Objective To systematically evaluate the clinical efficacy of pregabalin and gabapentin in the treatment of postherpetic neuralgia (PHN), including the difference in pain control and occurrence of adverse reactions. Methods PubMed, MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were searched for randomized controlled trials (RCTs) comparing the efficacy of pregabalin and gabapentin in patients with PHN. Data from studies meeting the inclusion criteria were extracted and the Cochrane Risk of Bias risk assessment tool was used to evaluate the quality of the included studies. Revman 5.3 and Stata17 were used to perform the meta-analysis and to detect publication bias. Results A total of 14 RCTs with 3545 patients were included in this study, including 926 in the pregabalin treatment group, 1256 in the gabapentin treatment group, and 1363 in the placebo control group. Pregabalin was better than gabapentin in alleviating pain and improving the global perception of change in pain and sleep (P < 0.05). Gabapentin was associated with a lower incidence of adverse events than pregabalin (P < 0.05). Funnel plot and Begg’s and Egger’s tests showed no significant publication bias. Conclusion Pregabalin appears to have a better overall therapeutic effect than gabapentin for patients with PHN, but gabapentin has a lower incidence of adverse reactions and a better safety profile. Clinicians should comprehensively consider patient factors and fully evaluate the advantages and disadvantages of each treatment option to select the most suitable drugs for patient use. Considering the limited quantity and quality of the existing literature, high-quality RCTs are needed to confirm the advantages of pregabalin over gabapentin in the treatment of PHN and guide clinical decision-making.

Introduction In recent years, as one of the drugs for the treatment of acute ischemic stroke (AIS), the clinical application of tenecteplase is still controversial. Therefore, we aimed to evaluate the safety and efficacy of tenecteplase versus alteplase to guide clinical practice. Methods A search of PubMed, MEDLINE, EMBASE, Cochrane Library, and Web of Science databases until February 15, 2023 was conducted to identify eligible articles. The quality of the included studies was assessed using the Cochrane Risk of Bias tool. RevMan 5.3 and Stata 17 were used to perform the meta-analysis and detect publication bias, and risk ratios (RRs) with 95% confidence intervals (95% CIs) were reported for each outcome measure. Results A total of 1326 records were retrieved in this meta-analysis. As a result of the limited reports on tenecteplase in patients with AIS and the lack of high-quality randomized controlled trials (RCTs), and considering the impact of publication bias, we did not include any of these studies published before 2015. Ultimately we included 16 RCTs with a total of 7508 patients, including 3940 patients treated with alteplase and 3568 patients treated with tenecteplase. Tenecteplase was associated with better early neurological improvement (RR 0.10; 95% CI 0.00–0.19; P = 0.04), recanalization of blood vessels (RR 0.24; 95% CI 0.07–0.40; P = 0.01), and 90-day excellent neurological recovery (RR 0.12; 95% CI 0.01–0.24; P = 0.04). In addition, there were no significant differences in other efficacy and safety outcomes between the two groups. The funnel plot and Begg’s as well as Egger’s tests showed no significant publication bias. Conclusions This meta-analysis showed that tenecteplase was not inferior to alteplase in early thrombolytic therapy in patients with AIS, and was even better than alteplase on some efficacy outcomes with no significant differences in safety. However, as a result of some inherent limitations of this study, more high-quality prospective clinical studies are needed to confirm these results.

Although Angelica sinensis (Oliv.) Diels possesses anti-glioma potential, its active compounds and molecular targets and molecular mechanisms are still not fully understood. This study aims to systematically identify the active components of Angelica sinensis involved in glioma treatment, elucidate its molecular mechanisms, and validate these findings through an integrated approach combining network pharmacology and experimental verification. An integrated methodological approach-incorporating network pharmacology, molecular docking techniques, and in vitro experiments-was adopted in the present research. Using network pharmacology, common targets of Angelica sinensis and stigmasterol in glioma were identified and subjected to GO and KEGG enrichment analysis. To evaluate the molecular interaction, docking simulations were performed between active constituents of Angelica sinensis and the core target proteins. Finally, we performed a battery of cellular assays to validate the effects of Angelica sinensis and stigmasterol on proliferation, clonogenicity, migration, invasion, and ferroptosis in U251-MG cells. Network pharmacology predictions indicated that the p53 signaling pathway is a key pathway mediated by stigmasterol. In vitro experiments confirmed that Angelica sinensis and stigmasterol significantly suppressed malignant phenotypes in U251-MG cells. Mechanistically, stigmasterol activated the p53 pathway, upregulating ACSL4 while downregulating GPX4 and SLC7A11 expression, thereby inducing ferroptosis. This study reveals that stigmasterol, an active component of Angelica sinensis, can inhibit the proliferation of glioma cells by activating the p53 signaling pathway to induce ferroptosis. These findings provide a theoretical basis for the development of novel stigmasterol-based therapeutic strategies against glioma.