Chinese medical drugs for coronavirus disease 2019: a systematic review and meta-analysis

Wentai Pang,Zhi Liu,Nan Li,Yuyun Li,Fengwen Yang,Pang Bo,Xin-Yao Jin,Wenke Zheng,Junhua Zhang 한국한의학연구원 2020 Integrative Medicine Research Vol.9 No.3

Background: Integration of Chinese medical drugs (CMD) and western medicine (WM) has been widely used in the treatment of Coronavirus Disease 2019 (COVID-19). This systematic review aimed to evaluate the efficacy and safety of CMD for COVID-19. Method: A literature search was performed in six databases from injection to June 2020. Both randomized controlled trials (RCTs) and quasi-RCTs were considered as eligible. The quality of included RCTs were assessed by Cochrane Risk of Bias Tool, and Review Manager 5.3 software was used to do meta-analysis. Result: Eleven studies with 1259 patients were included in this study. CMD included herbal decoction and Chinese patent medicine. The methodological quality was evaluated as generally unclear. The results of meta-analysis showed that the integration of CMD and WM had better efficacy than WM in number of patients turned to severe and critical type (RR = 0.47, 95% CI=[0.32, 0.69], P < 0.0001), length of hospital stay (MD= -7.95, 95% CI=[-14.66, -1.24], P = 0.02), defervescence time (MD= -1.20, 95% CI=[-2.03, -0.38], P = 0.004), cough resolution rate (RR = 1.37, 95% CI=[1.15, 1.64], P = 0.0004), fatigue resolution rate (RR = 1.37, 95% CI=[1.02, 1.83], P = 0.04), and tachypnea resolution rate (RR = 2.20, 95% CI=[1.11, 4.39], P = 0.02). As for safety, there was no significant difference between two groups. Conclusion: CMD may bring potential benefit to patients suffered from COVID-19. However, the quality of included trials is not good enough. High quality study with core outcome set are still required.

Evidence for the medicinal value of Squama Manitis (pangolin scale): A systematic review

Xinyao Jin,Hui Zi Chua,Keyi Wang,Nan Li,Wenke Zheng,Wentai Pang,Fengwen Yang,Bo Pang,Mingyan Zhang,Junhua Zhang 한국한의학연구원 2021 Integrative Medicine Research Vol.10 No.1

Background: Squama Manitis (pangolin scale) has been used in traditional Chinese medicine for thousands of years. However, its efficacy has not been systematically reviewed. This review aims to fill the gap. Methods: We searched six electronic databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI), WanFang Database and SinoMed from inception to May 1, 2020. Search terms included “pangolin”, “Squama Manitis”, “Manis crassicaudata”, “Manis javanica”, “Malayan pangolins”, “Manis pentadactyla”, “Ling Li”, “Chuan Shan Jia”, “Shan Jia”, “Pao Jia Zhu”, “Jia Pian” and “Pao Shan Jia”. The Cochrane Risk of Bias (RoB) assessment tool and Newcastle-Ottawa Scale (NOS) were used to evaluate the risk of bias of the included randomized controlled trials (RCTs) and case control studies (CCSs). Results: After screening, 15 articles that met the inclusion criteria were finally included. There were 4 randomized controlled trials, 1 case control study, 3 case series and 7 case reports. A total of 15 different diseases were reported in these studies, thus the data could not be merged to generate powerful results. Two RCTs suggested that Squama Manitis combined with herbal decoction or antibiotics could bring additional benifit for treating postpartum hypogalactia and mesenteric lymphadenitis. However, this result was not reliable due to low methodological quality and irrational outcomes. The other two RCTs generated negative results. All the non-RCTs did not add any valuable evidence to the efficacy of Squama Manitis beacause of small samples, incomplete records, non-standardized outcome detection. In general, currently available evidence cannot support the clinical use of Squama Manitis. Conclusion: There is no reliable evidence that Squama Manitis has special medicinal value. The removal of Squama Manitis from Pharmacopoeia is rational.

Tongue features of patients with coronavirus disease 2019: a retrospective cross-sectional study

Wentai Pang,Dong Zhang,Junhua Zhang,Nan Li,Wenke Zheng,Hui Wang,ChunxiangLiu,Fengwen Yang,Pang Bo 한국한의학연구원 2020 Integrative Medicine Research Vol.9 No.3

Background: Traditional Chinese medicine (TCM) has been widely used in the treatment of coronavirus disease 2019 (COVID-19). Tongue features should be referred for diagnosis and treatment of diseases in TCM. Therefore, it is necessary to analyze the tongue features of the patients suffered from COVID-19. Methods: COVID-19 Symptom Database (established by Evidence-based Medicine Center of Tianjin University of TCM) was searched for eligible tongue pictures. The tongue pictures were assessed by TCM experts to extract the data of tongue color, coating color, tongue body shape and coating proper feature. The relationship between tongue features and patient’s condition was analyzed. Results: Patients diagnosed as mild and moderate COVID-19 commonly had light red tongue and white coating. Severe patients had purple tongue and yellow coating. The proportion of critical patients with tender tongue increased to 75%. Greasy coating was a significant characteristic of patients with COVID-19. The proportions of greasy coating were 53.3%, 73.3%, 83.6% and 87.5% in disease category of mild, moderate, severe and critical. In addition, the thick coating proportion increased from mild (24.9%) to critical (50.0%). Conclusions: Tongue features have certain relationship with the category of COVID-19. Tongue features can serve as potential indicators for the evaluation of patient’s condition and prognosis. Further studies are needed to enhance the quantification of tongue features and develop standards.

Protective efficacy of a high-growth reassortant swine H3N2 inactivated vaccine constructed by reverse genetic manipulation

Feng Wen,Ji-Hong Ma,Hai Yu,Fu-Ru Yang,Meng Huang,Yan-Jun Zhou,Ze-Jun Li,Guangzhi Tong 대한수의학회 2014 JOURNAL OF VETERINARY SCIENCE Vol.15 No.3

Novel reassortant H3N2 swine influenza viruses (SwIV)with the matrix gene from the 2009 H1N1 pandemic virushave been isolated in many countries as well as duringoutbreaks in multiple states in the United States, indicatingthat H3N2 SwIV might be a potential threat to public health. Since southern China is the world’s largest producer of pigs,efficient vaccines should be developed to prevent pigs fromacquiring H3N2 subtype SwIV infections, and thus limit thepossibility of SwIV infection at agricultural fairs. In thisstudy, a high-growth reassortant virus (GD/PR8) wasgenerated by plasmid-based reverse genetics and tested as acandidate inactivated vaccine. The protective efficacy of thisvaccine was evaluated in mice by challenging them withanother H3N2 SwIV isolate [A/Swine/Heilongjiang/1/05(H3N2) (HLJ/05)]. Prime and booster inoculation withGD/PR8 vaccine yielded high-titer serum hemagglutinationinhibiting antibodies and IgG antibodies. Completeprotection of mice against H3N2 SwIV was observed, withsignificantly reduced lung lesion and viral loads invaccine-inoculated mice relative to mock-vaccinatedcontrols. These results suggest that the GD/PR8 vaccine mayserve as a promising candidate for rapid intervention ofH3N2 SwIV outbreaks in China.

A novel M2e-multiple antigenic peptide providing heterologous protection in mice

Feng Wen,Ji-Hong Ma,Hai Yu,Fu-Ru Yang,Meng Huang,Yan-Jun Zhou,Ze-Jun Li,Xiu-Hui Wang,Guo-Xin Li,Yi-Feng Jiang,Wu Tong,Guangzhi Tong 대한수의학회 2016 Journal of Veterinary Science Vol.17 No.1

Swine influenza viruses (SwIVs) cause considerable morbidity and mortality in domestic pigs, resulting in a significant economic burden. Moreover, pigs have been considered to be a possible mixing vessel in which novel strains loom. Here, we developed and evaluated a novel M2e-multiple antigenic peptide (M2e-MAP) as a supplemental antigen for inactivated H3N2 vaccine to provide cross-protection against two main subtypes of SwIVs, H1N1 and H3N2. The novel tetra-branched MAP was constructed by fusing four copies of M2e to one copy of foreign T helper cell epitopes. A high-yield reassortant H3N2 virus was generated by plasmid based reverse genetics. The efficacy of the novel H3N2 inactivated vaccines with or without M2e-MAP supplementation was evaluated in a mouse model. M2e-MAP conjugated vaccine induced strong antibody responses in mice. Complete protection against the heterologous swine H1N1 virus was observed in mice vaccinated with M2e-MAP combined vaccine. Moreover, this novel peptide confers protection against lethal challenge of A/Puerto Rico/8/34 (H1N1). Taken together, our results suggest the combined immunization of reassortant inactivated H3N2 vaccine and the novel M2e-MAP provided cross-protection against swine and human viruses and may serve as a promising approach for influenza vaccine development.