Publications by authors named "Meilu Liu"

9 Publications

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Serum exosomes from young rats improve the reduced osteogenic differentiation of BMSCs in aged rats with osteoporosis after fatigue loading in vivo.

Stem Cell Res Ther 2021 07 27;12(1):424. Epub 2021 Jul 27.

National Clinical Research Center for Metabolic Diseases, Institute of Metabolism and Endocrinology, Central South University, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.

Background: Osteoporosis is a major public health concern for the elderly population and is characterized by fatigue load resulting in bone microdamage. The ability of bone mesenchymal stem cells (BMSCs) to repair bone microdamage diminishes with age, and the accumulation of bone microdamage increases the risk of osteoporotic fracture. There is a lack of effective means to promote the repair of bone microdamage in aged patients with osteoporosis. Exosomes have been shown to be related to the osteogenic differentiation of BMSCs. Here, we aimed to evaluate the changes in the osteogenic differentiation capacity of BMSCs in aged osteoporotic rats after fatigue loading and the treatment potential of serum exosomes from young rats.

Methods: The tibias of six aged osteoporotic rats were subjected to fatigue loading in vivo for 2 weeks, and the bone microdamage, microstructures, and mechanical properties were assessed. Subsequently, BMSCs were extracted to evaluate their proliferation and osteogenic differentiation abilities. In addition, the BMSCs of aged osteoporotic rats after fatigue loading were treated with serum exosomes from young rats under osteogenic induction conditions, and the expression of osteogenic-related miRNAs was quantified. The osteogenetic effects of miRNA-19b-3p in exosomes and the possible target protein PTEN was detected.

Results: Obvious bone microdamage at the fatigue load stress point, the bone microstructure and biomechanical properties were not obviously changed. A decreased osteogenic differentiation ability of BMSCs was observed after fatigue loading, while serum exosomes from young rats highly expressing miRNA-19b-3p improved the decreased osteogenic differentiation ability of BMSCs. Transfection with miRNA-19b-3p mimic could promote osteoblastic differentiation of BMSCs and decreased the expression of PTEN. After transfection of miRNA-19b-3p inhibitor, the promotional effect of exosomes on bone differentiation was weakened. Treatment with transfected exosomes increased the expression of PTEN.

Conclusion: Serum exosomes derived from young rats can improve the decreased osteogenic differentiation ability of BMSCs in aged rats with osteoporosis after fatigue loading and can provide a new treatment strategy for the repair of bone microdamage and prevention of fractures.
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http://dx.doi.org/10.1186/s13287-021-02449-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8314589PMC
July 2021

Clinical features and risk factors of Raynaud's phenomenon in primary Sjögren's syndrome.

Clin Rheumatol 2021 Oct 29;40(10):4081-4087. Epub 2021 Apr 29.

Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases, Beijing, 100730, China.

Objective: The aim at the current study was to investigate the clinical characteristics and risk factors of Raynaud's phenomenon (RP) in patients with primary Sjögren's syndrome (pSS).

Methods: Retrospective analysis of the medical records of 333 new-onset pSS patients was performed. Demographic, clinical, and serological data were compared between individuals with and without RP. Logistic regression analysis was used to identify risk factors.

Results: RP was present in 11.41% of the pSS patients. pSS-RP patients were younger (49.74±14.56 years vs. 54.46±13.20 years, p=0.04) and exhibited higher disease activity (11 [5.75-15] vs. 7 [4-12], p=0.03) than those without. The prevalence of lung involvement was significantly higher in pSS patients with RP (60.53% vs. 17.29%; p<0.001). A significantly higher proportion of patients with pSS-RP tested positive about antinuclear (ANA), anti-RNP, and anti-centromere antibodies (ACA) compared to those without (p=0.003, <0.001, and 0.01, respectively). Multivariate analysis identified lung involvement (odds ratio [OR]=8.81, 95% confidence interval [CI] 2.02-38.47; p=0.04), anti-RNP positive status (OR=79.41, 95% CI 12.57-501.78; p<0.0001), as well as ACA (OR=13.17, 95% CI 2.60-66.72; p=0.002) as prognostic factors for pSS-RP.

Conclusion: The presence of RP defined a subset of pSS with a unique phenotype, manifesting as increased lung involvement and a higher frequency of anti-RNP antibodies and ACA, as well as greater disease activity. These results suggest that RP has clinical and prognostic value of pSS patients. Further prospective studies with a larger number of subjects are warranted to confirm our findings and assess the prognostic and treatment implications of RP in pSS patients. Key Points • Raynaud's phenomenon (RP) was present in 38 (11.41%) of 333 patients with primary Sjögren's syndrome (pSS), with patients with RP exhibiting a younger age and higher disease activity. • The presence of RP indicates a subset of pSS with a unique phenotype, with manifestations including increased lung involvement and a higher frequency of anti-RNP antibodies and anti-centromere antibodies. • Patients with pSS and RP need close follow-up and long-term observation (including assessment of microangiopathy), with specific attention paid to the possible development of clinical features of systemic sclerosis.
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http://dx.doi.org/10.1007/s10067-021-05749-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463379PMC
October 2021

Patients with early-onset primary Sjögren's syndrome have distinctive clinical manifestations and circulating lymphocyte profiles.

Rheumatology (Oxford) 2021 Apr 20. Epub 2021 Apr 20.

Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, State Key Laboratory of Complex Severe and Rare Diseases, Beijing, 100730, China.

Objectives: To further investigate the clinical characteristics and circulating lymphocyte profiles of patients with early-onset primary Sjögren's syndrome (pSS).

Method: Data of 333 patients with pSS were analyzed retrospectively. Early onset was defined as a pSS diagnosis at an age of 35 years or younger. The clinical, laboratory, and immunophenotypic profiles of peripheral blood lymphocyte subsets were compared between early- and later-onset pSS.

Results: Thirty-six (10.81%) patients matched the definition of early-onset pSS, with age at disease onset being 28.97 ± 5.53 years. Elevated serum IgG level (77.14% vs 31.16%, p < 0.001), low C3 (41.67% vs 20.20%, p = 0.004) and C4 levels (27.78% vs 6.40%, p < 0.001), anti-SSA positivity (91.67% vs 51.85%, p < 0.001), and anti-SSB positivity (50% vs 20.54%, p < 0.001) were more frequent in early-onset patients. The frequencies of hematological (80.56% vs 52.53%, p = 0.001), renal (19.44% vs 5.05%, p = 0.005), and mucocutaneous involvement (50% vs 22.56%, p < 0.001) were significantly higher in the early-onset pSS group, which showed a higher ESSDAI (11(6.25-17) vs 7(3-12); p = 0.003), compared with the later-onset group. In addition, profound CD4+ T-cell lymphopenia was found in patients with early-onset.

Conclusions: Patients with early-onset pSS have distinctive clinical manifestations and greater activation of the cellular immune system, present with more severe clinical symptoms and immunological features, have increased activation of circulating T cells, and have an unfavorable prognosis. Thus, they require more positive treatment with glucocorticoids and/or immunosuppressants and merit closer follow-up and regular monitoring.
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http://dx.doi.org/10.1093/rheumatology/keab367DOI Listing
April 2021

Adherence to the CONSORT statement and extension for nonpharmacological treatments in randomized controlled trials of bariatric surgery: A systematic survey.

Obes Rev 2021 08 4;22(8):e13252. Epub 2021 Apr 4.

Evidence-based Medicine Research Centre, Jiangxi University of Traditional Chinese Medicine, Nanchang, China.

Reporting is critical for establishing the value of randomized controlled trials (RCTs). This study evaluated the adherence of bariatric surgery RCT reporting to the CONsolidated Standards Of Reporting Trials (CONSORT) statement 2010 and its 2017 extension for non-pharmacologic treatments (NPT extension). We identified all RCTs comparing bariatric surgery with conservational therapy or alternative bariatric surgery up to June 30, 2020. Reporting quality was assessed using criteria developed from the CONSORT statement and the NPT extension and scored as a percentage. The factors associated with reporting quality were explored by univariate and multivariate analysis. In total, 102 RCTs of bariatric surgery were included. The median scores according to the CONSORT statement and NPT extension were 63.3 and 26.8 of a maximum possible 100, respectively. Two-thirds of NPT extension items were reported in less than 25% of the RCTs. The median score improved over time for the CONSORT statement but not the NPT extension. A higher CONSORT score was associated with publication in core clinical journals, protocol registration, and funding. No factors associated with the NPT extension score were identified. Substantial efforts are warranted from authors, journals, registration platforms, and funders to overcome the flaws in the reporting of bariatric surgery RCTs.
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http://dx.doi.org/10.1111/obr.13252DOI Listing
August 2021

Moxibustion for Essential Hypertension and Hypertensive Symptoms: A Systematic Review of 18 Randomized Controlled Trials.

Complement Med Res 2021 25;28(5):435-445. Epub 2021 Jan 25.

Department of Endocrinology, The First Affiliated Hospital of Nanchang University, Nanchang, China,

Introduction: This systematic review aims to update the evidence for moxibustion for essential hypertension.

Methods: Randomized controlled trials (RCTs) comparing moxibustion versus lifestyle intervention or moxibustion plus antihypertensive drugs versus antihypertensive drugs alone were searched in 9 databases up to March 29, 2020. In meta-analyses, mean difference (MD) and proportional odds ratio (pOR) with 95% confidence intervals (CIs) was pooled for continuous and ordinal outcomes, respectively.

Results: Eighteen RCTs were included, involving 1,460 patients. Moxibustion decreased systolic (MD -7.85 mm Hg, 95% CI -9.69 to -6.00, p < 0.00001, I2 = 46%) and diastolic (MD -4.09 mm Hg, 95% CI -5.45 to -2.73, p < 0.0001, I2 = 56%) blood pressures and improved the response to hypotensive treatment (pOR 2.37, 95% CI 1.49-3.75, p = 0.0003, I2 = 57%) significantly more than did the control treatment. Moxibustion also significantly relieved headache and dizziness but the effects changed to be statistically nonsignificant after excluding RCTs with a high risk of bias. Moxibustion did not significantly relieve insomnia and anxiety. No adverse events were reported.

Conclusions: Based on the current low to moderate quality evidence, our study suggests that moxibustion may have effects on reducing blood pressure. The effects of moxibustion on typical hypertension symptoms and the long-term safety of moxibustion remain uncertain.
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http://dx.doi.org/10.1159/000513701DOI Listing
October 2021

Yiqi Fumai Injection as an Adjuvant Therapy in Treating Chronic Heart Failure: A Meta-Analysis of 33 Randomized Controlled Trials.

Evid Based Complement Alternat Med 2020 19;2020:1876080. Epub 2020 Aug 19.

Evidence-based Medicine Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China.

Background: Yiqi Fumai injection (YQFM) is a traditional Chinese medicine widely used for cardiovascular diseases in China. This systematic review aimed to evaluate whether YQFM could be an effective and safe complementary therapy for chronic heart failure (CHF).

Methods: Eight electronic literature databases were searched up to March 31, 2020. Randomized controlled trials (RCTs) comparing YQFM + conventional treatment with conventional treatment alone for CHF were included. The primary outcome was response to treatment, which was graded by improvements in heart function based on the New York Heart Association (NYHA) criteria, while the secondary outcomes included the left ventricular ejection fraction (LVEF), cardiac output, left ventricular end-systolic diameter (LVESD), amino-terminal pro-brain natriuretic peptide (NT-proBNP), 6-minute walk test performance (6MWT), quality of life (QoL) as assessed by the Minnesota Living with Heart Failure questionnaire, and adverse reactions. Data from individual RCTs were pooled by a random-effects meta-analysis with effect measures of proportional odds ratios (pORs) and 95% confidence intervals (95% CIs) for the ordinal outcomes and the mean difference (MD) and 95% CI for the continuous outcomes.

Results: In total, 33 RCTs involving 3070 patients with an overall moderate-to-high risk of bias were selected. The meta-analysis showed that compared with conventional treatment alone, YQFM plus conventional treatment had a significantly higher likelihood of improving the response to treatment (pOR 1.88, 95% CI 1.47 to 2.42,  = 0%). YQFM also significantly improved the LVEF (MD 5.53%, 95% CI 4.73 to 6.33,  = 82%), cardiac output (MD 0.32 L/min, 95% CI 0.19 to 0.45,  = 47%), and LVESD (MD -3.73 mm, 95% CI -5.51 to -1.95,  = 22%), reduced the NT-proBNP levels (MD -341.83 pg/mL, 95% CI -417.89 to -265.77,  = 88%), and improved the 6MWT (MD 61.86 m, 95% CI 45.05 to 78.67,  = 64%) and QoL (MD -9.82, 95% CI -14.17 to -5.46,  = 81%). No serious adverse events related to YQFM were reported.

Conclusion: Although limited by a moderate-to-high risk of bias, the current evidence suggests that YQFM as a complementary treatment significantly improves heart function and related indicators in patients with CHF. The clinical use of YQFM needs careful safety monitoring. Well-designed studies are still required to further evaluate the efficacy and safety of YQFM for CHF.
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http://dx.doi.org/10.1155/2020/1876080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7453275PMC
August 2020

Oral and injectable Marsdenia tenacissima extract (MTE) as adjuvant therapy to chemotherapy for gastric cancer: a systematic review.

BMC Complement Altern Med 2019 Dec 12;19(1):366. Epub 2019 Dec 12.

Evidence-based Medicine Research Center, Jiangxi University of Traditional Chinese Medicine, Jiangxi, China.

Background: Marsdenia tenacissima extract (MTE) is a phytochemical widely used as complementary therapy in cancer care. This systematic review was conducted to investigate the anticancer and detoxification effects of MTE, as an adjuvant therapy to chemotherapy, for treating gastric cancer.

Methods: Ten databases were searched to identify randomized controlled trials (RCTs) comparing oral or injectable MTE plus chemotherapy versus chemotherapy alone for treating gastric cancer up to May 1, 2019. In meta-analyses, proportional odds ratios (PORs) with 95% confidence intervals (CIs) were pooled for the ordinal outcomes using the generalized linear model, and risk ratios (RRs) with 95% CIs were pooled for dichotomous outcomes using the Mantel-Haenszel method.

Results: Seventeen RCTs with 1329 individuals were included, with a moderate to high risk of selection and performance bias. Compared to chemotherapy alone, MTE adjuvant therapy significantly improved the response to anticancer treatment (POR 2.01, 95% CI 1.60-2.53) and patients' performance status (POR 3.15, 95% CI 2.22-4.48) and reduce the incidences of chemotherapy-induced leukopenia (RR 0.66, 95% CI 0.56-0.78), thrombocytopenia (RR 0.64, 95% CI 0.48-0.86), anemia (RR 0.89, 95% CI 0.72-1.10), nausea/vomiting (RR 0.79, 95% CI 0.69-0.91), hepatic injury (RR 0.77, 95% CI 0.61-0.96), and peripheral neurotoxicity (RR 0.77, 95% CI 0.59-1.01). However, MTE did not significantly alleviate anemia, diarrhea, constipation, kidney injury, and oral mucosal lesions after chemotherapy. Incidence of nausea/vomiting was lower in patients receiving oral MTE than those receiving injectable MTE (RR 0.47 vs. 0.82, interaction P = 0.04). Heterogeneity was generally low among these outcomes. Three out of five RCTs that reported survival data supported the effects of MTE for prolonging progression-free and/or overall survival. No studies reported safety outcomes of MTE.

Conclusions: The current evidence with limitations of risk of selection and performance bias suggests that MTE, as an adjuvant therapy to chemotherapy, is effective for inhibiting cancer growth and reducing incidences of multiple chemotherapy side effects. Oral MTE may be a better choice. Uncertainty remains regarding the effects of MTE on survival endpoints and the subgroup differences between acute and chronic use of MTE and between different chemotherapy regimens.
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http://dx.doi.org/10.1186/s12906-019-2779-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6909592PMC
December 2019

Efficacy and safety of moxibustion in patients with chronic prostatitis/chronic pelvic pain syndrome: A systematic review protocol.

Medicine (Baltimore) 2019 May;98(20):e15678

Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi.

Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common urogenital disease. Moxibustion is a complementary treatment option for CP/CPPS. This systematic review will assess the efficacy and safety of moxibustion as a sole or add-on therapy for CP/CPPS.

Methods: We will retrieve randomized controlled trials (RCTs) of moxibustion for CP/CPPS from the following databases: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, VIP, Chinese Biomedical Database, China National Knowledge Infrastructure Database, Wanfang Data, Chinese Medicine Database System, Google Scholar, Clinicaltrials.gov, and China Clinical Trial Registry from their inception to March 9, 2019, without language restrictions. RCTs comparing moxibustion with active drugs or moxibustion + drugs with these same drugs alone will be included. Primary outcomes will be the change in the total score of the National Institutes of Health's Chronic Prostatic Inflammatory States Index (NIH-CPSI) after moxibustion treatment. Secondary outcomes will include the scores of the individual NIH-CPSI domains, response to treatment of CP/CPPS, leucocyte and phosphatidylcholine corpuscle count in prostatic fluid, incidence of adverse events (AEs), and incidence of moxibustion-related AEs. The Cochrane risk of bias tool will be used for evaluating the risk of bias of individual trials. Heterogeneity will be detected by the Cochran Q test and I-square test. A random-effects model will be used to pool data in the meta-analysis. Risk ratio and weighted or standardized mean difference will be used as the effect measures. Three sets of subgroup analyses will be performed to explore the sources of heterogeneity. Where appropriate, we will assess the likelihood of publication bias based on funnel plots and quantitative tests.

Results: This study will produce the systematic review evidence regarding moxibustion for treating CP/CPPS based on current RCTs.

Conclusion: This study will provide a clear basis for understanding the efficacy and adverse reactions of moxibustion treatment for CP/CPPS.

Prospero Registration Number: CRD42019121338.
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http://dx.doi.org/10.1097/MD.0000000000015678DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531205PMC
May 2019

Acupuncture and related techniques for type 2 diabetes mellitus: A systematic review protocol.

Medicine (Baltimore) 2019 Jan;98(2):e14059

Evidence-based Medicine Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi.

Background: Type 2 diabetes mellitus (T2DM) is a major global health problem. As a complementary treatment, acupuncture and related techniques are widely used to treat metabolic and endocrine diseases, but their efficacy and safety for T2DM are yet to be established. This systematic review will qualitatively and quantitatively summarize the current randomized controlled trial (RCT) evidence regarding the efficacy and safety of acupuncture and related techniques in patients with T2DM.

Methods: Comprehensive literature searches will be performed on PubMed, Embase, Cochrane Central Register of Controlled Trials, and a trial registry "ClinicalTrials.gov" from inception to December 3, 2018. We will include RCTs for patients with T2DM that compared acupuncture with placebo, antidiabetic drugs, lifestyle interventions, or the combination. Primary outcomes are fasting blood glucose and hemoglobin A1c. Secondary outcomes include 2-hour blood glucose, fasting insulin, homeostatic model assessment for insulin resistance, incidence of diabetic complications, and acupuncture-related adverse events. The risk of bias of the RCTs included in the review will be examined using a revised Cochrane handbook tool. Heterogeneity will be detected using Cochran Q test and I statistics. With the use of random effects model, we will perform meta-analyses to pool results of RCTs. The effect measures will be weighted or standardized mean difference with 95% confidence intervals (CIs) for the continuous outcomes and risk ratio with 95% CIs for the dichotomous outcomes. Subgroup analyses and meta-regression with predefined effect modifiers will be performed to explore the sources of heterogeneity. Where appropriate, we will assess the possibility of reporting bias based on funnel plots and quantitative detection. We will appraise the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation system for each outcome.

Results: This study will provide accurate results and balanced inferences on the efficacy and safety of acupuncture and related techniques on T2DM.

Conclusion: This well-designed systematic review will establish high-quality evidence of the efficacy and safety of acupuncture and related techniques for T2DM to facilitate the clinical practice and guideline development.

Prospero Registration Number: CRD42018115639.
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http://dx.doi.org/10.1097/MD.0000000000014059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6336543PMC
January 2019
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