Risk of diabetes in stroke patients who used Bu Yang Huan Wu Tang: A nationwide propensity-score matched study

Characteristics of elderly diabetes patients: focus on clinical manifestation, pathogenic mechanism, and the role of traditional Chinese medicine

Diabetes mellitus has become a major public health issue globally, putting an enormous burden on global health systems and people. Among all diseased groups, a considerable part of patients are elderly, while their clinical features, pathogenic processes, and medication regimens are different from patients of other ages. Despite the availability of multiple therapies and techniques, there are still numerous elderly diabetes patients suffering from poor blood glucose control, severe complications, and drug adverse effects, which negatively affect the quality of life in their golden years. Traditional Chinese Medicine (TCM) has been widely used in the treatment of diabetes for several decades, and its relevant clinical practice has confirmed that it has a satisfactory effect on alleviating clinical symptoms and mitigating the progression of complications. Chinese herbal medicine and its active components were used widely with obvious clinical advantages by multiple targets and signaling pathways. However, due to the particular features of elderly diabetes, few studies were conducted to explore Traditional Chinese Medicine intervention on elderly diabetic patients. This study reviews the research on clinical features, pathogenic processes, treatment principles, and TCM treatments, hoping to provide fresh perspectives on the prevention and management strategies for elderly diabetes.

Buyang huanwu decoction combined with probiotics or prebiotics for functional recovery from stroke: A meta-analysis protocol for systematic review

BACKGROUND

Stroke is a global disease that compromises human health. Considering the side effects of Western medicine, alternative medicine, such as Chinese medicine, is widely used. Concurrently, the research and development on the microbiota-gut-brain axis in recent years have made intestinal microflora the new target of treatment. We aim to scientifically evaluate the advantages and clinical guidance of using Buyang-Huanwu (BYHW) decoction combined with probiotics in the intestinal microflora.

METHODS

The search will focus on published Randomized Controlled Trial (RCTs) that used BYHW decoction, probiotics, prebiotics, synbiotics, or similar microecological preparations to treat stroke. We will search for relevant studies in six databases: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and Chongqing VIP Information. The retrieval date will be limited to the period from inception to June 2021 and will not be restricted by language. The extracted data will be subjected to systematic review and meta-analysis to evaluate its clinical advantages and efficacy. Patient-centred and most responsive outcomes will be selected as major outcomes, including the Fugl-Meyer (FMA) and Barthel scales. Secondary outcomes will be clinically assessed factors, including inflammatory factors in serum, platelet aggregation, other laboratory parameters, and the number and distribution of flora in the gut. We will evaluate the bias of each included study using the latest version of the Cochrane Handbook and the RoB tool. The analysis of all data and the drawing of forest maps will be performed using STAT 15.1 SE software. Regardless of the I2 values generated between the studies, we will perform a subgroup analysis. The grouping method will be based on all included research characteristics and factors that may cause heterogeneity, and may depend on differences in intervention methods, sources of subjects, and other relevant factors.

RESULTS

We plan to present the results of this systematic review in a peer-reviewed scientific journal, conferences, and popular press.

CONCLUSION

The efficacy and safety of Buyang-Huanwu decoction combined with probiotics for the treatment of stroke will be evaluated, and the conclusion will be published to provide medical evidence for a better clinical decision of patients with stroke.

Hypoxia-inducible factor-1: Regulatory mechanisms and drug development in stroke

Stroke is an acute cerebrovascular disease caused by sudden rupture of blood vessels in the brain or blockage of blood vessels, which has now become one of the main causes of adult death. During stroke, hypoxia-inducible factor-1 (HIF-1), as an important regulator under hypoxia conditions, is involved in the pathological process of stroke by regulating multi-pathways, such as glucose metabolism, angiogenesis, erythropoiesis, cell survival. However, the roles of HIF-1 in stroke are still controversial, which are related with ischemic time and degree of ischemia. The regulatory mechanisms of HIF-1 in stroke include inflammation, autophagy, oxidative stress, apoptosis and energy metabolism. The potential drugs targeting HIF-1 have attracted more attention, such as HIF-1 inhibitors, HIF-1 stabilizers and natural products. Based on the role of HIF-1 in stroke, HIF-1 is expected to be a potential target for stroke treatment. Resolving when and what interventions for HIF-1 to take during stroke will provide novel strategies for stroke treatment.