Soyeong Yun

Objectives: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in adolescents with significant reproductive and metabolic implications. Although East Asian traditional medicine (EATM) has shown potential in managing PCOS, no study has comprehensively compared its modalities in adolescents.Methods: This protocol outlines a Bayesian network meta-analysis of randomized controlled trials assessing herbal medicine, acupuncture, and other EATM interventions versus conventional treatment or placebo in adolescents (≤19 years) diagnosed with PCOS. Comprehensive database searches will include PubMed, Embase, CENTRAL, and East Asian sources. Risk of bias will be evaluated using RoB2, and the certainty of evidence using CINeMA.Results: The primary outcome will be improvement in menstrual irregularity, assessed by cycle frequency, duration, and regularity. Secondary outcomes will include changes in serum hormone levels (luteinizing hormone, follicle-stimulating hormone, estradiol, testosterone, anti-Müllerian hormone) and the incidence of treatment-related adverse events. Comparative effectiveness and safety will be estimated using a Bayesian network meta-analysis under a random-effects model; the analysis will report mean differences with 95% credible intervals, assess inconsistency with node-splitting and heterogeneity with χ² (Q), τ², and I², and rank interventions via the surface under the cumulative ranking curve.Conclusions: This review will be the first to provide a ranked comparison of EATM interventions in adolescent PCOS. The findings are expected to guide clinical decision-making, promote safer and more effective individualized care, and support integrative approaches in adolescent PCOS management.

Background and Objectives: Heart failure with reduced ejection fraction (HFrEF) remains a significant burden. Traditional herbal medicines have shown cardioprotective effects in treating HFrEF. However, the implications of herbal formulation considering the dynamic immunohistological changes in the myocardium following acute ischemic injury have been insufficiently discussed. This review investigated the efficacy and mechanisms reported in studies using rat or mouse models of HFrEF induced by left descending coronary artery ligation. Materials and Methods: A systematic search was conducted using PubMed, Embase, AMED, CINAHL, and CENTRAL databases. Information was extracted regarding study characteristics, disease model induction protocols, intervention characteristics, treatment protocols, outcomes, and suggested mechanisms. Hierarchical cluster analysis of test drugs was performed based on constituent herb similarities. The risk of bias (RoB) was assessed using the Systematic Review Center for Laboratory animal Experimentation RoB tool. Results: Overall, 26 studies met the eligibility criteria. HF model induction periods after LADCA ligation ranged from 1 day to 12 weeks. Most studies administered the test drug for four weeks. Commonly used herbs included Panax ginseng, Astragalus membranaceus, Salvia miltiorrhiza, Carthamus tinctorius, and Lepidium apetalum, which demonstrated anti-fibrotic, anti-inflammatory, and anti-apoptotic effects through various signaling pathways. The overall RoB was relatively high. No significant association was found between model induction periods and herbal formulations or examined mechanisms. Conclusions: Future research should consider the time-dependent immunohistological features of the myocardium during HF treatment.