Ou (2021) Zhang 2021 Qin 2019 40/40 513/600 171/170 61.58 3.19/ 61.65 three.27 68 12/ 68 12 62.4 8.1/ 62.five 7.9 6 h 4.five h three h GDI + rtPA + CM GDI + rtPA + CM HES + rtPA + CM rt-PA + CM rt-PA + CM rtPA + CM six ml, qd 10 ml, qd 4 mg/kg 14 days 14 days 7 days mRS mRS mRS BFR, NIHSS NIHSS TGF-1,MMP2,MMP-9, TCD, NIHSS 7 NR NR Fatal symptomatic hemorrhage (two), coagulopathy (8) NR NR Symptomatic hemorrhage fatal (six), nonfatal (three), coagulopathy (ten) (Continued on following page)Li et al.ten.3389/fphar.2022.Note: GEDM, ginkgo endoterpene diester meglumine; GDI, ginkgolide injection; GBDP, ginkgo bilobate dropping pill; HES, hesperidin; GSRI, ginsenoside Rd injection; HSYA, hydroxysafflor yellow A; CM, traditional therapy; NBP, n-butylphthalide; EDV, edaravone; rt-PA, recombinant tissue plasminogen activator; DZXXI, Dengzhan Xixin injection; PLC, placebo; BR, blood routine; UR, urine routine; NIHSS, National Institute of Well being stroke scale; mRS, modified Rankin scale; NR, not reported; BFR, blood flow price; ADL, activities of daily living; NSE, neuron-specific enolase; hs-CRP, hypersensitive C-reactive protein; Fib, fibrinogen; FMA, Fugl-Meyer scale; PAdT, platelet adhesion test; PAgT, platelet aggregation test; CD62p, CD63, granule membrane glycoprotein; TGF-1, transforming growth factor; MMP-2, MMP-9, matrix metalloproteinases; TCD, transcranial Doppler; ADP, adenosine-5-diphosphate; PAF, platelet aggregation aspect; TXA2, thromboxane A2.Hepatobiliary disorders (6)Deterioration (20)2020), and HSYA (1 RCT, 6.7 ) (Hu et al., 2020). The course of treatment ranged from 7 days to 90 days. The detailed traits in the fifteen trials are summarized in Table 1.three.four Studies combining PAFRA with traditional treatment3.4.1 Ginkgo endoterpene diester meglumine (GEDM)GEDM is composed of ginkgolides A, B, and K, which are the key active compounds of PAFRAs. 5 trials investigated the use of GEDM in patients with AIS with CM, and a single trial (Su et al., 2018) utilized a placebo-controlled style to rule out the placebo impact as a partial explanation for differences in between groups. 3 trials measured long-term outcomes on D90 employing the mRS score. The mRS scores of individuals inside the GEDM combined with CM group on D90 have been lower than these of patients inside the group that received CM alone, plus the distinction was statistically considerable (p 0.SHH Protein Biological Activity 05) (Su et al.SARS-CoV-2 3CLpro/3C-like protease Protein manufacturer , 2018; Feng et al.PMID:27217159 , 2020; Sun et al., 2019). Having said that, one particular trial (Zheng and Jiang, 2018) discovered no difference within the mRS scores on D90 amongst the two groups (p 0.05). In addition, 1 trial (Huang et al., 2021) reported optimistic final results with reduce mRS scores on D60 inside the GEDM-treated group than in the CM group. In total, 5 articles reported that the mRS scores showed no statistical heterogeneity (p = 0.64, I2 = 0 ); hence, the fixed-effects model was employed for analysis. The results showed that the mRS scores of patients treated with GEDM combined with CM was decrease than these of individuals treated with CM alone [overall MD = -0.42, 95 CI (-0.47, -0.37), five trials, p 0.00001]. The forest plot and publication bias figure of GEDM combined with CM for AIS on mRS are presented in Supplementary Material S1. With regard to neurological function deficits, four articles reported the NIHSS scores with no statistical heterogeneity (p = 0.52, I2 = 0 ); thus, the fixed-effects model was utilized. The results showed that GEDM combined with CM was superior to CM alone in improving neurological function [overall M.