Background: Chronic complications are the major outcome of type 2 diabetes mellitus progress, which reduce the quality of life of patients, incur heavy burdens to the health care system, and increase diabetic mortality. The aims of this study were to describe the prevalence of chronic complications among urban Chinese type 2 diabetic outpatients; and to analyze the associations between chronic complications and patients' demographics, diabetic related clinical characteristics. Methods: This cross-sectional hospital-based study was carried out in 4 major Chinese cities: - Shanghai, Chengdu, Beijing and Guangzhou. The survey was conducted from March to July in 2007 among 1,524 type 2 diabetic outpatients. The subjects were interviewed face-to-face by trained interviewers using a questionnaire to capture information on demographics, disease presentations and complications. All the subjects were invited to have a HbA1c test free of charge by the standardized method with Bio-Rad Variant II. Results: Of the 1,524 study subjects, 637 (41.8%) were male, and the mean age was 63.3 ± 10.2 years. At least one chronic complication was diagnosed in 792 individuals (52.0%) of the study subjects; 509 (33.4%) presented with macrovascular complications and 528 (34.7%) with microvascular complications. The prevalence of cardiovascular and cerebrovascular conditions, neuropathy, nephropathy, ocular lesions and foot disease were 30.1%, 6.8%, 17.8%, 10.7%, 14.8% and 0.8%, respectively. The prevalence of chronic complications varied between cities, and significantly increased with age and duration of diagnosed diabetes. The mean of HbA1c in diabetic patients with chronic complications was 8.2% ± 1.6% and 63.0% of the subjects with type 2 diabetes related complications had a poor glycemic control with the HbA1c > 7.5%. Conclusions: Chronic complications are highly prevalent among type 2 diabetic outpatients, the glycemic control of diabetic patients with chronic complications was poor, and future efforts should be directed at intensive blood glucose control, strengthening early diagnosis and improving case management to prevent and minimize the occurrence of complications.

Background: Ulcerative colitis, characterized by diarrhea, bloody stools and abdominal pain, is a chronic, idiopathic inflammatory disease of the colonic mucosa. In recent years, the incidence of ulcerative colitis presents an increasing trend year by year. Acupuncture, as a potential effective treatment for ulcerative colitis, is widely used in clinical practice. Methods: We searched PubMed, the Cochrane Library, Chinese CBM Database, China National Knowledge Infrastructure, Chinese VIP Information, and Wanfang Database from the date of the establishment of each database up to March, 2019. We included randomized controlled clinical trials (RCT) comparing acupuncture versus conventional conventional medicine or comparing acupuncture combined with conventional medicine versus conventional medicine in participants with ulcerative colitis. Two authors screened all references, assessed the risk of bias and extracted data independently. We summarized data using risk ratios (RR) with 95% confidence intervals (CI) for binary outcomes. We performed meta-analyses using random effects model. We assessed overall quality of evidence using GRADE. Results: We included 13 RCTs (1030 participants, 515 in the acupuncture group and 515 in the control group). Only one study tested head acupuncture, and the other 12 tested body acupuncture. The treatment duration ranged from 14 to 60 days. Seven trials compared acupuncture alone versus conventional medicine, and six compared acupuncture combined with conventional medicine versus conventional medicine. Acupuncture combined with mesalazine showed better clinical effect (improved clinical symptoms, colonoscopy results and stool examination results) (RR 1.25, 95% CI 1.19 to 1.41; 232 participants; 4 trials; low quality evidence) and better colonoscopy curative effect (RR 1.33, 95% CI 1.04 to 1.71; 108 participants; 2 trials; moderate quality evidence) compared to mesalazine. Acupuncture showed better clinical effect compared to the combination of metronidazole and sulfasalazine (RR 1.21, 95%CI 1.10, 1.34; 318 participants; 3 trials; moderate quality evidence). There was no significant difference in the incidence of adverse events between groups. Conclusions: Both acupuncture alone and acupuncture combined with conventional medicine may be effective in treating ulcerative colitis compared to conventional medicine. Our findings must be interpreted with caution due to high or unclear risk of bias of the included trials.

An effective and safe treatment for nausea and vomiting of pregnancy (NVP) is lacking. To assess the efficacy and safety of acupuncture, doxylamine-pyridoxine, and a combination of both in women with moderate to severe NVP. Multicenter, randomized, double-blind, placebo-controlled, 2 × 2 factorial trial. (ClinicalTrials.gov: NCT04401384). 13 tertiary hospitals in mainland China from 21 June 2020 to 2 February 2022. 352 women in early pregnancy with moderate to severe NVP. Participants received daily active or sham acupuncture for 30 minutes and doxylamine-pyridoxine or placebo for 14 days. The primary outcome was the reduction in Pregnancy-Unique Quantification of Emesis (PUQE) score at the end of the intervention at day 15 relative to baseline. Secondary outcomes included quality of life, adverse events, and maternal and perinatal complications. No significant interaction was detected between the interventions (P = 0.69). Participants receiving acupuncture (mean difference [MD], -0.7 [95% CI, -1.3 to -0.1]), doxylamine-pyridoxine (MD, -1.0 [CI, -1.6 to -0.4]), and the combination of both (MD, -1.6 [CI, -2.2 to -0.9]) had a larger reduction in PUQE score over the treatment course than their respective control groups (sham acupuncture, placebo, and sham acupuncture plus placebo). Compared with placebo, a higher risk for births with children who were small for gestational age was observed with doxylamine-pyridoxine (odds ratio, 3.8 [CI, 1.0 to 14.1]). The placebo effects of the interventions and natural regression of the disease were not evaluated. Both acupuncture and doxylamine-pyridoxine alone are efficacious for moderate and severe NVP. However, the clinical importance of this effect is uncertain because of its modest magnitude. The combination of acupuncture and doxylamine-pyridoxine may yield a potentially larger benefit than each treatment alone. The National Key R&D Program of China and the Project of Heilongjiang Province "TouYan" Innovation Team.

Objectives To compare the effectiveness of different exercise interventions in improving sleep quality and alleviating insomnia severity among patients with insomnia. Design Our study design was a systematic review and network meta-analysis. Eligibility criteria Our study eligibility criteria was restricted to include randomised controlled trials (RCTs) involving adults with insomnia that evaluated exercise-based interventions. Data sources PubMed, Cochrane Library, Embase, Web of Science, SPORTDiscus, and PsycINFO databases were systematically searched from inception to 1 April 2025. Risk of bias and certainty assessment Risk of bias was assessed using the Cochrane Risk of Bias 2 Tool. The certainty of the evidence was evaluated using the Confidence in Network Meta-Analysis (CINeMA) platform. Synthesis of results A frequentist network meta-analysis was performed to assess the effectiveness of interventions, with outcomes presented as mean differences (MDs) and 95% confidence intervals (95% CIs). Sleep outcomes were measured using validated tools, including the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), sleep diaries, and combined objective sleep measures such as polysomnography or actigraphy. Results The review included 1348 participants from 22 RCTs, examining 13 distinct interventions, of which seven were exercise-based: yoga, Tai Chi, walking or jogging, aerobic plus strength exercise, strength training alone, aerobic exercise combined with therapy, and mixed aerobic exercises. Among the included trials, four (18%) were rated as low risk of bias, 15 (68%) had some concerns, and three (14%) were considered to have a high risk. Compared with active controls (eg, usual care, lifestyle modifications), yoga likely results in a large increase in total sleep time (MD 110.88 minutes (min), 95% CI 58.66 to 163.09; moderate-certainty evidence) and may improve sleep efficiency (MD 15.59%, 95% CI 5.76 to 25.42; low-certainty evidence), reduce wake after sleep onset (MD −55.91 min, 95% CI −98.14 to −13.68; low-certainty evidence), and shorten sleep onset latency (MD −29.27 min, 95% CI −50.09 to −8.45; low-certainty evidence), all based on sleep diary data. Walking or jogging may result in a large reduction in ISI scores (MD −9.57 points, 95% CI −12.12 to −7.02; low-certainty evidence). Tai Chi may reduce PSQI scores (MD −4.57 points, 95% CI −7.50 to −1.63; low-certainty evidence), increase total sleep time (MD 52.07 min, 95% CI 25.53 to 78.61; low-certainty evidence), reduce wake after sleep onset (MD −36.11 min, 95% CI −62.81 to −9.42; low-certainty evidence), and shorten sleep onset latency (MD −24.76 min, 95% CI −41.07 to −8.46; low-certainty evidence), also based on sleep diary data. Additionally, Tai Chi may increase total sleep time as measured by combined objective sleep measures (MD 24.09 min, 95% CI 4.66 to 43.52; low-certainty evidence). Conclusion Exercise is an effective treatment for improving sleep in patients with insomnia. Among the various exercise interventions, yoga, Tai Chi and walking or jogging are more effective than other exercises. To further validate and strengthen these conclusions, large-scale, high-quality and well-designed RCTs are needed. Trial registration number CRD42024541899.

Due to limitations of conventional medicine for atopic eczema (AE), complementary and alternative medicine (CAM) is widely used as an alternative, maintaining, or simultaneous treatment for AE. We aimed to evaluate the beneficial and harmful effects of CAM for children with AE under 14 years old. We searched for randomized trials on CAM in 12 Chinese and English databases from their inception to May 2018. We included children (< 14 years) diagnosed with AE, who received CAM therapy alone or combined with conventional medicine. We extracted data, and used the Cochrane “Risk of bias” tool to assess methodological quality. Effect was presented as relative risk (RR) or mean difference (MD) with 95% confidence interval (CI) using RevMan 5.3. Twenty-four randomized controlled trials involving 2233 children with AE were included. Methodological quality was of unclear or high risk of bias in general. The trials tested 5 different types of CAM therapies, including probiotics, diet, biofilm, borage oil, and swimming. Compared to placebo, probiotics showed improved effect for the SCORAD index (MD 9.01, 95% CI 7.12–10.90; n = 5). For symptoms and signs such as itching, skin lesions, CAM combined with usual care was more effective for symptom relief ≥95% (RR 1.47, 95% CI 1.30–1.68; n = 8), and for ≥50% symptoms improvement (RR 1.34, 1.25–1.45; n = 9) compared to usual care. There was no statistic significant difference between CAM and usual care on ≥95% improvement or ≥ 50% improvement of symptoms. However, swimming, diet and biofilm showed improvement of clinical symptoms compared with usual care. At follow-up of 8 weeks to 3 years, CAM alone or combined with usual care showed lower relapse rate (RR 0.38, 0.28–0.51, n = 2; RR 0.31, 0.24–0.40, n = 7; respectively) compared to usual care. Twelve out of 24 trials reported no occurrence of severe adverse events. Low evidence demonstrates that some CAM modalities may improve symptoms of childhood AE and reduce relapse rate. Safety remains unclear due to insufficient reporting. Further well-designed randomized trials are needed to confirm the potential beneficial effect and to establish safety use.

Objective: This study aimed to conduct the first meta-analysis to comprehensively evaluate the clinical effectiveness and safety of Xiaochaihu Decoction in treating Cancer-related Fever (CRF).Methods: Eight databases were systematically searched in September 2023. The risk of bias (ROB) 2.0 tool recommended by Cochrane Handbook was applied to evaluate the ROB of the included randomized controlled trials (RCTs). Additionally, the quality of evidence was assessed using the Grading of recommendations assessment, development and evaluation (GRADE) tool.Results: We included 18 RCTs involving 1,424 patients. Compared to Western medicine or Xinhuang Tablets, Xiaochaihu Decoction significantly improved clinical effectiveness in CRF patients (risk ratio [RR] = 1.24, 95% confidence interval [CI]: 1.17, 1.32) and expedited the normalization of body temperature (mean difference [MD] = −5.29, 95%CI: −5.59, −4.99). It also demonstrated a reduction in tumor necrosis factor-α (TNF-α) levels (MD = −0.63, 95%CI: −0.84, −0.41) and an increase in IL-2 levels (MD = 1.42, 95%CI: −1.09, 1.74). Analysis of Karnofsky Performance Status (KPS) scores showed that the use of Xiaochaihu Decoction improved the quality of life in CRF patients (RR = 1.57, 95%CI: 1.11, 2.22) and reduced the incidence of adverse events. However, it is important to note that the majority of included studies showed “some concerns” in risk of bias based on ROB 2.0, and the evidence quality assessed by GRADE method was rated as “low”.Conclusion: While this study suggests the clinical effectiveness and safety of Xiaochaihu Decoction in treating patients with CRF, confirming these findings will necessitate additional high-quality, large-scale RCTs in future research.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD42023484068.