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Wiriyakijja P, Niklander S, Santos-Silva AR, Shorrer MK, Simms ML, Villa A, Sankar V, Kerr AR, Riordain RN, Jensen SB, Delli K. World Workshop on Oral Medicine VIII: Development of a Core Outcome Set for Dry Mouth: A Systematic Review of Outcome Domains for Xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00068-8. [PMID: 37198047 DOI: 10.1016/j.oooo.2023.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/11/2022] [Accepted: 01/25/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE The purpose of this study was to identify all outcome domains used in clinical studies of xerostomia, that is, subjective sensation of dry mouth. This study is part of the extended project "World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research" to develop a core outcome set for dry mouth. STUDY DESIGN A systematic review was performed on MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials databases. All clinical and observational studies that assessed xerostomia in human participants from 2001 to 2021 were included. Information on outcome domains was extracted and mapped to the Core Outcome Measures in Effectiveness Trials taxonomy. Corresponding outcome measures were summarized. RESULTS From a total of 34,922 records retrieved, 688 articles involving 122,151 persons with xerostomia were included. There were 16 unique outcome domains and 166 outcome measures extracted. None of these domains or measures were consistently used across all the studies. The severity of xerostomia and physical functioning were the 2 most frequently assessed domains. CONCLUSION There is considerable heterogeneity in outcome domains and measures reported in clinical studies of xerostomia. This highlights the need for harmonization of dry mouth assessment to enhance comparability across studies and facilitate the synthesis of robust evidence for managing patients with xerostomia.
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Yu SS, Liu TT, Chen IH, Chiu HY, Huang HC. Efficacy of auricular acupuncture in improving dry mouth among an institutionalised older population: A randomised controlled study. J Clin Nurs 2023; 32:273-282. [PMID: 35118740 DOI: 10.1111/jocn.16225] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/17/2021] [Accepted: 01/10/2022] [Indexed: 12/14/2022]
Abstract
AIMS To investigate the efficacy of applying auricular acupuncture (AA) treatment in improving dry mouth in institution-dwelling older adults. BACKGROUND Dry mouth (xerostomia) is a common distressing problem in older populations, especially for institution-dwelling older adults that can affect oral health and quality of life. DESIGN A randomised controlled trial was conducted from December 2020 to March 2021 and performed according to STRICTA guidelines extended from the CONSORT statement. METHODS Older adults aged more than 65 years were randomly allocated to an AA group (n = 37) with an 8-week actual auricular points treatment or a control group (n = 38) receiving sham auricular point acupuncture. Measurements comprised a subjective assessment of the level of dry mouth as assessed by a visual analogue scale in a xerostomia questionnaire, and an objective assessment of the physiological wetness of the lingual mucosa measured with a moisture-checking device. A generalised estimating equation model was used for data analyses. RESULTS After completing an 8-week AA intervention stimulating the Shenmen, Point Zero and Salivary Gland 2-prime points, the AA group exhibited significantly improved subjective symptoms of dry mouth comprised of difficulty speaking (B = -6.47, p < .001), difficulty swallowing (B = -6.73, p < .001), the amount of oral saliva (B = -5.38, p < .001), a dry throat (B = -7.53, p < .001) and thirst (B = -8.06, p < .001) compared with the control group. Moreover, the AA group had higher objective oral saliva flow than the control group (B = 4.73, p < .001). CONCLUSION AA is an effective non-pharmacological method for improving subjective symptoms of dry mouth and objective saliva secretion in older populations living in nursing homes. RELEVANT TO CLINICAL PRACTICE Performing regular AA on the Shenmen, Point Zero and Salivary Gland 2-prime auricular points can be considered an alternative treatment approach to improve dry mouth in institution-dwelling older adults.
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Affiliation(s)
- Shiou-Shiun Yu
- Department of Nursing, Yilan Yuanshan Medical Foundation Yilan Yuanshan Hospital, Yuanshan Township, Taiwan
| | - Te-Tsai Liu
- Chinese medical physician, Department of Chinese medicine, Yilan Yuanshan Medical Foundation Yilan Yuanshan Hospital, Yuanshan Township, Taiwan.,Renji Traditional Chinese Medicine Clinic, Yilan City, Taiwan
| | - I-Hui Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hui-Chuan Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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The Relationship between Sleep Quality and Hemodialysis and Nursing Intervention in Uremia Patients Based on Intelligent Data. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3211144. [PMID: 35924263 PMCID: PMC9343211 DOI: 10.1155/2022/3211144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/07/2022] [Accepted: 07/15/2022] [Indexed: 11/17/2022]
Abstract
Uremia is a manifestation of end-stage renal failure and is a clinical syndrome shared by various advanced renal diseases. In recent years, the prevalence of uremia has been increasing. Maintenance hemodialysis therapy is used as the treatment of choice for uremia and is widely used. For uremia, the day-to-day treatment has a serious impact on the patient’s symptoms, causing a lot of unnecessary burdens to life. While imposing a severe symptom burden on patients, excessive sleep deprivation repair time can cause various risk injuries and further increase the probability of patient mortality. The resulting sleep deprivation can lead to the functional damage of multiple organs and systems such as the cardiovascular system and the immune system. Therefore, improving sleep quality can increase the survival rate of patients to a certain extent. There is less domestic attention to its related research, and there are not many discussions on the pathogenesis. Based on this, this paper proposes to explore the effect of hemodialysis on the sleep quality of patients with uremia under the support of intelligent data. In this study, it was found that MHD patients had various sleep quality problems, and the incidence of sleep disturbance was 61.78%. The experimental results in this paper show that the incidence of sleep disturbance in diabetic nephropathy is 89.7%. This may be combined with a series of complications in patients with diabetes, which in turn affects the quality of sleep in patients. It may increase patient mortality and affect patient quality of life and survival. Therefore, we should pay close attention to the prevention of various complications in diabetic dialysis patients, which will help to improve sleep quality.
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Chang A, Chung Y, Kang M. Effects of the Combination of Auricular Acupressure and a Fluid-Restriction Adherence Program on Salivary Flow Rate, Xerostomia, Fluid Control, Interdialytic Weight Gain, and Diet-Related Quality of Life in Patients Undergoing Hemodialysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910520. [PMID: 34639819 PMCID: PMC8508028 DOI: 10.3390/ijerph181910520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022]
Abstract
Adherence to fluid-restriction is a clinical priority in nephrology care. This study examines the effects of a combination of auricular acupressure (AA) and a fluid-restriction adherence program on the salivary flow rate, xerostomia, fluid control, interdialytic weight gain (IDWG), and diet-related quality of life (DQOL) among hemodialysis patients in South Korea. Using a quasi-experimental design, 84 hemodialysis patients were assigned to the experimental group (AA + fluid-restriction adherence program; n = 29), the comparison group (fluid-restriction adherence program; n = 27), and the control group (usual care; n = 28). The program lasted 6 weeks, and data were collected at baseline, immediately after the intervention, and 4 months post-intervention. There was a significant interaction between group and time for salivary flow rate, fluid control, IDWG, and DQOL (all p < 0.005). Compared with the control group, the experimental group had a significantly improved salivary flow rate, fluid control, IDWG, and DQOL at weeks 6 and 22, whereas the comparison group had improved fluid control and DQOL at week 6. The combination of AA and a fluid-restriction adherence program could be provided to hemodialysis patients as cost-effective, safe, and complementary interventions to promote sustainable patient adherence to fluid-restriction.
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Affiliation(s)
- AeKyung Chang
- College of Nursing Science, Kyung Hee University, Seoul 02447, Korea
- Correspondence: ; Tel.: +82-2-961-9589
| | - YoonChung Chung
- Department of Nursing, Graduate School, Kyung Hee University, Seoul 02447, Korea; (Y.C.); (M.K.)
| | - MoonJa Kang
- Department of Nursing, Graduate School, Kyung Hee University, Seoul 02447, Korea; (Y.C.); (M.K.)
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Menezes ASDS, Sanches GLG, Gomes ESB, Soares RG, Durães CP, Fonseca LL, Filho ADPS, Ribeiro AAADA, Nascimento JE, Santos SHS, de Paula AMB, Farias LC, Guimarães ALS. The combination of traditional and auricular acupuncture to prevent xerostomia and anxiety in irradiated patients with HNSCC: a preventive, parallel, single-blind, 2-arm controlled study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131:675-683. [PMID: 33839061 DOI: 10.1016/j.oooo.2021.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/16/2021] [Accepted: 02/19/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The purpose of the present study was to investigate the effect of acupuncture on xerostomia in irradiated patients with head and neck squamous cell carcinoma (HNSCC). STUDY DESIGN A preventive, 2-arm, parallel, single-blind trial was performed. Patients with HNSCC (N = 296) were checked for eligibility, and 107 patients were enrolled in the study. The study comprised 1 group that did not receive the intervention (n = 55) and the interventional group that received traditional and auricular acupuncture (n = 52). The primary outcome was the reduction of the patients' xerostomia after treatment. In addition, the secondary outcome was the reduction of anxiety. RESULTS The current acupuncture protocol reduced the xerostomia score and increased saliva volume and density without changing salivary pH. Additionally, acupuncture decreased the Beck Anxiety Inventory (BAI) score after radiation therapy. CONCLUSION Combining traditional and auricular acupuncture reduced xerostomia and increased saliva volume without changing the saliva's pH in irradiated patients with HNSCC. Additionally, the combination of traditional and auricular acupuncture reduced BAI scores.
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Affiliation(s)
| | | | | | - Raquel Gusmão Soares
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Cristina Paixão Durães
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - Larissa Lopes Fonseca
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | | | | | | | | | | | - Lucyana Conceição Farias
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil
| | - André Luiz Sena Guimarães
- Department of Dentistry, Universidade Estadual de Montes Claros, Montes Claros, Minas Gerais, Brazil; Dilson Godinho Hospital, Montes Claros, Minas Gerais, Brazil.
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Karjalian F, Momennasab M, Yoosefinejad AK, Jahromi SE. The Effect of Acupressure on the Severity of Pruritus and Laboratory Parameters in Patients Undergoing Hemodialysis: A Randomized Clinical Trial. J Acupunct Meridian Stud 2020; 13:117-123. [DOI: 10.1016/j.jams.2020.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 11/29/2022] Open
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Bossola M, Calvani R, Marzetti E, Picca A, Antocicco E. Thirst in patients on chronic hemodialysis: What do we know so far? Int Urol Nephrol 2020; 52:697-711. [PMID: 32100204 DOI: 10.1007/s11255-020-02401-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 02/01/2020] [Indexed: 01/11/2023]
Abstract
Thirst has been defined as "the sensation that leads animal's and human's actions toward the goal of finding and drinking water" or as "any drive that can motivate water intake, regardless of cause". Thirst, together with xerostomia, is the main cause of poor adherence to fluid restriction and of excessive intake of fluids in patients on chronic hemodialysis, and consequently of high interdialytic weight gain. Interdialytic weight gain (IDWG) should be lower than 4.0-4.5% of dry weight. Unfortunately, many patients have an IDWG greater than this value and some have IDWG of 10-20%. High IDWG is associated with a higher risk of all-cause and cardiovascular death and increased morbidity, such as ventricular hypertrophy and major adverse cardiac and cerebrovascular events. In addition, high IDWG leads to supplementary weekly dialysis sessions with consequent deterioration of quality of life and increased costs. Thus, the knowledge of thirst in patients on chronic hemodialysis is essential to prompt its adequate management to limit IDWG in the routine clinical practice. The present review aims to describe the physiology of thirst in patients on chronic hemodialysis, as well as the prevalence, its measures, the associated variables, the consequences, and the strategies for its reduction.
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Affiliation(s)
- Maurizio Bossola
- Servizio Emodialisi, Dipartimento Di Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy.
| | - Riccardo Calvani
- Divisione Di Geriatria, Neuroscienza E Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emanuele Marzetti
- Divisione Di Geriatria, Neuroscienza E Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Anna Picca
- Divisione Di Geriatria, Neuroscienza E Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Emanuela Antocicco
- Divisione Di Geriatria, Neuroscienza E Ortopedia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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Gao J, Chen G, He H, Liu C, He Q, Li J, Wang J. The effect of auricular therapy on blood pressure: A systematic review and meta-analysis. Eur J Cardiovasc Nurs 2019; 19:20-30. [PMID: 31583887 PMCID: PMC6927068 DOI: 10.1177/1474515119876778] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Although a number of clinical studies have investigated the effectiveness and safety of auricular therapy for treating hypertension, the overall evidence remains uncertain. Aims: We aimed to evaluate the evidence for the effect of auricular therapy on blood pressure using meta-analysis methodology. Methods: We searched PubMed, Embase, Cochrane Library databases, Clinicalkey, China National Knowledge Infrastructure, China Scientific Journal Database and Wanfang Database and Chinese Biomedicine for trials that compared the effects of auricular therapy to that of sham auricular therapy, antihypertensive drugs, or no intervention on blood pressure. Blood pressure values before and after treatment, magnitude of blood pressure change between baseline and post-intervention, and the efficacy rate, as outcomes, were synthesized by RevMan 5.3. Continuous outcomes were expressed as weighted mean differences, and dichotomous data were expressed as relative risks with 95% confidence intervals. Results: We systematically reviewed 44 randomized controlled trials (involving 5022 patients through June 2018). Auricular acupressure plus antihypertensive drugs might be more effective than antihypertensive drugs alone in both reducing systolic blood pressure value after treatment (n=464 patients; mean difference, −5.06 mm Hg; 95% confidence interval, –6.76– −3.36, p<0.00001; I2=32%), decreasing diastolic blood pressure after treatment (n=464 patients; mean difference, −5.30 mm Hg; 95% confidence interval, –6.27– −4.33, p<0.00001; I2=0%) and the efficacy rate (relative risk, 1.22; 95% confidence interval, 1.17–1.26; p<0.00001; I2=0%). Conclusion: Auricular therapy could be provided to patients with hypertension as an adjunct to antihypertensive drugs for lowering blood pressure value and achieving blood pressure targets.
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Affiliation(s)
- JiaLiang Gao
- Department of Cardiology, Guang'anmen Hospital, China
| | - Guang Chen
- Department of Cardiology, Guang'anmen Hospital, China.,Beijing University of Chinese Medicine, China
| | - HaoQiang He
- Department of Cardiology, Guang'anmen Hospital, China.,Beijing University of Chinese Medicine, China
| | - Chao Liu
- Department of Cardiology, Guang'anmen Hospital, China.,Beijing University of Chinese Medicine, China
| | - QingYong He
- Department of Cardiology, Guang'anmen Hospital, China
| | - Jun Li
- Department of Cardiology, Guang'anmen Hospital, China
| | - Jie Wang
- Department of Cardiology, Guang'anmen Hospital, China
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Affiliation(s)
- Maurizio Bossola
- Servizio Emodialisi Università Cattolica del Sacro Cuore Roma Italia
- Fondazione Policlinico Universitario A. Gemelli IRCCS Roma Italia
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Bossola M, Pepe G, Vulpio C. The Frustrating Attempt to Limit the Interdialytic Weight Gain in Patients on Chronic Hemodialysis: New Insights Into an Old Problem. J Ren Nutr 2018; 28:293-301. [DOI: 10.1053/j.jrn.2018.01.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/12/2018] [Accepted: 01/17/2018] [Indexed: 01/10/2023] Open
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Wu Y, Yang L, Li L, Wu X, Zhong Z, He Z, Ma H, Wang L, Lu Z, Cai C, Zhao D, Meng X, Qi A, Yang A, Su G, Guo X, Liu X, Zou C, Lin Q. Auricular acupressure for insomnia in hemodialysis patients: study protocol for a randomized controlled trial. Trials 2018. [PMID: 29514705 PMCID: PMC5842538 DOI: 10.1186/s13063-018-2546-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Patients on maintenance hemodialysis (MHD) frequently complain of insomnia. Poor sleep quality impairs their quality of life and adversely affects long-term outcome. Previously we applied auricular acupressure therapy (AAT) for MHD patients with insomnia and yielded favorable results. AAT probably improves sleep quality by stimulating the vagus nerve and inhibiting sympathetic overactivity. However, the efficacy of AAT for insomnia in this population is still lacking. The proposed randomized controlled trial (RCT) will evaluate the efficacy and safety of AAT for improvement of sleep quality in MHD patients with insomnia. Methods/design The proposed study is a multi-center, double-blind (participants and assessors), parallel-group RCT. A total of 112 participants with insomnia will be recruited from six hemodialysis centers in Guangzhou, China, and randomly allocated in a 1:1 ratio to receive auricular acupressure on either active points (AA group) or control points (points irrelevant to insomnia management, SAA group). The treatment will last for 8 weeks prior to a follow-up period of 12 weeks. Evaluation by blinded assessors at baseline, at 8 weeks (end of treatment) as well as at 4-week, 8-week and 12-week follow-ups (after intervention) will include Pittsburgh Sleep Quality Index (PSQI) scores and average weekly dose of hypnotics. The primary endpoint is clinical response rate (percentage of participants who reach a reduction of PSQI global score ≥ 3 in each group) at 8 weeks from baseline. Secondary endpoints include the changes in PSQI scores over time from baseline, as well as the changes in weekly dose of hypnotics. Discussion This paper describes the rationale and design of a double-blind RCT that aims to determine the efficacy and safety of AAT for insomnia of hemodialysis patients. If successful, this project will provide evidence of the efficacy and safety of AAT for insomnia of hemodialysis patients. Trial registration ClinicalTrials.gov, Identifier: NCT03015766. Registered on 22 December 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2546-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuchi Wu
- Hemodialysis Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Lihong Yang
- Hemodialysis Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Lingli Li
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Xiuqing Wu
- Hemodialysis Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Zhicong Zhong
- Hemodialysis Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Zhiren He
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.,Hemodialysis Department, Guangzhou Charity Hospital, Guangzhou, People's Republic of China
| | - Hongyan Ma
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.,Hemodialysis Department, Guangzhou Charity Hospital, Guangzhou, People's Republic of China
| | - Lixin Wang
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.,Hemodialysis Department, Guangzhou Charity Hospital, Guangzhou, People's Republic of China
| | - Zhaoyu Lu
- Hemodialysis Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Cun Cai
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.,Hemodialysis Department, Guangzhou HEMC (Higher Education Mega Center) Hospital, Guangzhou, People's Republic of China
| | - Daixin Zhao
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.,Hemodialysis Department, Guangzhou HEMC (Higher Education Mega Center) Hospital, Guangzhou, People's Republic of China
| | - Xiangxin Meng
- Hemodialysis Department, Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou, People's Republic of China
| | - Airong Qi
- Hemodialysis Department, Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen, People's Republic of China
| | - Aicheng Yang
- Hemodialysis Department, Wuyi Hospital of Traditional Chinese Medicine, Jiangmen, People's Republic of China
| | - Guobin Su
- Hemodialysis Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Xinfeng Guo
- Hemodialysis Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.,Evidence-based Medicine and Clinical Research Service Group, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, People's Republic of China
| | - Xusheng Liu
- Hemodialysis Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.,Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Chuan Zou
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
| | - Qizhan Lin
- Hemodialysis Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.
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