目的系统评价坤宝丸治疗更年期综合征的有效性和安全性。方法采用计算机检索PubMed,EMbase,The Cochrane Library,Web of Science及中国知网(CNKI)、万方(WanFang)、维普(VIP)数据库自建库起至2022年12月的相关文献。由2位评价员独立筛...目的系统评价坤宝丸治疗更年期综合征的有效性和安全性。方法采用计算机检索PubMed,EMbase,The Cochrane Library,Web of Science及中国知网(CNKI)、万方(WanFang)、维普(VIP)数据库自建库起至2022年12月的相关文献。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用RevMan 5.3软件对纳入研究进行Meta分析。结果共纳入13项研究,涉及1590例更年期综合征患者,其中观察组803例,对照组787例。按对照组的用药种类进行亚组分析,坤宝丸单用组的临床疗效显著高于氟桂利嗪+谷维素+维生素B1组[RR=1.75,95%CI(1.38,2.22),P<0.00001],坤宝丸联用组临床疗效显著高于戊酸雌二醇+甲羟孕酮组[RR=1.18,95%CI(1.03,1.34),P=0.01]和刺五加组[RR=1.20,95%CI(1.08,1.33),P=0.0007];坤宝丸单用组对更年期临床症状调查表(Kupperman)评分显著低于替勃龙组[MD=-6.00,95%CI(-7.72,-4.28),P<0.00001];坤宝丸联用组卵泡刺激素(FSH)显著低于刺五加组[MD=-25.70,95%CI(-33.22,-18.18),P<0.00001];坤宝丸联用组促黄体素(LH)显著低于刺五加组[MD=-11.20,95%CI(-12.05,-10.35),P<0.00001];坤宝丸单用组雌二醇(E2)显著高于替勃龙组[MD=-7.00,95%CI(-11.44,-2.56),P=0.002]。药品不良反应主要为腹胀、便秘、头晕、阴道出血、体质量增加等,患者均能耐受。结论坤宝丸对更年期综合征患者的临床疗效、Kupperman评分、激素指标等的改善效果与激素类药物相当,甚至更优。但由于纳入研究的质量不高,尚需更严格、高质量的临床研究进一步证实。展开更多
Subterranean estuaries(STEs)are characterized by the mixing of terrestrial fresh groundwater and seawater in coastal aquifers.Although microorganisms are important components of coastal groundwater ecosystems and play...Subterranean estuaries(STEs)are characterized by the mixing of terrestrial fresh groundwater and seawater in coastal aquifers.Although microorganisms are important components of coastal groundwater ecosystems and play critical roles in biogeochemical transformations in STEs,limited information is available about how their community dynamics interact with hydrological,geochemical and environmental characteristics in STEs.Here,we studied bacterial and archaeal diversities and distributions with 16S rRNA-based Illumina MiSeq sequencing technology between surface water and groundwater in a karstic STE.Principal-coordinate analysis found that the bacterial and archaeal communities in the areas where algal blooms occurred were significantly separated from those in other stations without algal bloom occurrence.Canonical correspondence analysis showed that nutrients and salinity can explain the patterns of bacterial and archaeal community dynamics.The results suggest that hydrological,geochemical and environmental characteristics between surface water and groundwater likely control the bacterial and archaeal diversities and distributions in STEs.Furthermore,we found that some key species can utilize terrestrial pollutants such as nitrate and ammonia in STEs,indicating that these species(e.g.,Nitrosopumilus maritimus,Limnohabitans parvus and Simplicispira limi)may be excellent candidates for in situ degradation/remediation of coastal groundwater contaminations concerned with the nitrate and ammonia.Overall,this study reveals the coupling relationship between the microbial communities and hydrochemical environments in STEs,and provides a perspective of in situ degradation/remediation for coastal groundwater quality management.展开更多
基金The National Key R&D Program of China under contract No.2022YFE0209300the National Natural Science Foundation of China under contract No.42006152+1 种基金the Zhejiang Provincial Natural Science Foundation of China under contract No.LQ21D060005the 111 Project under contract No.BP0820020.
文摘Subterranean estuaries(STEs)are characterized by the mixing of terrestrial fresh groundwater and seawater in coastal aquifers.Although microorganisms are important components of coastal groundwater ecosystems and play critical roles in biogeochemical transformations in STEs,limited information is available about how their community dynamics interact with hydrological,geochemical and environmental characteristics in STEs.Here,we studied bacterial and archaeal diversities and distributions with 16S rRNA-based Illumina MiSeq sequencing technology between surface water and groundwater in a karstic STE.Principal-coordinate analysis found that the bacterial and archaeal communities in the areas where algal blooms occurred were significantly separated from those in other stations without algal bloom occurrence.Canonical correspondence analysis showed that nutrients and salinity can explain the patterns of bacterial and archaeal community dynamics.The results suggest that hydrological,geochemical and environmental characteristics between surface water and groundwater likely control the bacterial and archaeal diversities and distributions in STEs.Furthermore,we found that some key species can utilize terrestrial pollutants such as nitrate and ammonia in STEs,indicating that these species(e.g.,Nitrosopumilus maritimus,Limnohabitans parvus and Simplicispira limi)may be excellent candidates for in situ degradation/remediation of coastal groundwater contaminations concerned with the nitrate and ammonia.Overall,this study reveals the coupling relationship between the microbial communities and hydrochemical environments in STEs,and provides a perspective of in situ degradation/remediation for coastal groundwater quality management.
