Efficacy and safety of Xiaoyao pills for mild to moderate depression: study protocol for a randomized controlled trial

Comprehensive multicomponent characterization and quality assessment of Xiaoyao Wan by UPLC-Q-Orbitrap-MS, HS-SPME-GC-MS and HS-GC-IMS

Xiaoyao Wan (XYW) is a prescription medicine of traditional Chinese medicine (TCM) with the effects of "soothing the liver and relieving depression," and "strengthening spleen and nourishing blood". XYW has been widely concerned in the treatment of depression and has become one of the commonly used classic formulas in clinical practice. However, the pharmacodynamic substance basis and the quality control studies of XYW are hitherto quite limited. Here, we aim to fully utilize an advanced ultra - performance liquid chromatography-quadrupole - Orbitrap mass spectrometry (UPLC-Q-Orbitrap-MS), headspace-solid phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS) and headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS) technique to deep characterization of the pharmacological substance basis and quantitatively evaluate the quality of XYW. Firstly, 299 compounds were identified or tentatively characterized, including 198 non-volatile organic compounds (n-VOCs) and 101 volatile organic compounds (VOCs). Secondly, principal component analysis (PCA) and hierarchical cluster analysis (HCA) was used to analyze quality differences in XYW at different manufacturers. Thirdly, a parallel reaction monitoring (PRM) method was established and validated to quantify the fourteen major effective substances in different manufacturers of XYW, which were chosen as the benchmarked substances to evaluate the quality of XYW. In conclusion, this study shows that the strategy provides a useful method for quality control of TCM and offers a practical workflow for exploring the quality consistency of TCM.

History and Accomplishments of the North American Clinical Trials Network for Spinal Cord Injury, 2004-2022

This is a historical account of the origin and accomplishments of the North American Clinical Trials Network (NACTN) for traumatic spinal cord injury (SCI), which was established in 2004 by Christopher Reeve and Robert Grossman. Christopher Reeve was an actor who became quadriplegic and started the Christopher & Dana Reeve Foundation (CDRF), and Robert Grossman was a neurosurgeon experienced in neurotrauma and a university professor in Houston. NACTN has member investigators at university and military centers in North America and has contributed greatly to the improvement of care, primarily acute care, of patients sustaining traumatic SCI. Its accomplishments are a clinical registry database of >1000 acute SCI patients documenting the care pathways, including complications. NACTN has assessed the effectiveness of treatment, including pharmacotherapy and the role and timing of surgery, and has also identified barriers to early surgery. The principal focus has been on improving neurological recovery. NACTN has trained many SCI practitioners and has collaborated with other SCI networks and organizations internationally to promote the care of SCI patients.

Efficacy and safety of Banxia-Houpo-Tang (Banha-Hubak-Tang) for depression: A systematic review and meta-analysis

BACKGROUND

and purpose: Banxia-Houpo-Tang (Banha-Hubak-Tang, BHT) is an East Asian traditional herbal medicine used for treating depression. Hence, this review aimed to provide reliable evidence on the efficacy and safety of BHT for depression.

METHODS

Overall, 15 electronic databases were searched until July 31, 2022, and randomized controlled trials (RCTs) of BHT for depression were reviewed. The cochrane risk of bias tool version 2.0 was used for quality assessment. A meta-analysis was conducted to evaluate the efficacy and safety of BHT for depression.

RESULTS

Fifteen RCTs (1,714 participants) were included. The pooled results suggested that the efficacy of BHT alone (standardized mean difference [SMD], -0.39; 95% confidence interval [CI], -0.79 to 0.00; P = 0.05) was similar to that of antidepressants alone in terms of the Hamilton depression scale (HAMD) scores. Their combination led to a more significant improvement in HAMD scores (SMD, -0.91; 95% CI, -1.21 to 0.60; P < 0.00001). Moreover, compared with antidepressants alone, BHT alone had a lower risk of causing adverse events, but the combination therapy exhibited a similar risk. No severe adverse events were reported. The overall risk of bias was high. The quality of evidence was very low to moderate.

CONCLUSION

The study results indicate that BHT may be beneficial for treating depression. However, due to the clinical heterogeneity and low methodological quality of the included studies, the obtained findings should be interpreted with caution. Hence, further studies on this topic are warranted.