90 research outputs found
Effectiveness and potential mechanism of Jiawei-Xiaoyao-San for hyperthyroidism: a systematic review
Objectives: To evaluate the effectiveness and potential mechanism of traditional Chinese medicine Jiawei-Xiaoyao-San (JWXYS) as an adjunct or mono- therapy for antithyroid drugs (ATDs) in the treatment of hyperthyroidism.
Methods: Eight databases and three trial registries were searched from inception until May 2023. Randomized controlled trials (RCTs) were included and meta-analysis was conducted using RevMan 5.4 and Stata 14.0. The Cochrane risk of bias (ROB) tool 1.0 and GRADE tool was used for quality appraisal. The findings from case reports using mono-JWXYS and pharmacological studies were summarized in tables.
Results: Thirteen RCTs with 979 participants were included. The majority of the included studies were assessed as high risk of bias in one ROB domain. Compared with ATDs, JWXYS plus ATDs resulted in lower free triiodothyronine (FT3) (MD = -1.31 pmol/L, 95% CI [-1.85, -0.76]; low-certainty), lower free thyroxine (MD = -3.24 pmol/L, 95% CI [-5.06, -1.42]; low-certainty), higher thyroid stimulating hormone (MD = 0.42 mIU/L, 95% CI [0.26, 0.59]; low-certainty), higher effectiveness rate of traditional Chinese medicine syndrome (RR = 1.28, 95% CI [1.08, 1.52]; low-certainty), lower goiter score (MD = -0.66, 95% CI [-1.04, -0.29]; very low-certainty), lower thyrotrophin receptor antibody (SMD = -0.44, 95% CI [-0.73, -0.16]; low-certainty) and fewer adverse events (AEs) (RR = 0.34, 95% CI [0.18, 0.67]; moderate-certainty). Compared with regular dosage of ATDs, JWXYS plus half-dose ATDs resulted in fewer AEs (RR = 0.24, 95% CI [0.10, 0.59]; low-certainty). Compared with ATDs in 1 trial, JWXYS resulted in higher FT3, lower goiter score and fewer AEs. Three case reports showed that the reasons patients sought TCM-only treatment include severe AEs and multiple relapses. Three pharmacological studies demonstrated that JWXYS restored Th17/Treg balance, lowered deiodinases activity, regulated thyroid cell proliferation and apoptosis, and alleviated liver oxidative stress in mouse or rat models. Conclusion: JWXYS may enhance the effectiveness of ATDs for hyperthyroidism, particularly in relieving symptoms and reducing AEs. Mono-JWXYS is not recommended except in patients intolerant to ATDs. The findings should be interpreted with caution due to overall high risk of bias. Further pharmacological studies with more reliable models are needed
Experimental investigation of kinetic instabilities driven by runaway electrons in the EXL-50 spherical torus
In this study, the first observation of high-frequency instabilities driven
by runaway electrons has been reported in the EXL-50 spherical torus using a
high-frequency magnetic pickup coil. The central frequency of these
instabilities is found to be exponentially dependent on the plasma density,
similar to the dispersion relation of the whistler wave. The instability
frequency displays chirping characteristics consistent with the Berk-Breizman
model of beam instability. Theoretically, the excitation threshold of the
instability driven by runaway electrons is related to the ratio of the runaway
electron density to the background plasma density, and such a relationship is
first demonstrated experimentally in this study. The instability can be
stabilized by increasing the plasma density, consistent with the wave-particle
resonance mechanism. This investigation demonstrates the controlled excitation
of chirping instabilities in a tokamak plasma and reveals new features of these
instabilities, thereby advancing the understanding of the mechanisms for
controlling and mitigating runaway electrons
Observation of whistler wave instability driven by temperature anisotropy of energetic electrons on EXL-50 spherical torus
Electromagnetic modes in the frequency range of 30-120MHz were observed in
electron cyclotron wave (ECW) steady state plasmas on the ENN XuanLong-50
(EXL-50) spherical torus. These modes were found to have multiple bands of
frequencies proportional to the Alfv\'en velocity. This indicates that the
observed mode frequencies satisfy the dispersion relation of whistler waves. In
addition, suppression of the whistler waves by the synergistic effect of Lower
Hybrid Wave (LHW) and ECW was also observed. This suggests that the whistler
waves were driven by temperature anisotropy of energetic electrons. These are
the first such observations (not runaway discharge) made in magnetically
confined toroidal plasmas and may have important implications for studying
wave-particle interactions, RF wave current driver, and runaway electron
control in future fusion devices
The genetic architecture of the human cerebral cortex
The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder
The genetic architecture of the human cerebral cortex
The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder
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