plans were also higher in the whole hospital group (P < 0.05). There was no significant difference in incidence of adverse events. ConclusionsMultidisciplinary blood glucose management is highly recommended for patients with COVID-19 who have hyperglycemia due to its effectiveness, standardization, safety, and improvement of inflammation indicators.

Efficacy of ornidazole for pericoronitis: a meta-analysis and systematic review.

Timely and effective treatments of pericoronitis are very important. We aimed to evaluate the role of ornidazole in the treatment of pericoronitis, to provide insights for clinical pericoronitis treatment. The PubMed, Clinical trials, EMBASE, Science Direct, Cochrane Library, China National Knowledge Infrastructure (CNKI), Weipu and Wanfang databases were searched to find randomized controlled trials (RCTs) of ornidazole in the treatment of pericoronitis from the establishment of the database to March 15, 2023. Review Manager 5.3 software was used for meta-analysis. A total of 16 RCTs involving 2004 patients were included. The results of the meta-analysis showed that the effective rate of ornidazole treatment was significantly higher than that of the routine treatment group (RR = 1.22, 95% CI (1.15, 1.29), p < 0.001). Ornidazole treatment was beneficial to reduce the oral bacterial density (MD = -26.13, 95% CI (-32.08, -21.51)), time to pain disappearance (MD = -0.64, 95% CI (-0.92, -0.17)) and time to disappearance of redness and swelling of the teeth crown (MD = -1.45, 95% CI (-2.43, -1.01)) compared to the routine treatment (all p = 0.05). No publication bias was found by the funnel plots and Egger test (p = 0.206). Ornidazole is effective in the treatment of pericoronitis, with more advantages. Still, the effects and safety of ornidazole in the treatment of pericoronitis need to be evaluated by more high-quality RCTs with larger sample sizes.

Shared decision-making improving efficacy in diarrhoea-dominant irritable bowel syndrome in Chinese outpatient setting: protocol of a prospective, randomised controlled trial

IntroductionDiarrhoea-dominant irritable bowel syndrome (IBS-D) is a disorder with multiple pathogenesis; many people with IBS-D may have psychosocial issues which can make assessment and treatment more difficult. Routine treatment procedure...

A service evaluation of patients requiring growth modification in a public service setting.

Aim To conduct a service evaluation of patients who had functional appliance treatment to correct Class II malocclusions in a public orthodontic clinic. To evaluate the effect of prioritisation and earlier treatment of these patients on treatment duration and patient compliance. Methodology The prioritised treatment group (PTG) had twin block appliances fitted when they were 11 or 12 years old. In comparison, the routine treatment group (RTG) had twin block appliances fitted when they were 13 or 14. Electronic patient records were screened to find a sample of 100 patients from each cohort. The number of compliance issues, functional appliance treatment duration, fixed appliance treatment duration and total treatment duration was recorded retrospectively from patient charts. Results While mean total treatment time was similar across the two cohorts, the PTG did have significantly shorter fixed appliance treatment durations than the RTG. The PTG was also found to have better compliance than the RTG. Conclusion Prioritising patients who require functional appliance treatment does not reduce total treatment duration. A correlation between earlier treatment, improved patient compliance, and a shorter course of fixed appliance therapy can be seen, which may prove clinically beneficial. Further research in this area would be valuable.

The efficacy and safety of microneedling with topical tranexamic acid for melasma treatment: A systematic review and meta-analysis.

Microneedling with topical tranexamic acid (TXA) is a novel treatment option for melasma; however, the efficacy and safety of this combined administration therapy is in controversial. This study is conducted to address this issue of this technique in melasma. An extensive literature review was performed to identify relevant trials, including randomized split-face studies, randomized controlled trials and prospective non-randomized split-face studies, comparing microneedling plus topical TXA to routine treatments or placebo. The primary outcomes were changes of the Melasma Area Severity Index (MASI)/modified MASI (mMASI)/hemi MASI between before and after treatment, as well as the changes between a particular treatment and microneedling plus TXA. The mean differences (MDs) and 95% confidence intervals (CIs) were calculated for the reduction of melasma severity scores from baseline to each time point. In contrast, the standard mean differences (SMDs) and 95% CIs were calculated for the differences in reduction in melasma severity scores between the experimental and control groups at each time point. A total of 16 trials were included in the systematic review and data synthesis. The pooled analysis demonstrated that MASI, mMASI, and hemiMASI scores decreased significantly at 4 weeks (MD = 1.85; 95% CI = 1.15-2.54), 8 weeks (MD = 3.28; 95% CI = 2.31-4.24), 12 weeks (MD = 4.73; 95% CI = 2.79-6.50), 16 weeks (MD = 3.18; 95% CI = 1.50-4.85), and 20 weeks (MD = 3.20; 95% CI = 1.95-4.46) after treatment when compared with baseline. The reduction in melasma severity scores of microneedling with TXA group at 4 weeks was more significant than the routine treatment group (SMD = 0.97; 95% CI = 0.09-1.86), while insignificant at 8 weeks (SMD = 1.21; 95% CI = -0.17 to 2.59), 12 weeks (SMD = 0.63; 95% CI = -0.03 to 1.29), 16 weeks (SMD = 0.61; 95% CI = -2.85 to 4.07), or 20 weeks (SMD = 1.04; 95% CI = -1.28 to 3.36). Despite the high heterogeneity across these studies, the current findings indicated that microneedling with topical TXA is an alternative treatment option for melasma treatment; and more well-designed studies are needed to confirm it.

Serum and supplemental vitamin D levels and insulin resistance in T2DM populations: a meta-analysis and systematic review

Observational studies have shown a negative correlation between Vitamin D level and the likelihood of developing insulin resistance (IR) and/or diabetes over time, yet evidence remains inconsistent. In this meta-analysis and systematic review, we strive to define the potential association between serum or supplemental Vitamin D Levels and insulin resistance respectively, as well as the contribution of Vitamin D to type 2 diabetes, and to summarize the biologic plausibility of Vitamin D. Four databases (PubMed, Embase, Cochrane Library, and Web of Science) were searched for this Systematic Literature Review (SLR) to find appropriate observational studies and clinical trials published in English through to July 2022. EndNote (version X9) is used to manage the literature search results. We calculated Standard Mean Differences (SMDs) and Risk Ratios (RRs) with their 95% Confidence Intervals (CIs), separately, for continuous and dichotomous outcomes. The correlation coefficients were normalized to z values through Fisher’s z-transformation to calculate the relevant statistics. Meta-analyses were carried out for all comparisons, based on a random-effects pooling model. Data analysis was performed using RevMan (version 5.3) and STATA (version 15.1). All statistical tests were two-sided, with P < 0.05 were regarded as significant. In our current meta-analysis, there are 18 RCTs and 20 observational studies including 1243 and 11,063 participants respectively. In the overall analysis, the diabetic with Vitamin D supplement treatment group showed significantly improve serum insulin (SMD = − 0.265, 95% CI − 0.394 to − 0.136, P < 0.05), glucose (SMD = − 0.17, 95% CI − 0.301to − 0.039, P < 0.05) and HOMA-IR (SMD = − 0.441, 95% CI − 0.582 to − 0.3, P < 0.05) compared with the routine treatment group. Correlation analysis results showed that all three outcomes were significantly correlated in a negative manner with raised Vitamin D (insulin: r = − 0.08 95% = − 0.12 to − 0.04; glucose: r = − 0.06 95% = − 0.11 to − 0.01; HOMA-IR: r = − 0.08 95% = − 0.09 to − 0.06). Results of overall analysis proved that vitamin D has shown significant effect on regulates insulin resistance, and there is a significant inverse association between serum Vitamin D level and IR. Vitamin D supplementation is expected to be integrated into conventional medical approaches to prevent type 2 diabetes and to mitigate the burden of diabetes for individuals and society.PROSPERO registration number: CRD42022348295.

Effect of Vitamin D Supplementation on Clinical Course and T Helper 17/ T-Regulatory Balance in Peripheral Blood of Patients with Crohn's Disease.

Vitamin D has anti-inflammatory properties and is involved in immune function, making it a potential therapy for Crohn's disease. This study aimed to investigate the effects of vitamin D supplementation on immune function and the clinical efficacy of patients with Crohn's disease. From September 2017 to September 2021, patients with Crohn's disease were recruited and randomly divided into 2 groups: the routine treatment group (n = 52) and the vitamin D supplement group (n = 50). In addition to routine treatment, the vitamin D group received oral calcitriol capsule supplementation, while the routine treatment group did not receive any additional intervention. T helper 17/T-regulatory cell level, inflammatory indicators, and nutritional status were compared between the 2 groups, as well as mucosal healing under endoscopy and the life quality of patients. C-reactive protein was significantly lower in the vitamin D treatment group compared to the routine treatment group (6.08 ± 2.72 vs. 18.91 ± 2.66, P < .05). Compared to the routine treatment group, the ratio of T helper 17/T-regulatory cells was significantly lower in the vitamin D group (0.26 ± 0.12 vs. 0.55 ± 0.11, P < .05). After vitamin D treatment, both of the average Crohn's disease activity index score (from 319.7 ± 72.7 to 179.6 ± 48.5, P < .05) and simple endoscopic score for Crohn's disease score (from 7.9 ± 2.3 to 3.9 ± 0.6, P < .05) were significantly decreased, while the Inflammatory Bowel Disease Questionnaire score was significantly increased (from 137.8 ± 21.2 to 158.1 ± 25.1, P < .05). Vitamin D has the potential to improve the inflammatory status and immune environment of patients with Crohn's disease, which can reduce the level of inflammatory factors and help the recovery of symptoms, thus improving the clinical course and quality of life in Crohn's disease patients.

Clinical observation of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in patients with acute heart failure

Objective: To observe the clinical effect of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in acute left heart failure patients 7 days after onset as well as the effects of plasma MDA and ET-1. Methods: In total, 240 hospitalized patients with acute left heart failure from October 2017 to May 2021 were selected from the Department of Emergency and Critical Care Center of Beijing Anzhen Hospital, Capital Medical University and the Department of Cardiology of the Jilin Provincial People's Hospital. They were randomly divided into routine treatment group and combined treatment group, with 120 cases in each group. The routine treatment group was treated with vasodilation, diuresis, cardiotonic and recombinant human brain natriuretic peptide. The combined treatment group was treated with Qiliqiangxin capsules based on the routine treatment group. One week later, the changes in clinical efficacy, ejection fraction, left ventricular commoid diameter, and plasma BNP, MDA, and ET-1 were compared between the two groups before and after treatment. SPSS 11.5 statistical software was used. The measurement data was expressed in x¯±s, the independent sample t-test was used for comparison between groups, and the paired t-test was used for comparison before and after treatment within groups. Counting data was expressed as case (%), and the rank sum test was used for inter-group comparison. Result: In terms of clinical efficacy, the total effective rate of the combined treatment group was significantly higher than that of the conventional treatment group, and the difference was statistically significant (P<0.05). Compared with the routine treatment group, the left ventricular ejection fraction in the combined treatment group was significantly increased (P<0.05). The levels of plasma BNP, MDA and ET-1 were significantly decreased (P<0.05). Conclusion: Qiliqiangxin capsule combined with rhBNP treatment can effectively improve the clinical symptoms of acute heart failure, as well as reduce the lipid peroxidation product MDA content and endothetin ET-1 level in blood. The clinical application value of the Qiliqiangxin capsule needs to be further confirmed by further trials.

Efficacy of acupuncture therapy for post-stroke fatigue: a systematic review and Meta-analysis.

To assess the effectiveness and safety of acupuncture for post-stroke fatigue (PSF). Eight online databases were searched to collect relevant trials of acupuncture for PSF published before April 2021. Meta-analysis was performed by using RevMan 5.4 software. The Grading of Recommendations, Assessment, Development and Evaluation system was used to assess the certainty of evidence. Four randomized controlled trials involving 289 PSF patients were identified and included in the systematic review. The results of the Meta-analysis revealed that acupuncture group was significantly better than routine treatment group in improving the effective rate [risk ratio () = 1.15, 95%(1.01, 1.33), = 0.04], reducing the FSS score [mean difference () =?－4.71, 95% ?(－6.22, －3.20), < 0.000 01] and FMA score [=?15.60, 95%?(11.96, 19.23), < 0.000 01]. Side effects of acupuncture were mild and rarely reported. The certainty of evidence of the outcomes based on the four trials was assessed as low. The existing evidence suggests acupuncture as an adjunct to routine treatment may benefit in managing fatigue in stroke patients. However, high-quality RCTs are needed to further confirm these findings.

Efficacy of electroacupuncture in assisting postoperative healing of distal radius fractures: study protocol for a randomized controlled trial

BackgroundManual reduction and surgical treatment are common methods for distal radius fractures (DRFs). The existing literature suggests that postoperative combined rehabilitation treatment and medication are effective for the healing of DRFs. However, the side effects of these treatments remain to be solved. Previous studies have shown that electroacupuncture (EA) can effectively relieve wrist swelling and improve the joint function in patients with DRFs, but more evidence is needed to prove the effectiveness of EA. This trial aims to explore the efficiency and feasibility of combined EA treatment in postoperative treatment of DRFs compared with routine treatment.MethodsThis is a parallel randomized controlled trial. A total of 222 patients diagnosed with moderate DRFs will be recruited and randomly assigned to an EA group or a routine treatment group at a ratio of 1:1. Routine treatment group will receive medication and rehabilitation. Yangxi (LI 5), Yangchi (TE 4), Yanggu (SI 5), Hegu (LI 4), and Taiyuan (LU 9) will be selected in the EA group for intervention three times a week on the basis of routine treatment. Both groups will receive 8 weeks of treatment and 4 weeks of follow-up. The primary outcome will be ulnar positive variance. The secondary outcomes will include radiographic healing rate, bone strength, hemorheological indices, serum biochemical indicators and inflammatory factors, grip strength, wrist swelling score, patient-rated wrist evaluation, disabilities of arm, shoulder and hand, and visual analogue scale. Outcomes will be evaluated at baseline, postoperative 3rd day, 2nd, 4th, 6th, 8th, and 12th weeks.DiscussionThe results of this study will help establish a more optimized scheme to treat patients with DRFs.Trial registration Chinese Clinical Trial Registry ChiCTR2200062857. Registered on 21 August 2022, www.chictr.org.cn/com/25/showproj.aspx?proj=175567.

A physician-nurse partnership &lt;i&gt;via&lt;/i&gt; online healthcare platforms protects infertile women from anxiety and depression: A multi-center prospective study from Shanghai, China

Effective health interventions are a priority for future infertility research, and effective interventions in patient-centered care are still needed. A multi-center prospective study was conducted in order to investigate the effects of a physician-nurse partnership (patients receive guidance and health education via online healthcare platforms) on depression and anxiety disorders in infertile women. The women were randomly assigned to a physician-nurse partnership group (n = 90) or a routine treatment group (n = 90). The primary endpoints were self-rating anxiety scale and self-rating depression scale scores. This study also examined the waiting time as an outpatient and the frequency of using online medical platforms. Compared to the routine treatment group, scores on the self-rating anxiety scale (48.4) and the self-rating depression scale (48.0) were significantly lower in the physician-nurse partnership group (p = 0.004, p = 0.001). Moreover, the mean waiting time (3.4) was shorter and online platforms (6.1) were used more frequently in the physician-nurse partnership group than in the routine treatment group (p < 0.001, p < 0.001). These data suggest that a physician-nurse partnership could reduce patients' anxiety, depression, and their waiting time as an outpatient.

Therapeutic effect of autologous bone marrow cells injected into the liver under the guidance of B‑ultrasound in the treatment of HBV‑related decompensated liver cirrhosis.

The 5-year mortality rates associated with decompensated liver cirrhosis (DLC) can reach 50%, which suggests that this condition poses a serious health risk. In previous studies conducted by our group, autologous bone marrow nucleated cells (ABMNCs) were used to treat HIV-positive patients with DLC through the right omental vein; however, trauma and poor compliance were encountered. In the present study, the percutaneous liver approach to inject ABMNCs under the guidance of B-ultrasound was employed for the treatment of DLC. A total of 108 patients with DLC were retrospectively divided into the routine drug treatment group (control group; 30 cases), the right omental vein infusion of ABMNCs group (observation group 1; 38 cases) and the B-ultrasound-guided liver injection of ABMNCs group (observation group 2; 40 cases). After treatment, the liver synthesis (prothrombin time, albumin and ascites) and secretion functions (total bilirubin) in observation groups 1 and 2 were significantly improved compared with those of the control group (P<0.01) and the bone marrow function was also significantly improved compared with that of the control group (P<0.01). While, the bone marrow function (white blood cell, platelet, and hemoglobin) in observation group 1 was significantly improved compared with that of observation group 2 at the end of treatment (P<0.01). After a 1-year follow-up, the case fatality rate was 2.5% (1/40) in observation group 2, which was significantly lower than the 20% fatality rate (6/30) recorded in the control group (P<0.05). The injection of ABMNCs into the liver under the guidance of B-ultrasound was significantly better than conventional drug therapy in treating DLC. This approach has obvious advantages such as no hospitalization, minimal trauma, rapid recovery and good compliance, all of which make it worthy of application in primary hospitals.

Effects of Anticoagulants and Immune Agents on Pregnancy Outcomes and Offspring Safety in Frozen-Thawed Embryo Transfer Cycles-A Retrospective Cohort Study.

The application of anticoagulants and immune agents in assisted reproduction technology has been in a chaotic state, and no clear conclusion has been reached regarding the effectiveness and safety of this treatment. We aimed to explore the potential association between adjuvant medication and pregnancy outcomes and offspring safety in a retrospective cohort study including 8,873 frozen-thawed embryo transfer cycles. The included cycles were divided into three groups according to the drugs used, namely, the routine treatment group (without anticoagulant agents and immune agents), the anticoagulant agent group, and the immunotherapy group. Among normal ovulatory patients, those who used immune agents had a 1.4-fold increased risk of miscarriage (≤13 weeks), but a 0.8-fold decreased chance of birth (≥28 weeks) compared with the routine treatment group. Among patients with more than 1 embryo transferred, those who used anticoagulant agents showed a 1.2-fold higher risk of multiple birth than those undergoing routine treatment. Among patients without pregnancy complications, anticoagulant treatment was associated with a 2.1-fold increased risk of congenital anomalies. Among young patients (<26 years) with a singleton pregnancy, the neonatal birth weight of the immunotherapy group and the anticoagulant treatment group was 305.4 g and 175.9 g heavier than the routine treatment group, respectively. In conclusion, adjuvant anticoagulants or immune agent treatment in assisted reproductive technology should be used under strict supervision, and the principle of individualized treatment should be followed.

Efficacy of a Persian herbal medicine compound on coronavirus disease 2019 (COVID-19): A randomized controlled trial

BackgroundThe global attention to the capacities of traditional medicine for alleviating the clinical manifestations of COVID-19 has been growing. The present trial aimed to evaluate the efficacy and safety of a Persian herbal medicine formula among patients with COVID-19. MethodsThe present trial was conducted in Afzalipour hospital, Kerman, Iran, from June to September 2020. Hospitalized COVID-19 patients were randomly divided into intervention (Persian herbal medicine formula + routine treatment) or control (only routine treatment) groups. The intervention group received both capsule number 1 and 2 every 8 hours for 7 days. Capsule number 1 contained extract of the Glycyrrhiza glabra, Punica granatum, and Rheum palmatum, and the second capsule was filled by Nigella sativa powder. Participants were followed up to 7 days. The primary outcome was the number of hospitalization days, while cough, fever, and respiratory rate, days on oxygen (O2) therapy, and mortality rate were considered as the secondary outcomes. ResultsEighty-two patients were enrolled to the study, while 79 cases completed the trial and their data were analyzed (mean age: 59.1 ± 17.1 years). Based on the results, the Persian medicine formula decreased the mean hospitalization days, so that the mean difference of length of hospitalization as primary outcome was 2.95 ± 0.43 days. A significant clinical improvement was observed regarding dyspnea, need for O2) therapy, and respiratory rate in the intervention group. No adverse effects were reported. ConclusionThe present study supported the use of the Persian medicine formula as an adjuvant therapy for hospitalized COVID-19 patients. Study registrationIranian Registry of Clinical Trials (www.irct.ir): IRCT20200330046899N1.

AngioJet rheolytic thrombectomy in patients with thrombolysis in myocardial infarction thrombus grade 5: an observational study

The aim of this study was to evaluate the effectiveness and safety of AngioJet rheolytic thrombectomy among patients with high thrombus burden. Routine manual thrombus aspiration in patients with ST-segment elevation myocardial infarction (STEMI) does not improve clinical outcomes and was associated with an increased rate of stroke. However, the safety of mechanical thrombus aspiration is still unknown. This was a retrospective, single-center study involving 621 patients with Thrombolysis In Myocardial Infarction thrombus grade 5. The primary outcome was the composite of major adverse cardiovascular events (MACE) within 12 months. The safety outcome was stroke within 1-year. Propensity matching score was calculated due to the significant baseline differences between the AngioJet rhelytic thrombectomy group and the routine treatment group. AngioJet rheolytic thrombectomy was performed in 117 patients. After propensity-score matching, there was no significant difference both in the incidence of MACE (11.1% vs 17.9%, hazard ratio, 1.641; 95% confidence interval [CI] 0.822 to 3.277, p = 0.161) and the incidences of stroke (1.7% vs 2.6%, hazard ratio 1.522; 95% confidence interval [CI] 0.254 to 9.107, p = 0.646) between two groups at 1-year follow-up. In patients with Thrombolysis In Myocardial Infarction thrombus grade 5, AngioJet rheolytic thrombectomy did not improve clinical outcomes at 1 year. However, AngioJet rheolytic thrombectomy did not increase the risk of stroke in patients with high thrombus burden.

Observation on the efficacy of post-stroke dysphagia treated with He's santong acupuncture therapy through surface electromyography: a randomized controlled trial

To observe the clinical therapeutic effect on post-stroke dysphagia treated with He's santong (triple promotion) acupuncture therapy through surface electromyography (sEMG). A total of 60 patients with post-stroke dysphagia were divided into a routine treatment group and a He's santong acupuncture therapy group, using blocked randomization, 30 cases in each one. In the routine treatment group, the secondary prevention and swallowing rehabilitation training were adopted. In the He's santong acupuncture therapy group, on the base of the treatment as the routine treatment group, weitong (mild promotion, routine acupuncture at bilateral Fengchi ［GB20］, Fengfu ［GV16］, Yifeng ［TE17］, Lianquan ［CV23］, Jia-lianquan ［Extra］, Fenglong ［ST40］ and Tongli ［HT5］, needle retaining for 30 min, 5 treatments a week), wentong (warm promotion, pricking with fire needle at bilateral GB20 and CV23, twice a week) and qiangtong (strong promotion, blood-letting with three-edge needle at Jinjin ［EX-HN12］, Yuye ［EX-HN13］ and Yanhoubi ［Extra］, twice a week) treatment was added. The therapy was given consecutively for 4 weeks in each group. The score of fiberoptic endoscopic examination of swallowing (FEES) and Rosenbek-penetration-aspiration scale (PAS), the score of swallowing grading scale, the score of the modified Mann assessment of swallowing ability (MMASA) and the peak amplitude of sEMG were recorded before and after treatment in patients. Compared with before treatment, the score of FEES and PAS after treatment was decreased (P<0.05), the scores of swallowing grading scale and MMASA after treatment were increased in both routine treatment group and He's santong acupuncture therapy group (P<0.05), the peak amplitude of sEMG was increased (P<0.05) in the He's santong acupuncture therapy group and decreased (P<0.05) in the routine treatment group. Compared with the routine treatment group, the score of FEES and PAS was decreased (P<0.05), the scores of swallowing grading scale and peak amplitude of sEMG were increased in the He's santong acupuncture therapy group (P<0.05). He's santong acupuncture therapy is obviously effective on post-stroke dysphagia, which may be related to its effects in increasing the contraction of swallowing-related muscles and improving the peak amplitude of hyoid muscle group.

Comparative Analysis of the Effects of Escitalopram, Pramipexole, and Transcranial Magnetic Stimulation on Depression in Patients With Parkinson Disease: An Open-Label Randomized Controlled Trial.

ObjectiveThis study aimed to compare the effects of different antidepressant therapies on depression in patients with Parkinson disease (PD) and to provide a reference for clinical treatment.MethodsA total of 328 patients with idiopathic PD were selected consecutively. Subjects met Diagnostic and Statistical Manual of Mental Disease, Fourth Edition, criteria for a depressive disorder, or operationally defined subsyndromal depression, and scored greater than 17 on the 17-item Hamilton Depression Scale (HAMD-17). One hundred thirty-one patients with PD accompanied with depression were enrolled into the experimental group. The subjects were randomly divided into 4 groups, and 118 were eventually completed: routine treatment group (n = 29), routine treatment + escitalopram group (n = 29), routine treatment + pramipexole group (n = 31), and routine treatment + transcranial magnetic stimulation (TMS) group (n = 29). After 4 weeks of treatments, the efficacy of each treatment was evaluated using HAMD score and reduction rate.ResultsAfter 4 weeks of treatment, the HAMD score was used for pair-to-pair comparison between the 4 groups. The therapeutic efficiency of escitalopram, pramipexole, and repetitive TMS was superior to routine anti-PD treatment, and the differences were statistically significant (P < 0.05). There was no statistical difference between escitalopram and pramipexole, but all of them were superior to rTMS. Further logistic regression analysis suggested that 50% reduction in HAMD score from baseline was associated with the treatment method. Among them, escitalopram had statistical significance (P < 0.05).ConclusionsEscitalopram, pramipexole, and high-frequency TMS had better efficacy in patients with PD complicated with depression. At 4 weeks, escitalopram showed better antidepressant effects and improved patients' quality of life and did not worsen motor function.