Effectiveness of telehealth interventions on depression symptoms after stroke: A systematic review and meta-analysis.

BACKGROUND: Depression symptoms are common after stroke, and affect survivors' recovery of neurological function, ability to return to society, and quality of life. Telehealth has been shown to improve depression symptoms and quality of life among patients post-stroke. However, evidence from clinical trials has not previously been systematically synthesized. OBJECTIVE: This study aimed to systematically evaluate the effectiveness of telehealth interventions in reducing depression symptoms among patients post-stroke. METHODS: Following the PRISMA guidelines, we conducted a meta-analysis of randomized control trials of telehealth interventions for post-stroke depression symptoms. The quality of included studies was assessed using the Cochrane risk of bias tool. RevMan 5.4 software was used for the meta-analysis. Data were synthesized by fixed (I2 ≤ 50 %) or random (I2 > 50 %) effects models based on a heterogeneity test. RESULTS: In total, ten studies with 1717 participants were included, eight of which were eligible for the meta-analysis. There were no significant differences in efficacy between the telehealth and control groups for depression symptoms (standardized mean difference [SMD] = -0.16, 95 % confidence interval [CI] -0.67 to 0.36; P = .54), quality of life (SMD = 0.00, 95%CI -0.18 to 0.18; P = .99), limb function (SMD = 0.46, 95%CI -0.26 to 1.18; P = .21), and daily living ability (SMD = 0.38, 95%CI -1.39 to 2.15; P = .67). The telemedicine group had significantly lower anxiety scores than the control group (SMD = -1.05, 95%CI -1.22 to -0.89; P < .001). LIMITATIONS: The number of randomized controlled trials (RCTs) included in the review was relatively small. CONCLUSIONS: This study suggests that telehealth interventions have comparable effects to usual nursing care in improving depression symptoms after a stroke. However, large-scale, high-quality RCTs are needed to further explore the potential of telehealth interventions in improving mental health among patients post-stroke.

Low-dose interleukin-2 can improve salivary secretion but not lymphocyte infiltration of salivary glands in a murine model of Sjögren's syndrome.

INTRODUCTION/AIM: Effects of low-dose interleukin-2 (IL-2) on the exocrine glandular glands of Sjögren's syndrome are unknown. The aim of this study was to investigate the effects of low-dose IL-2 on salivary gland structure and function in a murine model of Sjögren's syndrome. MATERIALS AND METHODS: Non-obese diabetic/Ltj (NOD) mice were used as the animal model of Sjögren's syndrome, and low-dose IL-2 or phosphate buffered saline was administered subcutaneously from 5 weeks of age, while ICR mice were used as controls. Some mice were sacrificed at 9 weeks of age, while the other mice that continued to receive treatment were sacrificed at 23 weeks. We determined the salivary flow rate of mice every 3 weeks during the intervention. After the mice were sacrificed, one submandibular gland was removed for pathological evaluation, while the other submandibular gland was used to measure the levels of 25 cytokines by Luminex technology. Cervical lymph nodes and spleens were examined by flow cytometry for the proportions of CD8+ T cells and Treg cells. RESULTS: The results showed that the salivary flow rate of NOD mice was slower than that of control-group mice, and there were more pathological changes in the submandibular gland. The levels of many cytokines in the submandibular gland were elevated. The proportion of CD8+ T cells in the cervical lymph nodes and spleens was increased; however, the proportion of Treg cells was decreased. After treatment with IL-2, the exocrine function of the salivary glands of mice was improved. IL-2 also promoted the proliferation of Treg cells in the cervical lymph nodes and spleens, but it did not alter the extent of lymphocyte infiltration in the submandibular gland. The levels of cytokines in the submandibular glands, as well as the proportion of CD8+ T cells in the cervical lymph nodes and spleens, were unchanged significantly after IL-2 treatment. CONCLUSION: Our results demonstrate that treatment with low-dose IL-2 improves the secretory function of the exocrine glands of mice with Sjögren's syndrome, but it does not reverse the structural damage of the exocrine glands.

Dendrobium officinale leaf polysaccharides ameliorated hyperglycemia and promoted gut bacterial associated SCFAs to alleviate type 2 diabetes in adult mice.

The present study aimed to explore the possible mechanisms underlying Dendrobium officinale leaf polysaccharides of different molecular weight to alleviate glycolipid metabolic abnormalities, organ dysfunction and gut microbiota dysbiosis of T2D mice. An ultrafiltration membrane was employed to separate two fractions from Dendrobium officinale leaf polysaccharide named LDOP-A and LDOP-B. Here, we present data supporting that oral administration of LDOP-A and LDOP-B ameliorated hyperglycemia, inhibited insulin resistance, reduced lipid concentration, improved ß-cell function. LDOP-A with lower molecular weight exhibited improved effect on diabetes than LDOP-B, concurrent with increased levels of colonic short-chain fatty acids (SCFAs) i.e., butyrate, decreased ratio of Firmicutes to Bacteroidetes phyla, and increased abundance of the gut beneficial bacteria i.e., Lactobacillus, Bifidobacterium and Akkermansia. These results suggest that LDOP-A possesses a stronger effect in ameliorating T2D than LDOP-B which may be related to the distinct improved SCFAs levels produced by the change of intestinal flora microstructure.

Dendrobium officinale leaf polysaccharides regulation of immune response and gut microbiota composition in cyclophosphamide-treated mice.

In this study, the polysaccharides extracted from Dendrobium officinale leaf (DOLP) was used in immune deficiency mice to evaluate the bioactivity. Thymus and spleen indices were calculated while the alleviation of the colon and liver histopathological progression was evaluated by H&E staining. The data indicated that DOLP improved immunity status by restoring the gut barrier and atrophy of immune organs. Cytokines levels as marker of inflammation were determined using ELISA in serum and colon. Which proved that DOLP inhibited the expression of pro-inflammatory cytokines (TNF-α, TGF- ß1, IL-6, IL-1ß) and promoted the expression of anti-inflammatory cytokines (IL-10). Short chain fatty acids (SCFAs) levels and microbial composition in feces were determined using GS and high-throughput sequencing. DOLP improved gut microbiota by increasing the relative abundance of total bacteria and probiotics such as Bacteroides, Lactobacillus and Lachnospiraceae. Therefore, DOLP has potential effect for the treatment of chronic immune diseases.

Inulin fructans in diet: Role in gut homeostasis, immunity, health outcomes and potential therapeutics.

Inulin consumption in both humans and animal models is recognized for its prebiotic action with the most consistent change that lies in enhancing the growth and functionality of Bifidobacterium bacteria, as well as its effect on host gene expression and metabolism. Further, inulin-type fructans are utilized in the colon by bacterial fermentation to yield short-chain fatty acids (SCFAs), which play important role in its biological effects both locally inside the gut and in systemic actions. The gut symbiosis sustained by inulin supplementation among other dietary fibers exerts preventive and/or therapeutic options for many metabolic disorders including obesity, type 2 diabetes mellitus, cardiometabolic diseases, kidney diseases and hyperuricemia. Although, gastrointestinal negative effects due to inulin consumption were reported, such as gastrointestinal symptoms in humans and exacerbated inflammatory bowel disease (IBD) in mice. This comprehensive review aims to present the whole story of how inulin functions as a prebiotic at cellular levels and the interplay between physiological, functional and immunological responses inside the animal or human gut as influenced by inulin in diets, in context to its structural composition. Such review is of importance to identify management and feed strategies to optimize gut health, for instance, consumption of the tolerated doses to healthy adults of 10 g/day of native inulin or 5 g/day of naturally inulin-rich chicory extract. In addition, inulin-drug interactions should be further clarified particularly if used as a supplement for the treatment of degenerative diseases (e.g., diabetes) over a long period. The combined effect of probiotics and inulin appears more effective, and more research on this synergy is still needed.

Association between the Platelet-Derived Growth Factor/Platelet-Derived Growth Factor Receptor System and Risk of Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.

This research examines the association between the platelet-derived growth factor/platelet-derived growth factor receptor (PDGF/PDGFR) system and rheumatoid arthritis (RA) susceptibility through a comprehensive search of the PubMed database to study the expression of the PDGF/PDGFR system in RA. Review Manager software version 5.3 was used for statistical analysis. Six eligible studies published in the English language were included, including 108 rheumatoid arthritis cases and 85 controls with the corresponding 126 and 97 tests, respectively, relating the expression of the PDGF/PDGFR system to the risk of RA. The overall results indicated a significant association between the PDGF/PDGFR system expression and RA (OR = 5.25, 95% CI: 3.00-9.18, p < 00001), RA patients in Asian countries (OR = 4.13, 95% CI = 2.04-8.39, p < 0.0001) and in Western countries (OR = 9.18, 95% CI = 2.04-8.39, p = 0.03), and only PDGF expression in RA patients (OR = 5.28, 95% CI = 2.73-10.21, p < 0.00001). Thus, only the PDGFR expression was insignificantly associated with RA susceptibility (OR = 9.25, 95% CI = 0.63-136.30, p = 0.11). Hence, the PDGF/PDGFR system most likely contributes to susceptibility to RA.

Synergistic cytotoxicity of erianin, a bisbenzyl in the dietetic Chinese herb Dendrobium against breast cancer cells.

Erianin (ER), a dietary compound extracted from Dendrobium, a traditional Chinese medicinal edible herb, is well recognized for its potential anti-cancer activity. Nevertheless, its limitations, regarding its complex isolation procedure, low yield and low water solubility, limit large scale application. Combinatorial therapeutic regimen that combines several drugs to target different pathways in a characteristically synergistic manner at lower doses of drugs proved effective in several diseases treatment. Besides, new knowledge aimed at improving drug delivery into the intracellular environment is essential. In this study, ER was assessed for its cytotoxic effect in combination with doxorubicin hydrochloride (DOX·HCl) against breast cancer cells. Drug synergy was calculated by using combination index (CI) index and we discovered that they had positive effects. To ensure uniform delivery of both drugs to cells for a desired synergistic action, a dual drug loaded liposomes was developed using thin-film dispersion, and coated by a layer of folate-chitosan. Cytotoxicity and cell proliferation based assays revealed the increase of cell inhibition rate by more than 30% compared with free drugs. Fluorescence imaging revealed that liposomes can aid faster drugs accumulate in cancer cells. The study presented a novel strategy for the treatment of breast cancer.