rongsheng cai md manufacturer

Dr. Rongsheng Cai is a Neurosurgery Specialist in Tulsa, Oklahoma. He graduated with honors in 1985. Having more than 38 years of diverse experiences, especially in NEUROSURGERY, Dr. Rongsheng Cai affiliates with no hospital, cooperates with many other doctors and specialists in medical group University Of Arkansas. Call Dr. Rongsheng Cai on phone number (918) 494-1710 for more information and advice or to book an appointment.

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Dr. Rongsheng Cai M.D. is a male health care provider in Tulsa with Neurological Surgeon listed as his primary medical specialization. His credentials are: M.D. (Doctor of Medicine). Dr. Rongsheng Cai M.D."s practice location is: 6151 S Yale Ave Ste 2403 Tulsa, OK 74136-1907.

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Systematic review and meta-analysis were performed using RevMan 5.2. Dichotomous variables were expressed as pooled risk ratios (RR) with 95% confidence interval (CI) and continuous variables were expressed as the weighted mean difference (MD) with 95% CI. Heterogeneity across the RCTs was assessed by Chi-squared test and I2 statistic. If p < 0.05 or I2 > 50%, it suggested that there was significant statistical heterogeneity and the random-effect model was used to calculate the outcomes; otherwise, the fixed-effect model was considered. The Z-test was employed to verify the overall effects of ligustrazine injection as adjunctive therapy over using Western medicine alone in the treatment of ACI. Significant statistical difference was considered in this meta-analysis when p < 0.05.

Five RCTs reported the NDS as their secondary outcome measure for ACI patients. As shown in Figure 4, ligustrazine injection as adjunctive therapy significantly reduced the NDS in ACI patients (MD = −3.88; 95% CI, −4.15 to −3.61; Z = 28.35, p < 0.00001) with moderate heterogeneity (I2 = 41%; χ2 = 6.80; df = 4, p = 0.15). As shown in Supplementary Table S3, results from the sensitivity analysis and subgroup analysis showed that no significant difference was found in the overall mean differences (MDs) of NDS. Results of Begg’s test (Z = −0.24, p = 1.00) and Egger’s test (t = 0.37, p = 0.739) suggested that there were no significant publication biases among the five RCTs.

Seven RCTs mentioned fibrinogen as the secondary outcome measure. As shown in Figure 5, results indicated that ligustrazine injection combined with Western medicine was superior to Western medicine alone in reducing the fibrinogen in ACI patients (MD = −0.59; 95% CI, −0.76 to −0.42; Z = 6.77, p < 0.00001) with high heterogeneity (I2 = 93%; χ2 = 86.28; df = 6, p < 0.00001). As shown in Supplementary Table S4, sensitivity analysis and subgroup analysis showed that there were little changes in the overall MDs of fibrinogen. Results from Begg’s test (Z = 0.30, p = 0.764) and Egger’s test (t = 1.24, p = 0.269) indicated that no significant publication biases were found among the included seven RCTs.

LBV was reported as the outcome measure in four RCTs. As shown in Figure 6, results suggested that ligustrazine injection as adjunctive therapy was better than Western medicine alone in reducing LBV for ACI patients (MD = −2.11; 95% CI, −3.16 to −1.06; Z = 3.95, p < 0.0001) with high heterogeneity (I2 = 86%; χ2 = 21.17; df = 3, p < 0.0001). Sensitivity analysis and subgroup analysis were performed to evaluate the overall MDs influenced by the factors of low quality RCTs, sample size and publication date. Results showed that little differences were found in the overall MDs of LBV (Supplementary Table S5). Results of Begg’s test (Z = 0.34, p = 0.734) and Egger’s test (t = −0.64, p = 0.585) demonstrated that there were no significant publication biases among the four RCTs.

HBV was reported in six RCTs and it was selected for one of the outcome measures. As shown in Figure 7, results demonstrated that ligustrazine injection as adjunctive therapy was more effective than Western medicine alone to reduce HBV in the treatment of ACI patients (MD = −0.88; 95% CI, −1.20 to −0.55; Z = 5.27, p < 0.00001) with high heterogeneity (I2 = 98%; χ2 = 304.24; df = 5, p < 0.00001). In this meta-analysis, sensitivity analysis and subgroup analysis were conducted to verify if the overall MDs were affected by the low quality of RCTs, sample size and publication date and results suggested that little differences were found in the overall MDs of HBV (Supplementary Table S6). Results of Begg’s test (Z = 0, p = 1.00) and Egger’s test (t = −0.41, p = 0.70) indicated that no significant publication biases were found among the six RCTs.

Many RCTs on ligustrazine injection combined with Western medicine for the treatment of ACI. However, the clinical efficacy of ligustrazine injection is not yet well confirmed. Although a former meta-analysis published in 2016 had evaluated the efficacy and safety of ligustrazine in the treatment of cerebral infarction, the poor methodological quality (the Jadad score of all the studies was 1 point) prevented the author from making firm conclusions (Yu et al., 2016). The lack of a subgroup and sensitive analysis also resulted in its result being more unreliable. Moreover, the former meta-analysis was not conducted according to the PRISMA guidelines. This study aims to provide a PRISMA-compliant systematic review (PRISMA Checklist was provided in Supplementary Table S7) and meta-analysis for evaluating the efficacy of ligustrazine injection as adjunctive therapy in treating ACI. Meta-analysis results of the primary outcome measure (clinical effective rate) showed that ligustrazine injection combined with Western medicine appeared to be more effective than Western medicine alone (RR = 1.24; 95% CI, 1.19–1.29). Results of the secondary outcome measures including NDS (MD = −3.88; 95% CI, −4.15 to −3.61), fibrinogen (MD = −0.59; 95% CI, −0.76 to −0.42), LBV (MD = −2.11; 95% CI, −3.16 to −1.06), and HBV (MD = −0.88; 95% CI, −1.20 to −0.55) confirmed that the therapeutic effect of ligustrazine injection as adjunctive therapy surpassed the Western medicine alone in the treatment of ACI. Moreover, the combination of ligustrazine injection did not result in adverse reactions for ACI patients.

ACI is the ischemic necrosis or cerebral softening of local brain tissues caused by the obstruction of acute local blood supply in brain tissues, ischemia, and hypoxia (Regenhardt et al., 2018). The decrease or interruption of cerebral blood flow is the main reason of ACI, which seriously damages the function of the nervous system. Clinical efficacy of ligustrazine in the remediation of neurological deficits and reduction of the fibrinogen, LBV, and HBV has been demonstrated by many pharmacological experiments. Kong et al. found that ligustrazine could promote neural progenitor cells move to the damaged area by activating the phosphatidylinositol 3-kinase pathway to achieve the protective effect on the brain (Kong et al., 2016). Whole-blood viscosity and platelet aggregation are usually used as the prognostic indicators of ischemic cerebral and myocardial diseases. Cai et al. confirmed that ligustrazine could significantly decrease whole-blood viscosity and inhibit platelet aggregation through down-regulate the expression of CXCR4 in platelets, lymphocytes, and blood red cells (Cai et al., 2014). These available evidences also consistently supported the adjunctive use of ligustrazine injection in the treatment of ACI.

ACI, acute cerebral infarction; CI, confidence interval; CNKI, China national knowledge infrastructure; HBV, high shear blood viscosity; LBV, low shear blood viscosity; LSI, ligustrazine injection; MD, mean difference; NDS, neurological deficit score; RCTs, randomized controlled trials; RR, relative risk; rt-PA, recombinant tissue plasminogen activator; TCM, traditional Chinese medicine; UK, urokinase; VIP, China Science and Technology Journal Database; WM, western medicine.

Cai, X., Chen, Z., Pan, X., Xia, L., Chen, P., Yang, Y., et al. (2014). Inhibition of Angiogenesis, Fibrosis and Thrombosis by Tetramethylpyrazine: Mechanisms Contributing to the SDF-1/CXCR4 Axis. Plos One 9, e88176. doi:10.1371/journal.pone.0088176

Zhang, Y. H., Cai, X. Z., and Guo, M. H. (2013). Effects of Ligustrazine Injection on Serum High-Sensitivity C-Reactive Protein, Interleukin-6 and Matrix Metalloproteinases-9 in Treating Acute Cerebral Infarction. J. Clin. Med. Pract. 17, 78–80. (In Chinese). doi:10.7619/jcmp.201317026

After serum starvation for 24 h, cells were treated with inflammatory mediator or rapamycin (containing 100 nmol/L insulin or not) at 37 °C for 24 h. For analysis of glucose concentrations before and after the 24-hour treatment, the medium was spun down in a centrifuge column and subjected to glucose analysis in a GOPOD kit (Rongsheng Biotech, Shanghai, China) according to the manufacturer’s instructions.