Efficacy and safety of tongxinluo capsule for angina pectoris of coronary heart disease: an overview of systematic reviews and meta-analysis

BackgroundTongxinluo capsule (TXLC) is a common drug for treating angina pectoris of coronary heart disease (CHD). In recent years, many systematic reviews (SRs) and meta-analyses (MAs) have reported the efficacy and safety of TXLC for improving angina symptoms in patients with CHD. We aimed to comprehensively evaluate the existing SRs and MAs of TXLC in treating angina pectoris of CHD, summarize the evidence quality, and provide scientific evidence and recommendations.MethodsWe searched seven databases for relevant SRs/MAs published up to 1 June 2023. Two reviewers independently completed the literature retrieval, screening, and data extraction. We used A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) to evaluate the methodological quality, the Risk of Bias in Systematic Reviews (ROBIS) to assess the risk of bias, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to determine the strength of the evidence. RevMan 5.3 was used to synthesize data.ResultsWe identified 15 SRs/MAs, including 329 RCTs and 33,417 patients. According to the evaluation results of AMSTAR-2, only one SR was of high methodological quality, the others were very low. ROBIS assessment showed that one SR (6.67%) had a low risk, 3 SRs (20%) had an unclear risk, and 11 SRs (73.33%) had a high risk. We assessed 42 outcomes by the GRADE, 10 (23.81%) for moderate-quality evidence, 17 (40.48%) for low-quality evidence, and 15 (35.71%) for very-low-quality evidence. Mate-analysis showed that TXLC combined with conventional western medications improved electrocardiogram efficacy (RR = 1.38, 95% CI: 1.23–1.43, P < 0.001) and angina efficacy (OR = 3.58, 95% CI: 3.02–4.24, P < 0.001), reduced angina attack frequency (SMD = −0.54, 95% CI: −0.64 to −0.44, P < 0.001) and angina duration (SMD = −0.42, 95% CI: −0.57 to −0.28, P < 0.001), with general heterogeneity. The pooled results showed that TXLC appears to have some efficacy in improving cardiac function and relieving angina symptoms, but there is limited evidence that it improves cardiovascular event rates, hemorheology, lipids, or hs-CRP. In the assessment of drug safety, TXLC was associated with different degrees of adverse drug reactions.ConclusionBased on the evidence, TXLC may be effective as an adjuvant treatment for angina pectoris of CHD. However, the quality of the evidence is low, and the drug's safety must be carefully interpreted. In future studies, high-quality randomized controlled trials are needed to confirm the effectiveness and safety of TXLC.Systematic Review Registrationhttp://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42022365372)

A systematic assessment of major water institutional mechanisms in the Murray Darling Basin during 1905 to 2011

Murray-Darling Basin (MDB) is located in south-east Australia. The basin has significant agricultural and ecological value and is considered as the food bawl of Australia. However because of over allocation of water for irrigation, the basin is now suffering many environmental problems including salinity and change of flow regime. Climate change adds more threats to the basin. The crisis of MDB is attributed to the failure of river governance. Efforts have been taken by Australian governments. Many reform of water governance in MDB have been carried out since year 1905 trying to manage MDB in a better way. However, little progress has been made. Assessments of the governance mechanisms have been taken by scholars to find the reason of governance failure. These studies successfully identified some flaws in previous governance mechanisms. However most of the studies lack comprehensive assessment of the problem and the results provided are not comparable. The assessments thus provide limited understanding of the governance in the basin. In this research, a quantitative and comprehensive assessment of some major basin level water governance mechanisms from 1905 to 2011 has been carried out. The information for of the governance was collected through an intensive literature review. A set of indicators which support the good river governance has been adopted to assess the governance mechanisms and a scoring system was used to convert the narrative assessment to quantitative data. Then the assessment of governance in different period has been conducted. An analysis of the availability of information has also been carried out to analysis the type of information available in the reviewed literatures. Thirteen governance mechanisms has been assessed in this research, which includes: 1905 VSRWSC, 1915 River Murray Waters Agreement, 1915 River Murray Commission/Murray-Darling Basin Commission (MDBC), 1989 Water Act, 1992 MDBMC, 1994 CoAG water reform framework , 1995 Water Cap, 2000 National Action Plan for Salinity and Water Quality, 2004 NWI, 2004 Living Murray First Step, 2007 MDBA, 2008 Return to Balance, 2011 Murray Darling Basin Plan. The result shows that there is an uneven development of each indicator during the time. Two different pressures have been identified which contribute to the uneven development. The first is environmental problems and the change of understanding. The second pressure is the tension and complexity of federation government in Australia. The availability of information in literatures reveals the interests of scholars for the federal level water governance mechanism assessment, researchers have less interest in assessing management method which is partly due to the federation tension in the basin governance. There are some limitations of this research, first is the information been analysis is limited. Also the scoring system ignored the time scale of governance mechanism and the possible institutional path dependence of the governance mechanisms. The lack of the understanding of the relationships among the indicators and the success of governance mechanisms is still not clear

ESR study of free radicals photoinduced by C60 solution(C60光敏反应产生自由基的ESR研究)

富勒烯(C60)的吡啶溶液在光辐射下,以5,5-二甲基-1-吡咯啉-N-氧化物(DMPO)为捕捉剂,用电子自旋共振法(ESR)直接检测到很强的ESR信号,证明C60在光辐射下有自由基产生.通过计算机的ESR模拟和分析,认为得到的ESR信号为[DMPO-O2-]·与[DMPO-OH]·的叠加信号.当分别用超氧化物歧化酶和甘露醇为清除剂时,ESR信号明显降低,证明在光辐射下产生的自由基为超氧阴离子自由基()和羟自由基(OH·)

Does foreign aid reduce the country's risk of OFDI? The Chinese experience

Abstract Using a sample of 124 countries assisted by China from 2000 to 2019, this paper examines the impact of foreign aid on outward foreign direct investment (OFDI) and the mitigation mechanism of risk. The research finds that, first, foreign aid can significantly reduce the country risk of recipient countries, especially political risk and financial risk, and thus play a role in promoting the inflow of OFDI of donor countries, and there is a lagged effect of this role; Second, foreign aid from other countries has a negative impact on China's OFDI to recipient countries, indicating that foreign aid is nonaltruistic and exclusive; Third, the mitigation effect of foreign aid on country risk is achieved through five channels: compensation effect, synergistic effect, pioneer effect, assimilation effect, and redistribution effects