Efficacy and Safety of Chinese Herbal Medicine in Patients with Acute Intracerebral Hemorrhage: Protocol for a Randomized Placebo-Controlled Double-Blinded Multicenter Trial.

INTRODUCTION: The popular traditional Chinese medicine (TCM) compound FYTF-919 (Zhong Feng Xing Nao prescription) may improve outcome from acute intracerebral hemorrhage (ICH) through effects on brain edema, hematoma absorption, and the immune system. This study is to assess whether FYTF-919 is safe and effective as compared to matching placebo treatment in patients with acute ICH. METHODS: The ongoing Chinese Herbal medicine in patients with Acute INtracerebral hemorrhage (CHAIN) is a multicenter, prospective, randomized, double-blind placebo-controlled trial of FYTF-919 in patients with acute ICH at 20-30 hospital sites in China. Eligible ICH patients presenting within 48 h after symptom onset are randomly allocated to receive either FYTF-919 (100 mL per day × 28 d, oral) or matching placebo. A sample size of 1,504 patients is estimated to provide 90% power (α 0.05) to detect a ≥20% improvement in average utility-weight scores on the modified Rankin scale (UW-mRS) assessed at 90 days, with 6% non-adherence and 10% lost to follow-up. The primary efficacy outcome is UW-mRS at 90 days. Secondary outcomes include binary measures of the mRS, neurological impairment on the National Institute of Health Stroke Scale, and health-related quality of life on the EuroQol EQ-5D-5L scale at different time points over 6 months of follow-up. The key safety measure is serious adverse events. CONCLUSION: CHAIN is on schedule to provide reliable evidence over the benefits of a popular herbal TCM for the treatment of acute ICH.

A Fast-Response Ultraviolet Phototransistor with a PVK QDs/ZnO Nanowire Heterostructure and Its Application in Pharmaceutical Solute Detection.

The sensitivity and photoelectric noise of UV photodetectors are challenges that need to be overcome in pharmaceutical solute detection applications. This paper presents a new device concept for a CsPbBr3 QDs/ZnO nanowire heterojunction structure for phototransistors. The lattice match of the CsPbBr3 QDs and ZnO nanowire reduces the generation of trap centers and avoids carrier absorption by the composite center, which greatly improves the carrier mobility and high detectivity (8.13 × 1014 Jones). It is worth noting that by using high-efficiency PVK quantum dots as the intrinsic sensing core, the device has a high responsivity (6381 A/W) and responsivity frequency (300 Hz). Thus, a UV detection system for pharmaceutical solute detection is demonstrated, and the type of solute in the chemical solution is estimated by the waveform and the size of the output 2f signals.

Gut microbiota composition reflects disease progression, severity and outcome, and dysfunctional immune responses in patients with hypertensive intracerebral hemorrhage.

Objective: In this study, we aimed to explore the alterations in gut microbiota composition and cytokine responses related to disease progression, severity, and outcomes in patients with hypertensive intracerebral hemorrhage (ICH). Methods: Fecal microbiota communities of 64 patients with ICH, 46 coronary heart disease controls, and 23 healthy controls were measured by sequencing the V3-V4 region of the 16S ribosomal RNA (16S rRNA) gene. Serum concentrations of a broad spectrum of cytokines were examined by liquid chips and ELISA. Relationships between clinical phenotypes, microbiotas, and cytokine responses were analyzed in the group with ICH and stroke-associated pneumonia (SAP), the major complication of ICH. Results: In comparison with the control groups, the gut microbiota of the patients with ICH had increased microbial richness and diversity, an expanded spectrum of facultative anaerobes and opportunistic pathogens, and depletion of anaerobes. Enterococcus enrichment and Prevotella depletion were more significant in the ICH group and were associated with the severity and functional outcome of ICH. Furthermore, Enterococcus enrichment and Prevotella depletion were also noted in the SAP group in contrast to the non-SAP group. Enterococci were also promising factors in the prognosis of ICH. The onset of ICH induced massive, rapid activation of the peripheral immune system. There were 12 cytokines (Eotaxin, GM-CSF, IL-8, IL-9, IL-10, IL-12p70, IL-15, IL-23, IL-1RA, IP-10, RANTES, and TNF-α) changed significantly with prolongation of ICH, and the Th2 responses correlated with the 90-day outcomes. Cytokines TNF-α, IP-10, IL-1RA, IL-8, IL-18, and MIP-1ß in SAP group significantly differed from non-SAP group. Among these cytokines, only IP-10 levels decreased in the SAP group. Enterococcus was positively associated with IL-1RA and negatively associated with IP-10, while Prevotella was inversely associated in both the ICH and SAP groups. Conclusion: This study revealed that gut dysbiosis with enriched Enterococcus and depleted Prevotella increased the risk of ICH and subsequently SAP. The altered gut microbiota composition and serum cytokine profiles are potential biomarkers that reflect the inciting physiologic insult/stress involved with ICH.

Clinical Characteristics, Outcomes, and Risk Factors of Disease Severity in Patients With COVID-19 and With a History of Cerebrovascular Disease in Wuhan, China: A Retrospective Study.

Background and Purpose: Coronavirus disease 2019 (COVID-19) rapidly resulted in a pandemic. Information on patients with a history of cerebrovascular disease (CVD) infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is limited. This study investigated the clinical features and the risk factors of developing adverse outcomes in patients with COVID-19 and with previous CVD. Methods: This was a single-center retrospective clinical study including all the confirmed cases of COVID-19 at Wuhan Huoshenshan Hospital from February 4 to April 7, 2020. Differences in clinical characteristics were compared between patients with and without a history of CVD. The incidences of severe events comprising all-cause death, intensive care unit admission, shock, and mechanical ventilation usage during hospitalization in two groups were compared using propensity score matching analysis and multivariate logistic regression analyses. Besides, the risk factors of developing severe events in patients with COVID-19 who also have history of CVD were analyzed. Results: A total of 2,554 consecutive patients were included in our study, of whom 109 (4.27%) had a medical history of CVD. Patients with CVD tend to be older and with more comorbidities, including hypertension, diabetes, coronary heart disease, and chronic obstructive pulmonary disease. The levels of white blood cell, neutrophil, C-reactive protein, creatine kinase isoenzymes, and lactate dehydrogenase were higher, whereas the levels of lymphocyte and albumin were lower in the CVD group. Compared to those without CVD, patients with CVD were more likely to have severe events after age matching (12.8 vs. 5.7%, P = 0.012). After adjusting for the confounding effects of age, sex, smoking, and comorbidities, the odds ratio for developing severe events with a history of CVD was 2.326 (95% CI, 1.168-4.630; P = 0.016). Besides, patients with CVD, either with decreased lymphocyte count (OR 9.192, 95% CI, 1.410-59.902, P = 0.020) or increased blood urea nitrogen (OR 5.916, 95% CI, 1.072-32.641, P = 0.041), had a higher risk of developing severe events during hospitalization. Conclusions: Patients with CVD history tend to have adverse clinical outcomes after being infected with SARS-COV-2. Decreased lymphocyte counts and increased blood urea nitrogen levels may be risk factors for adverse outcomes in patients with COVID-19, and had CVD.

A new simple and rapid electrochemical method for the determination of hydroxyl radical generated by Fenton reaction and its application.

A simple and rapid electrochemical method to detect the hydroxyl radical is described. This method employed the reaction between.OH and dimethyl sulfoxide (DMSO) to generate quantitatively formaldehyde, which then reacted with hydrazine hydrochloride at pH 6.2. The product showed a second-order derivative cathodic wave with the peak potential of -1.08 V( vsSCE) by single sweep oscillopolarography. The electrochemical behavior of the product was investigated by single sweep oscillopolarography and cyclic voltammetry. The experimental conditions for the measurement were optimized and the scavenging activity of some flavonoids on hydroxyl radicals was studied.

A new simple and sensitive fluorometric method for the determination of hydroxyl radical and its application.

A simple and sensitive fluorometric method to detect the hydroxyl radical is described. This method employs the reaction between OH and dimethyl sulfoxide (DMSO) to generate quantitatively formaldehyde, which then reacts with ammonia and 1,3-cyclohexanedione (CHD) at pH 4.5. The product produces the characteristic fluorescence with its excitation and emission wavelength at 400.4 and 452.3 nm, respectively. The quantitative analysis of hydroxyl radical can be done through the determination of the fluorescence intensity. By the developed method, the scavenging abilities of some amino acids and flavonoids on hydroxyl radical are studied.