BACKGROUND Previous studies had shown endoscopic retrograde appendicitis therapy(ERAT)is an effective treatment for acute appendicitis.However,different studies reported conflicting outcomes regarding the effectivenes...BACKGROUND Previous studies had shown endoscopic retrograde appendicitis therapy(ERAT)is an effective treatment for acute appendicitis.However,different studies reported conflicting outcomes regarding the effectiveness of ERAT in comparison with laparoscopic appendectomy(LA).AIM To compare the effectiveness of ERAT with LA.METHODS Randomized controlled trials(RCTs)and retrospective studies of ERAT for acute uncomplicated appendicitis were searched in PubMed,Cochrane Library,Web of Science,Embase database,China National Knowledge Infrastructure(CNKI),the WanFang Database,and Chinese Scientific Journals Database(VIP)from the establishment date to March 12021.Heterogeneity was assessed using the Isquared statistic.Pooled odds ratios(OR),weighted mean difference(WMD),and standard mean difference(SMD),with 95%confidence intervals(CI)were calculated through either fixed-effects or random-effects model.Sensitivity analysis was also performed.Publication bias was tested by Egger's test,and Begg’s test.The quality of included RCT were evaluated by the Jadad scale,while Newcastle-Ottawa scale is adopted for assessing the methodological quality of case-control studies.All statistical analysis was performed using Stata 15.1 statistical software.All statistical analysis was performed using Stata 15.1 statistical software.This study is registered with PROSPERO,CRD42021243955.RESULTS After screening,10 RCTs and 2 case-control studies were included in the current systematic review.Firstly,the length of hospitalizations[WMD=-1.15,95%CI:-1.99,-0.31;P=0.007]was shorter than LA group.Secondly,the level of postoperative CRP[WMD=-10.06,95%CI:(-17.39,-2.73);P=0.007],TNF-α[WMD=-7.70,95%CI:(-8.47,-6.93);P<0.001],and IL-6 Levels[WMD=-9.78,95%CI:(-10.69,-8.88);P<0.001;P<0.001]in ERAT group was significantly lower than LA group.Thirdly,ERAT group had a lower incidence of intestinal obstruction than LA group.[OR=0.19,95%CI:(0.05,0.79);P=0.020].Moreover,the quality of 10 RCTs were low with 0-3 Jadad scores,while the methodological quality 展开更多
Objective:To investigate the active compounds,key targets and molecular mechanism of Qizhu Yuling Decoction in the treatment of esophageal carcinoma based on network pharmacology.Methods:The active compounds of Qizhu ...Objective:To investigate the active compounds,key targets and molecular mechanism of Qizhu Yuling Decoction in the treatment of esophageal carcinoma based on network pharmacology.Methods:The active compounds of Qizhu Yuling Decoction with anti-esophageal cancer activity were screened by TCMSP and literature search,and the drug targets were searched by DrugBank and predicted by SwissTargetPrediction.The esophageal cancer-related genes were obtained from GeneCards,OMIM,DrugBank,TTD,DisGeNET,and the intersection network was selected to obtain candidate genes.The"herb-compound-target-disease"network was constructed with Cytoscape,the PPI network was constructed in STRING and core network modules were screened.Gene ontology and KEGG enrichment analysis was performed by using Metascape,and the"pathway-gene"network was constructed to further screen key targets.Results:A total of 47 active compounds(19 Astragalus,4 Zedoary turmeric,11 Atractylodes macrocephala,9 Curcuma longa,5 Clematis root,and 5 Salvia chinensis),297 candidate genes,2413 GO and 119 KEGG pathways were obtained.Conclusion:The active compounds of Qizhu Yuling Decoction in the treatment of esophageal cancer are quercetin,kaempferol,glycine and ursolic acid.The potential targets are AKT1,MAPK1,MAPK3,PIK3R1 and RELA.GO involves oxidative stress,cell cycle,apoptosis and cell death,and KEGG involves typical cancer pathways,MAPK,NF-κB and PI3K-Akt signaling pathways.This study reveals the molecular biological mechanism of Qizhu Yuling Decoction in the treatment of esophageal cancer,and speculates that the function of potential targets focuses on the interaction of multiple signaling pathways,which can antagonize the proliferation,invasion,metastasis and recurrence of esophageal cancer and improve the prognosis of patients.This study provides new evidence for subsequent new drug development,clinical application and experimental study.展开更多
文摘BACKGROUND Previous studies had shown endoscopic retrograde appendicitis therapy(ERAT)is an effective treatment for acute appendicitis.However,different studies reported conflicting outcomes regarding the effectiveness of ERAT in comparison with laparoscopic appendectomy(LA).AIM To compare the effectiveness of ERAT with LA.METHODS Randomized controlled trials(RCTs)and retrospective studies of ERAT for acute uncomplicated appendicitis were searched in PubMed,Cochrane Library,Web of Science,Embase database,China National Knowledge Infrastructure(CNKI),the WanFang Database,and Chinese Scientific Journals Database(VIP)from the establishment date to March 12021.Heterogeneity was assessed using the Isquared statistic.Pooled odds ratios(OR),weighted mean difference(WMD),and standard mean difference(SMD),with 95%confidence intervals(CI)were calculated through either fixed-effects or random-effects model.Sensitivity analysis was also performed.Publication bias was tested by Egger's test,and Begg’s test.The quality of included RCT were evaluated by the Jadad scale,while Newcastle-Ottawa scale is adopted for assessing the methodological quality of case-control studies.All statistical analysis was performed using Stata 15.1 statistical software.All statistical analysis was performed using Stata 15.1 statistical software.This study is registered with PROSPERO,CRD42021243955.RESULTS After screening,10 RCTs and 2 case-control studies were included in the current systematic review.Firstly,the length of hospitalizations[WMD=-1.15,95%CI:-1.99,-0.31;P=0.007]was shorter than LA group.Secondly,the level of postoperative CRP[WMD=-10.06,95%CI:(-17.39,-2.73);P=0.007],TNF-α[WMD=-7.70,95%CI:(-8.47,-6.93);P<0.001],and IL-6 Levels[WMD=-9.78,95%CI:(-10.69,-8.88);P<0.001;P<0.001]in ERAT group was significantly lower than LA group.Thirdly,ERAT group had a lower incidence of intestinal obstruction than LA group.[OR=0.19,95%CI:(0.05,0.79);P=0.020].Moreover,the quality of 10 RCTs were low with 0-3 Jadad scores,while the methodological quality
基金National Natural Science Foundation of China(No.81774289)Beijing Science and Technology Plan Major Fund Project(No.D161100005116004)China Academy of Chinese Medical Sciences(No.ZZ11-028)。
文摘Objective:To investigate the active compounds,key targets and molecular mechanism of Qizhu Yuling Decoction in the treatment of esophageal carcinoma based on network pharmacology.Methods:The active compounds of Qizhu Yuling Decoction with anti-esophageal cancer activity were screened by TCMSP and literature search,and the drug targets were searched by DrugBank and predicted by SwissTargetPrediction.The esophageal cancer-related genes were obtained from GeneCards,OMIM,DrugBank,TTD,DisGeNET,and the intersection network was selected to obtain candidate genes.The"herb-compound-target-disease"network was constructed with Cytoscape,the PPI network was constructed in STRING and core network modules were screened.Gene ontology and KEGG enrichment analysis was performed by using Metascape,and the"pathway-gene"network was constructed to further screen key targets.Results:A total of 47 active compounds(19 Astragalus,4 Zedoary turmeric,11 Atractylodes macrocephala,9 Curcuma longa,5 Clematis root,and 5 Salvia chinensis),297 candidate genes,2413 GO and 119 KEGG pathways were obtained.Conclusion:The active compounds of Qizhu Yuling Decoction in the treatment of esophageal cancer are quercetin,kaempferol,glycine and ursolic acid.The potential targets are AKT1,MAPK1,MAPK3,PIK3R1 and RELA.GO involves oxidative stress,cell cycle,apoptosis and cell death,and KEGG involves typical cancer pathways,MAPK,NF-κB and PI3K-Akt signaling pathways.This study reveals the molecular biological mechanism of Qizhu Yuling Decoction in the treatment of esophageal cancer,and speculates that the function of potential targets focuses on the interaction of multiple signaling pathways,which can antagonize the proliferation,invasion,metastasis and recurrence of esophageal cancer and improve the prognosis of patients.This study provides new evidence for subsequent new drug development,clinical application and experimental study.
