Treatment of diabetic foot with moxibustion: Clinical evidence from meta-analysis.

To assess the efficacy of moxibustion for diabetic foot, and compile the findings of randomised clinical trials. China National Knowledge Infrastructure Database, Medicine, WanFang Database, Embase, Chinese Scientific Journal Database and Web of Science were from the establishment to January, 2024 were searched. Randomised controlled trials, which evaluated the effects of moxibustion were included. A total of 12 randomised controlled trials involving 1196 patients were included. According to the pooled results of this meta-analysis, effective rate (relative risk 1.16, 95% confidence intervals, CI [1.11, 1.22]), healing time (mean difference [MD] -6.27, 95% CI [-8.68, -3.86]), wound area (MD 3.46, 95% CI [0.84, 6.09]), and ankle brachial index (MD 0.14, 95% CI [0.03, 0.24]) were statistically significant compared to the control group. This study suggests that moxibustion treatment has the potential for improving symptoms of diabetic foot. However, future in-depth research on the benefits and harms of moxibustion for the diabetic foot is needed before it can be accepted as an evidence-based treatment.

Quality of evidence supporting the role of hyperbaric oxygen therapy for diabetic foot ulcers.

The goal of this overview of systematic reviews (SRs) and meta-analyses (MAs) was to methodically gather, evaluate and summarize the data supporting the use of hyperbaric oxygen therapy (HBOT) to treat diabetic foot ulcers (DFUs). The Cochrane Library, Embase, PubMed, Web of Science and Embase were all searched thoroughly to identify SRs/MAs that qualified. AMSTAR-2 tool, PRISMA checklists and GRADE system were applied by two reviewers independently to assess the methodological quality, reporting and evidence quality of the included SRs/MAs, respectively. Eleven SRs/MAs were enrolled in this overview. According to AMSTAR-2, a very low methodological quality assessment was given to the included SRs/MAs due to the limitations of items 2, 4 and 7. For the PRISMA, the overall quality of reporting is not satisfactory due to missing reporting on protocol, search, as well as additional analysis. The majority of outcomes had low- to moderate-quality evidence, and no high-quality evidence was found to support the role of HBOT for DFUs, according to GRADE. To conclude, the potential of HBOT in treating DFUs is supported by evidence of low to moderate quality. More rigorously designed, high-level studies are needed in the future to determine the evidence for HBOT for DFU, including the timing, frequency and duration of HBOT interventions.

Correlation between MRI features and CSF inflammatory factor levels in patients with infarction or TIA, assessed by contrast-enhanced high-resolution MRI.

OBJECTIVE: To explore the correlation between the time course of CE-T1WI plaque and the level of CSF inflammatory factors in patients with cerebral infarction or TIA assessed by contrast-enhanced high-resolution MRI. METHODS: From August 2019 to December 2021, 136 patients with ischemic stroke-related neurological symptoms or suspected ischemic stroke in Gong'an County Hospital of Traditional Chinese Medicine were retrospectively analyzed, including 69 men and 67 women aged 45-80 years old, with an average age of 65.98±8.29. The study was divided into two groups: infarction group (patients with high DWI signal in the middle cerebral artery supply area, n=68) and TIA group (patients with ischemic neurologic symptoms but no relevant imaging findings, n=68). Patients with grade 1 or grade 2 image quality were included in the study after imaging with a 3.0T MRI device. Unenhanced MRI (T1WI and T2WI) and contrast-enhanced T1WI (CE+T1WI) plaque signals were compared between the two groups. The expression levels of TNF-α, IL-6, and IL-1ß in CSF of the two groups were detected by ELISA. VAMLN, LAMLN, PA, stenosis rate, and reconstruction index were compared between the two groups. The SNR and CNR values on T1WI and CE+T1WI were compared. The expression levels of TNF-α, IL-6, and IL-1ß detected by ELISA in cerebrospinal fluid of patients with CE-T1WI plaque enhancement were compared. RESULTS: The expression levels of TNF-α, IL-6, and IL-1ß in the cerebral infarction group were higher than those in the TIA group (P<0.05). Comparing the VAMLN, LAMLN, PA, stenosis rate and remodeling index of the two groups, the VAMLN, PA, and remodeling index of the cerebral infarction group were higher than in the TIA group (P>0.05), and there was no significant difference in VAMLN and stenosis rate between groups (P<0.05). Comparing the plaque SNR and CNR values on T1WI and CE+T1WI, the signal intensity, adjacent signal intensity, SNR, and CNR of carotid plaque on CE+T1WI were higher than those on T1WI (P>0.05). The expression levels of TNF-α, IL-6, and IL-1ß in the moderate enhancement group were higher than those in the non-enhancement group, and the expression levels of TNF-α, IL-6 and IL-1ß in the high enhancement group were higher than those in the moderate enhancement group (P<0.05). CONCLUSION: The temporal variation of CE-T1WI plaque was positively correlated with the level of cerebrospinal fluid inflammatory factors. High levels of inflammatory factors, positive remodeling, and significant enhancement were closely related to unstable plaque, which may increase the risk of stroke in patients with atherosclerosis.

Strategy for cost-effective BMPs of non-point source pollution in the small agricultural watershed of Poyang Lake: A case study of the Zhuxi River.

In recent years, Poyang Lake has been affected by severe agricultural non-point source (NPS) pollution, a global water pollution problem. The most recognized and effective control measure for agricultural NPS pollution is the strategic selection and placement of best management practices (BMPs) for critical source areas (CSAs). The present study employed the Soil and Water Assessment Tool (SWAT) model to identify CSAs and evaluate the effectiveness of different BMPs in reducing agricultural NPS pollutants in the typical sub-watersheds of the Poyang Lake watershed. The model performed well and satisfactorily in simulating the streamflow and sediment yield at the outlet of the Zhuxi River watershed. The results indicated that urbanization-oriented development strategies and the Grain for Green program (returning the grain plots to forestry) had certain effects on the land-use structure. The proportion of cropland in the study area decreased from 61.45% (2010) to 7.48% (2018) in response to the Grain for Green program, which was mainly converted to forest land (58.7%) and settlements (36.8%). Land-use type changes alter the occurrence of runoff and sediment, which further affect the nitrogen (N) and phosphorus (P) loads since sediment load intensity is a key factor affecting the P load intensity. Vegetation buffer strips (VBSs) proved the most effective BMPs for NPS pollutant reduction, and the cost of 5-m VBSs proved the lowest. The effectiveness of each BMP in reducing N/P load ranked as follows: VBS > grassed river channels (GRC) > 20% fertilizer reduction (FR20) > no-tillage (NT) > 10% fertilizer reduction (FR10). All combined BMPs had higher N and P removal efficiencies than the individual measures. We recommend combining FR20 and VBS-5m or NT and VBS-5m, which could achieve nearly 60% pollutant removal. Depending on the site conditions, the choice between FR20+VBS and NT + VBS is flexible for targeted implementation. Our findings may contribute to the effective implementation of BMPs in the Poyang Lake watershed and provide theoretical support and practical guidance for agricultural authorities to perform and direct agricultural NPS pollution prevention and control.

Effects of incorporation with clove (Eugenia caryophyllata) essential oil (CEO) on overall performance of chitosan as active coating.

This research is focused on improving performance of chitosan based functional material by introducing active additive. A series of assays revealed incorporation with clove essential oil (CEO) significantly improved the physical, chemical and antimicrobial performance of chitosan. In this work, the prepared chitosan-CEO film (CH-CEO) showed varieties in color parameters, mechanical strength and water vapor permeability. Moreover, chitosan was endowed with significant antioxidant and antimicrobial activities, thereby it was used as protective coatings for fresh-cutting apple tubes at ~1 °C. Results demonstrated the treatment slowed down the quality deterioration process of preserved apple samples, especially for firmness and color. As well, CH-CEO coating reduced microbial counts in the preserved apple samples and inhibited the varieties in the chemical properties. The overall observations revealed that CH-CEO film has remarkable potential as an antioxidant and antimicrobial material, especially as an active coating for fresh-cutting foods during storage.

Chitosan-based bifunctional composite aerogel combining absorption and phototherapy for bacteria elimination.

The bacterial infection is one of the most common but critical problems in the wound healing process due to the general antibiotic resistance of bacteria. Hence it is increasingly necessary and urgent to develop an advanced and efficient sterilization strategy. Herein, a chitosan-based aerogel embedded amino-functionalized molybdenum disulfide nanosheets (abbreviated to CS/NMNSs) was successfully constructed through amino modification and physical assembly. Scanning electron microscopy characterizations and swelling experiments indicated that freeze-dried chitosan aerogel is provided with extremely regular sponge-like structure, high porosity, and favorable swelling property. The CS aerogel can be used as an ideal bacterial adsorption agent ascribed to its inherent positive charge. The result of antibacterial studies showed that the CS/NMNSs exhibited efficient bacterial elimination capacity via capture ability of chitosan aerogel and near infrared induced photothermal sterilization. Therefore, the CS/NMNSs have great potential in developing as a photothermal antibacterial agent in future application.

A bifunctional nanoplatform based on copper manganate nanoflakes for bacterial elimination via a catalytic and photothermal synergistic effect.

Bacterial infection has been recognized as one of the greatest threats to public health. In view of the continuous increase of bacterial resistance, constructing a collaborative bactericidal platform is a promising strategy to enhance the efficiency of antimicrobial agents. Herein, we report a facile, biocompatible and versatile nano-platform based on positively charged copper manganate nanoflakes (CuMnO2 NFs), which exhibits intrinsic peroxidase-like catalytic activity and excellent photothermal properties. The CuMnO2 NFs can bind with negatively charged bacteria via electrostatic interactions, and generate hydroxyl radicals (˙OH) through catalysis involving hydrogen peroxide (H2O2) to make bacteria more susceptible to temperature. Introducing near-infrared light generates hyperthermia to fight against bacteria and enhances the peroxidase-like catalytic activity of the CuMnO2 NFs, thus producing more ˙OH to combat bacteria. The PTT-enhanced ˙OH synergistic antibacterial strategy exerts desirable antibacterial efficiencies of 98.78% and 99.92% against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) at a controlled low temperature (below 50 °C), without damage to healthy tissues. Animal experiments indicate that this synergistic treatment has a better therapeutic effect on S. aureus-infected wounds in mice, compared with either treatment by itself. Therefore, this work holds great promise for developing new synergistic antimicrobial strategies to treat bacterial infections.

Multifunctional Magnetic Copper Ferrite Nanoparticles as Fenton-like Reaction and Near-Infrared Photothermal Agents for Synergetic Antibacterial Therapy.

Synergistic therapeutic strategies for bacterial infection have attracted extensive attentions owing to their enhanced therapeutic effects and less adverse effects compared with monotherapy. Herein, we report a novel synergistic antibacterial platform that integrates the nanocatalytic antibacterial therapy and photothermal therapy (PTT) by hemoglobin-functionalized copper ferrite nanoparticles (Hb-CFNPs). In the presence of a low concentration of hydrogen peroxide (H2O2), the excellent Fenton and Fenton-like reaction activity of Hb-CFNPs can effectively catalyze the decomposition of H2O2 to produce hydroxyl radicals (·OH), rendering an increase in the permeability of the bacterial cell membrane and the sensitivity to heat. With the assistance of NIR irradiation, hyperthermia generated by Hb-CFNPs can induce the death of the damaged bacteria. Additionally, owing to the outstanding magnetic property of Hb-CFNPs, it can improve the photothermal efficiency by about 20 times via magnetic enrichment, which facilitates to realize excellent bactericidal efficacy at a very low experimental dose (20 µg/mL). In vitro antibacterial experiment shows that this synergistic antibacterial strategy has a broad-spectrum antibacterial property against Gram-negative Escherichia coli (E. coli, 100%) and Gram-positive Staphylococcus aureus (S. aureus, 96.4%). More importantly, in vivo S. aureus-infected abscess treatment studies indicate that Hb-CFNPs can serve as an antibacterial candidate with negligible toxicity to realize synergistic treatment of bacterial infections through catalytic and photothermal effects. Accordingly, this study proposes a novel, high-efficiency, and multifunctional therapeutic system for the treatment of bacterial infection, which will open up a new avenue for the design of synergistic antibacterial systems in the future.

Neferine in the Lotus Plumule Potentiates the Antitumor Effect of Imatinib in Primary Chronic Myeloid Leukemia Cells In Vitro.

Imatinib, the prototype BCR-ABL tyrosine kinase inhibitor (TKI), is the first-line treatment for Philadelphia chromosome-positive chronic myeloid leukemia (CML) in the chronic phase. However, a subgroup of patients exhibit poor response or experience relapse. This issue may be overcome by combination therapy using natural compounds. Neferine, a major bisbenzylisoquinoline alkaloid extracted from "lotus plumule" (seed embryo of lotus) commonly used in traditional Chinese medicine and tea, was used herein in the combination treatment of CML. The MTT assay showed that neferine exerted cytotoxicity in primary CML cells in a dose-dependent manner. Moreover, low concentrations of neferine (4 and 8 µM) sensitized primary CML cells to imatinib (CI < 1), and significantly decreased its IC50 from 0.70 ± 0.10 to 0.32 ± 0.06 µM and 0.16 ± 0.02 µM, respectively. Cotreatment of neferine and imatinib significantly decreased the expression of BCR-ABL protein and its molecular chaperone heat shock protein 90 (Hsp90) mRNA and protein levels, and further decreased phospho-extracellular regulated protein kinase 1/2 (p-Erk1/2) and myeloid cell leukemia (Mcl-1) expression. These results suggest that neferine might be a potential imatinib sensitizer in CML treatment. PRACTICAL APPLICATION: In China, Lotus plumule, the green embryo of lotus, is used as a tea and as a source of herbal medicine in the treatment of anxiety, insomnia, spermatorrhea, and thirst. Additional, neferine, a bisbenzylisoquinoline alkaloid extracted from lotus plumule has been shown to have antitumor potential. Herein, the effect of neferine and imatinib cotreatment on primary CML cells obtained from CML patients was assessed, with a synergistic effect being observed between the two compounds. Therefore, neferine might be a promising natural compound to potentiate imatinib in CML patients.

[Effects of aqueous extracts of gecko on stemness of hepatocellular carcinoma].

To explore the effects and mechanism of aqueous extracts of gecko on cancer stem cells properties of hepatocellular carcinoma. In vitro, MTT assay was used to detect the cells growth in Huh7 and Hep3B. Spheroid-forming assay and flow cytometry were performed to observe the the stemness of Huh7 and Hep3B cells. The protein expressions of ß-catenin, CD44, c-Myc, CCND1, Sox2, Oct4, Nanog and ABCG2 were detected by Western blot. Interacting proteins were detected by co-immunoprecipitation; and a subcutaneous xenograft model was used to detect the stemness of hepatoma carcinoma cells. The results indicated that aqueous extracts of gecko induced cell growth inhibition in a dose- and time-dependent manner, with the IC50 of (0.750±0.112) g•mL⁻¹ for Huh7 and (0.454±0.039) g•mL⁻¹ for Hep3B, respectively. The number and size of tumor spheres formed by hepatoma carcinoma cells were decreased after treatment by aqueous extracts of gecko(P<0.05); the proportions of cells staining with putative markers for cancer stem cells, such as CD133 and CD44, were decreased(P<0.05). After treatment with aqueous extracts of gecko, the expression levels of ß-catenin, CD44, c-Myc, CCND1, Sox2, Oct4, Nanog and ABCG2 were decreased. Co-immunoprecipitation results showed that the aqueous extracts of gecko could inhibit the interaction between LRP6 and Frizzled6, indicating that the aqueous extracts of gecko could inhibit the proliferation of hepatoma cells, the formation of tumor spheres and the proportion of tumor stem cells, and inhibit the Wnt signaling pathway by targeting LRP6 to prevent the formation of LRP6 and Frizzled6 complexes.

Lichong decoction reduces Matrix Metalloproteinases-2 expression but increases Tissue Inhibitors of Matrix Metalloproteinases-2 expression in a rat model of uterine leiomyoma.

OBJECTIVE: To study the effect of Lichong decoction (LD) on expression of matrix metalloproteinase- 2 (MMP-2) and metalloproteinase-2 (TIMP-2) in a rat model of uterine leiomyoma (UL). METHODS: UL was induced in rats using exogenous estrogen and progesterone. LD was administered (p.o.) for 4 weeks, and mifepristone (RU-486) used as a control. To observe the effect of LD on the uterine coefficient and uterine transverse diameter, a radioimmunoassay method was used to detect serum levels of sex hormones. Light microscopic analyses of pathologic changes in the tissues of UL rats were evaluated. Expression of the proteins of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in uterine tissues was assessed by immunohistochemical staining and western blotting. RESULTS: A UL model in rats was established successfully. LD reduced uterine weight, uterine coefficient, and uterine transverse diameter compared with untreated controls. LD reduced levels of estradiol, progesterone, follicle-stimulating hormone, and luteinizing hormone in our UL models. LD improved the pathologic condition of uterine muscle. Expression of MMP-2 protein decreased to varying extents in LD-treated groups, but TIMP-2 levels were enhanced. LD appears to reduce MMP-2 expression and increase TIMP-2 expression in UL tissue. CONCLUSION: These data suggest that the mechanism of action of LD on ULs may involve reduction of MMP-2 expression and increase in TIMP-2 expression in rats.

[Treatment of diabetic foot by clearing heat, detoxification, activating blood, and dredging collaterals method].

OBJECTIVE: To study the mechanism of treating diabetic foot by clearing heat, detoxification, activating blood, and dredging collaterals method. METHODS: Sixty diabetic foot patients were randomly assigned to the treatment group and the control group, 30 cases in each group. On the basis of the same routine treatment, patients in the treatment group were treated by Qingjie Tongluo Recipe (QTR) plus external washing of Chinese herbs plus external dressing by herbs with removing necrosis and promoting granulation actions, while those in the control group were treated with routine aseptic external dressing. Three months was taken as one therapeutic course. The wound area and basic fibroblast growth factor (bFGF) were detected before and after treatment. The content of vascular endothelial growth factor (VEGF), the peripheral vascular and nerve functions were also measured. The therapeutic effects were also observed. RESULTS: After treatment, in the treatment group,15 patients were cured, 12 markedly effective, 2 effective, 1 ineffective, the cure rate was 50.0% and the total effective rate was 96.7%, while in the control group, 9 cases were cured, 6 markedly effective, 8 effective, 7 ineffective, the cure rate was 30.0% and the total effective rate was 76.7%. The total effective rate was better in the treatment group than in the control group (P <0. 01). The contents of bFGF and VEGF were significantly higher in the two groups after treatment (P <0.01). Besides, better results were obtained in the treatment group (P < 0.01). The blood flow speed of the dorsalis pedis artery, the inner diameter of the dorsalis pedis artery, and the common peroneal nerve conduction velocity were somewhat improved (P <0.05, P <0.01). Besides, better results were obtained in the treatment group (P <0.01). CONCLUSIONS: QTR combined external washing plus external dressing by herbs with removing necrosis and promoting granulation actions could promote the healing of diabetic foot induced ulcers, improve the vascular and nerve functions. Its efficacy was superior to that of the control group.

Effect of lichong decoction on expression of IGF-I and proliferating cell nuclear antigen mRNA in rat model of uterine leiomyoma.

OBJECTIVE: To study the effect of Lichong Decoction (Lichong Decoction for strengthening anti-pathogenic Qi and eliminating blood stasis) on the expression of insulin-like growth factor-I (IGF-I) and proliferating cell nuclear antigen (PCNA) mRNA in a rat model of uterine leiomyoma. METHODS: Fifty female Wistar rats were randomized into a normal control group, model group, Lichong Decoction group, Guizhifuling Capsule (Capsule containing Cassia Twig and Poria) group, and Mifepristone group. The uterine leiomyoma model was established by peritoneal injections of exogenous estrogen and progesterone hormone. The ultrastructural changes in cells of rat uterine tissues were observed with transmission electron microscopy, and the expression of IGF-I and PCNA mRNA was detected by real-time fluorescent quantitative PCR. RESULTS: Following treatment, cells in the Lichong Decoction group appeared to be arranged normally, the cellular morphology were almost in a normal state, hyperplasia and hypertrophy of the chondriosome was reduced, collagen fibers were arranged in a regular manner, without obvious hyperplasia, and the expression of IGF-I and PCNA mRNA was significantly decreased compared with the model group (P < 0.01). CONCLUSIONS: The effect of Lichong Decoction on uterine leiomyoma is related to its function in reducing the expression of IGF-I and PCNA mRNA.

The appearance of a protein kinase A-regulated splice isoform of slo is associated with the maturation of neurons that control reproductive behavior.

In response to brief synaptic stimulation that activates protein kinase A (PKA), the bag cell neurons of Aplysia trigger the onset of reproductive behaviors by generating a prolonged afterdischarge. In juvenile animals, such afterdischarges are inhibited by a high density of Ca2+ -activated K+ (BK) channels, encoded by the slo gene. An increase in this current also follows an afterdischarge in mature animals, contributing to a subsequent refractory state that limits reproductive behaviors. Using a bag cell cDNA library, we have isolated two alternative transcripts of the slo gene, differing in the presence (slo-a) or absence (slo-b) of a consensus phosphorylation site for PKA. Expression of either isoform in Chinese hamster ovary cells produced Ca2+ - and voltage-dependent channels with macroscopic and unitary properties matching those in bag cell neurons. The isoforms differed, however, in their response to application of the catalytic subunit of PKA, which reduced the open probability of Slo-a, an effect that was reversed by a PKA inhibitor. In contrast, PKA had no effect on Slo-b. By immunocytochemistry, we determined that the PKA-regulated Slo-a subunit is present in adult, but not juvenile, bag cell neurons. Patch clamp recordings from adult and juvenile bag cell neurons confirmed that PKA decreases BK channel activity only in adults. Our findings suggest that a change in the identity of Slo isoforms expressed during development allows mature neurons to generate afterdischarges that are required for reproduction.