Comprehensive effects of traditional Chinese medicine treatment on heart failure and changes in B-type natriuretic peptide levels: A meta-analysis.

BACKGROUND: Heart failure (HF), a common cardiovascular condition, is characterized by significant morbidity and mortality. While traditional Chinese medicine (TCM) is often used as a complementary approach in HF management, systematic evaluations of its impact on clinical outcomes, TCM syndrome scores, and B-type natriuretic peptide (BNP) levels are lacking. This study fills this gap through a comprehensive analysis of randomized controlled trials (RCTs) focusing on TCM for HF treatment. It encompasses an assessment of methodological quality, a meta-analysis, and an evaluation of evidence quality based on established standards. The results offer crucial insights into the potential advantages and constraints of TCM in HF management. AIM: To systematically analyze the effects of TCM on the clinical comprehensive outcomes, TCM syndrome scores, and BNP levels in patients with HF and evaluated the quality of evidence for these trials. METHODS: RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases, including China National Knowledge Infrastructure, Wanfang, VIP Information Chinese Science and Technology Journal, and PubMed. Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool, and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software. Finally, the quality of evidence was rated according to the GRADE criteria. RESULTS: A total of 1098 RCTs were initially retrieved. After screening, 16 RCTs were finally included in our study, which were published between 2020 and 2023. These RCTs involved 1660 HF patients, including 832 in the TCM group [TCM combined with conventional Western medicine (CMW) treatment] and 828 in the CWM group (CWM treatment). The course of treatments varied from 1 wk to 3 months. TCM syndrome differentiation was analyzed in 11 of the included RCTs. In all included RCTs, outcome indicators included comprehensive clinical outcomes, TCM syndrome scores, and BNP levels. The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes [risk ratio = -0.54; 95% confidence interval (CI) = -0.61, -0.47; P < 0.00001], TCM syndrome scores [weighted mean difference (WMD) = -142.07; 95%CI = -147.56, -136.57; P < 0.00001], and BNP levels (WMD = -142.07; 95%CI = -147.56, -136.57; P < 0.00001). According to the GRADE criteria, RCTs where "TCM improves clinical comprehensive outcomes" were rated as low-quality evidence, and RCTs where "TCM reduces TCM syndrome scores" or "TCM decreases BNP levels" were rated as medium-quality evidence. CONCLUSION: TCM combined with CWM treatment effectively improves comprehensive clinical outcomes and diminishes TCM syndrome scores and BNP levels in HF patients. Given the low and medium quality of the included RCTs, the application of these results should be cautious.

Structural, gelation properties and microstructure of rice glutelin/sugar beet pectin composite gels: Effects of ionic strengths.

In this study, the rice glutelin (RG)/sugar beet pectin (SBP) composite gels were prepared by laccase induced cross-linking and subsequent heat treatment, and the effects of different calcium ion concentrations (0-400 mM) on the gelation, structural properties and microstructure of the RG/SBP composite gels were investigated. The results showed that the addition of 200 mM calcium ion could improve the rheological, textural properties and water holding capacity of the RG/SBP composite gels. The addition of SBP and calcium ions enhanced the hydrophobic interaction between RG molecules, thereby increased the gel properties of RG. The changes in Raman spectroscopy reflected the positive effect of the addition of SBP and calcium ions on the formation of a denser and more homogeneous protein gel, as evidenced by the results of scanning electron microscopy. Overall, SBP and calcium ions could be applied to the plant protein gel systems as gel-strengthening agents.

Biochanin A protects against angiotensin II-induced damage of dopaminergic neurons in rats associated with the increased endophilin A2 expression.

The brain renin-angiotensin system plays a vital role in the modulation of the neuroinflammatory responses and the progression of dopaminergic (DA) degeneration. Angiotensin II (Ang II) induces microglia activation via angiotensin II type 1 receptor (AT1R), which in turn affects the function of DA neurons. Endophilin A2 (EPA2) is involved in fast endophilin-mediated endocytosis and quickly endocytoses several G-protein-coupled receptor (GPCR), while AT1R belongs to GPCR family. Therefore, we speculated that EPA2 may modulate microglia activation via endocytosing AT1R. Biochanin A is an O-methylated isoflavone, classified as a kind of phytoestrogen due to its chemical structure that is similar to mammalian estrogens. In this study, we investigated the protective effects of biochanin A on Ang II-induced DA neurons damage in vivo, and molecular mechanisms. The results showed that biochanin A treatment for 7 days attenuated the behavioral dysfunction, inhibited the microglial activation, and prevented DA neuron damage in Ang II-induced rats. Furthermore, biochanin A increased EPA2 expression and decreased the expression of AT1R, gp91phox, p22 phox, NLRP3, ASC, Caspase-1, IL-1ß, IL-6, IL-18, and TNF-α. In summary, these results suggest that biochanin A exerts protective effects in Ang II-induced model rats, and the mechanisms may involve inhibition of inflammatory responses, an increase in EPA2 expression and a decrease in AT1R expression.

Effect of glutenin and gliadin modified by protein-glutaminase on retrogradation properties and digestibility of potato starch.

The glutenin (Glu) and gliadin (Gli) were modified by protein-glutaminase (PG) to obtain soluble glutenin (PG-Glu) and gliadin (PG-Gli), and PG-Glu or PG-Gli was added to potato starch (PS) according to different amounts (0.5%, 1.0%, and 1.5%, based on dry starch weight, w/w) to explore the effect of modified proteins on the retrogradation behavior and digestibility of PS. The results showed that the long-term retrogradation of PS was accelerated by the addition of PG-Glu or PG-Gli. The addition of PG-Glu or PG-Gli led to an increase in hydrogen bonds within starch molecules and induced a significant increase in resistant starch content. The hydrolysis kinetic parameters, C∞ and K, both decreased with the increasing level of modified protein, indicating the deceleration of hydrolysis rate by the addition of PG-Glu or PG-Gli. In summary, the addition of PG-Glu or PG-Gli could promote the retrogradation of PS and mitigate the digestion of starch.

Structural characterization and hepatoprotective activities of polysaccharides from the leaves of Toona sinensis (A. Juss) Roem.

Two polysaccharide fractions (TSP-1 and TSP-2) with molecular weights of 833.6 kDa and 81.6 kDa were isolated from Toona sinensis leaves (Meliaceae) by hot water extraction, DEAE Cellulose-52 chromatography and Sephacryl S-400 gel permeation chromatography. Structural analysis indicated that TSP-1 and TSP-2 consisted of Manp, GlcpA, Glcp, Galp, Xylp and Araf with different molar ratios. Methylation and NMR analysis revealed that the backbone of TSP-1 might consist of 1,6-linked-Glcp, 1,3,6-linked-Manp and 1,6-linked-Galp, while TSP-2 was mainly composed of 1,3,5-linked-Araf, 1,6-linked-Glcp, 1,4-linked-Xylp and 1,6-linked-Galp. Congo red assay indicated that TSP-1 and TSP-2 had no triple-helix structure, which was consistent with the results of AFM. In vivo hepatoprotective activity showed that TSP-1 and TSP-2 could improve CCl4-induced mice liver injury by reducing the activities of AST, ALT and the level of MDA, increasing the activities of SOD, GSH-Px, and CAT and the level of GSH in liver and decreasing the expression levels of TNF-α and IL-6 in liver. These results suggest that TSP-1 and TSP-2 have promising potential to serve as hepatoprotective agents.

Evaluation studies on effects of pectin with different concentrations on the pasting, rheological and digestibility properties of corn starch.

In this paper, the effects of pectin (PE) with different concentrations on the pasting, rheological and digestibility properties of corn starch (CS) were evaluated. The Rapid Visco-Analyzer results showed that the peak viscosity was decreased with the concentrations of PE (0.5% and 1.0%) and then increased when the concentration of PE exceeded 2.0%. PE resulted in lower breakdown and setback values of CS. Rheological results revealed that the CS and CS-PE mixtures exhibited a pseudoplastic and shear-thinning behavior. The storage modulus (G') and loss modulus (G″) of CS were increased with increasing PE concentrations from 2.0% to 10.0%. PE resulted in a decrease in the starch susceptibility to α-amylase and promoted a remarkable reduction (P < 0.05) in the fraction of rapidly digested starch. The hydrolysis kinetic analysis suggested a decelerating effect of pectin on the hydrolysis rate of CS with lower values of equilibrium hydrolysis percentage (C∞) and kinetic constant (k).

Effects of pectin with different molecular weight on gelatinization behavior, textural properties, retrogradation and in vitro digestibility of corn starch.

Effects of pectin with different molecular weight (Mw) on gelatinization behavior, textural properties, retrogradation, and in vitro digestibility of corn starch (CS) were investigated. The pectin addition led to the decrease of peak, setback, and final viscosities of CS, and a further decrease was provided with the pectin of high Mw, whereas the pasting temperature was increased. The syneresis of starch gel during freeze-thaw process was reduced by the addition of pectin. High Mw pectin significantly lowered the hardness of the starch gel from 238.9 and 350.2 N to 222.7 and 318.5 N after 7 and 14 days storage (P < 0.05), respectively. Compared with the retrograded CS alone, the relative crystallinity of starch-pectin mixtures significantly decreased (P < 0.05), but the crystal type of starch remained unchanged. A significant increase was observed in both the proportion of slowly digestible starch and resistant starch for retrograded starch-pectin mixtures.

Evaluation studies on the combined effect of hydrothermal treatment and octenyl succinylation on the physic-chemical, structural and digestibility characteristics of sweet potato starch.

In order to increase the degree of substitution (DS), a combination of heat-moisture treatment (HMT) and octenyl succinylation (OSA) was used to modify sweet potato starch (SPS). The content of OSA had significant influence on the DS of starch, and DS of HMT OSA-modified SPS (HOSA-SPS) was higher than that of OSA-modified SPS (OSA-SPS), indicating that prior HMT could enhance the reaction. HOSA-SPS showed higher contents of SDS and RS in comparison with OSA-SPS as OSA concentration was beyond 6%. HMT decreased swelling power of starch while OSA modification had a contrary role (p < 0.05). Scanning electron microscopy (SEM) showed starch was destroyed by OSA modification while HMT had slight effect on the structure. X-ray diffraction (XRD) indicated that crystal type of starch was transformed from C- to A-type resulted from HMT, and remained unchanged by OSA modification. The onset, peak, and conclusion gelatinization temperatures of starch increased by HMT and decreased by OSA modification (p < 0.05).

Effects of glutenin and gliadin modified by protein-glutaminase on pasting, rheological properties and microstructure of potato starch.

Glutenin and gliadin were treated with protein-glutaminase in order to obtain soluble glutenin (PG-Glu) and gliadin (PG-Gli). PG-Glu or PG-Gli was added to potato starch at various concentrations (0.5%, 1.0%, and 1.5% of starch weight, w/w), and the physicochemical properties and microstructure of starch/protein mixtures were investigated. The results showed that the presence of PG-Glu or PG-Gli decreased the viscosity parameters and yield stress and consistency coefficient of mixed pastes. The starch/protein mixed pastes exhibited a pseudoplastic and shear-thinning behavior under yield stress condition, and the storage modulus and loss modulus increased. Moreover, the To, Tp, Tc, and ΔH of starch/protein mixtures varied insignificantly compared with native starch. CLSM results confirmed the inhibition of PG-Glu and PG-Gli on the gelatinization of starch, and the morphology of starch granules became more compact. These results suggest that the physicochemical properties and microstructure of potato starch are effectively influenced by PG-Glu or PG-Gli.

Biochanin A Protects Against Lipopolysaccharide-Induced Damage of Dopaminergic Neurons Both In Vivo and In Vitro via Inhibition of Microglial Activation.

Neuroinflammation has been reported to be involved in the pathogenesis of Parkinson's disease (PD). Inhibition of microglia-mediated neuroinflammation might be a potential strategy for PD treatment. Biochanin A, is an O-methylated isoflavone, classified as a kind of phytoestrogens due to its chemical structure that is similar to mammalian estrogens. It has been found to possess antifibrotic, antiapoptotic, and antioxidant effects. In the present study, we investigated the neuroprotective effects of biochanin A on lipopolysaccharide (LPS)-induced dopaminergic neurons damage both in vivo and in vitro and the related molecular mechanisms. The results showed that biochanin A treatment for 21 days significantly attenuated the behavioral dysfunction of PD rats, prevented dopaminergic neurons damage, and inhibited activation of microglia in the LPS-induced PD rats. Furthermore, biochanin A decreased the levels of interleukin-1ß (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the serum, and inhibited the phosphorylation of ERK, JNK, p38 in the substantia nigra of PD rats. In vitro test, biochanin A also inhibited primary microglial activation and protected dopaminergic neurons, decreased the content of nitric oxide, IL-1ß, and TNF-α in supernatants, and inhibited the reactive oxygen species production. Taken together, these results suggest that biochanin A exerts protective effects on LPS-induced PD rats, and the mechanisms may be associated with the inhibition of inflammatory response and the MAPK signaling pathway.

Advances on Bioactive Polysaccharides from Medicinal Plants.

In recent decades, the polysaccharides from the medicinal plants have attracted a lot of attention due to their significant bioactivities, such as anti-tumor activity, antioxidant activity, anticoagulant activity, antidiabetic activity, radioprotection effect, anti-viral activity, hypolipidemic and immunomodulatory activities, which make them suitable for medicinal applications. Previous studies have also shown that medicinal plant polysaccharides are non-toxic and show no side effects. Based on these encouraging observations, most researches have been focusing on the isolation and identification of polysaccharides, as well as their bioactivities. A large number of bioactive polysaccharides with different structural features and biological effects from medicinal plants have been purified and characterized. This review provides a comprehensive summary of the most recent developments in physiochemical, structural features and biological activities of bioactive polysaccharides from a number of important medicinal plants, such as polysaccharides from Astragalus membranaceus, Dendrobium plants, Bupleurum, Cactus fruits, Acanthopanax senticosus, Angelica sinensis (Oliv.) Diels, Aloe barbadensis Miller, and Dimocarpus longan Lour. Moreover, the paper has also been focused on the applications of bioactive polysaccharides for medicinal applications. Recent studies have provided evidence that polysaccharides from medicinal plants can play a vital role in bioactivities. The contents and data will serve as a useful reference material for further investigation, production, and application of these polysaccharides in functional foods and therapeutic agents.

Protective effect of polysaccharides from Opuntia dillenii Haw. fruits on streptozotocin-induced diabetic rats.

In this study, a novel water-soluble polysaccharide fraction with molecular weight of 6479.1kDa was isolated from the fruits of Opuntia dillenii Haw., which consisted of rhamnose, xylose, mannose and glucose in the molar ratio of 14.99:1.14:1.00:6.47. The protective effect of O. dillenii Haw. fruits polysaccharide (ODFP) against oxidative damage in streptozotocin (STZ)-induced diabetic rats was investigated. The results showed that oral administration of ODFP significantly decreased food intake, water intake, urine production, organ weights and blood glucose level, and increased body weight in STZ-induced diabetic rats. ODFP also significantly increased the activities of SOD, GPx and CAT, and decreased malondialdehyde level in serum, liver, kidney, and pancreas in STZ-induced diabetic rats. Moreover, histopathological examination showed that ODFP could markedly improve the structure integrity of pancreatic islet tissue in STZ-induced diabetic rats. These results suggest that ODFP have hypoglycemic and antioxidant properties and can protect rats from STZ-induced oxidative damage.

A survey and analysis of using traditional Chinese medicine during pregnancy.

BACKGROUND: The usage of Traditional Chinese Medicine (TCM) during pregnancy is very common for Chinese people. However, there are only a few studies relevant to the usage of TCM during pregnancy-providing very little knowledge on the benefits or harmful effects of these medicines to pregnant women or the fetus. OBJECTIVES: The purpose of this study is to survey the current situation of TCM usage during pregnancy, and to explore the factors that affect the use of TCM. METHODS: Data was collected from pregnant patients who delivered in our hospital, from March 2012 to August 2012. All patients who agreed to join this study were asked to fill-up a questionnaire. RESULTS: 1,010 patients were willing to participate in this study. 11.2% (113, 1,010) of patients used at least one kind of TCM during pregnancy. The average TCM usage is 2.1 species. The most commonly used drugs are Antai pill (39 cases, 34.5%), Xiaochaihu granules (31 cases, 27.4%), and Shengxuening tablets (23 cases, 20.4%). Patients who smoke during pregnancy (OR=1.8, 95% CI: 0.7~5.1), drink during pregnancy (OR=1.6, 95% CI: 0.4~6.1), have been hospitalized during pregnancy (OR=4.8, 95% CI: 2.9~7.9), have pregnancy complications (OR=2.7, 95% CI: 1.5~4.9) and those who are infertile (OR=2.6, 95% CI: 1.4~4.8) have higher chances of using TCM during pregnancy. CONCLUSIONS: Pregnant women commonly use TCM during pregnancy. Pregnant women who smoke, drink, hospitalized during pregnancy, experience pregnancy complications and infertility are more likely to use TCM.

Effect of repeated retrogradation on structural characteristics and in vitro digestibility of waxy potato starch.

The effects of repeated retrogradation (RR) treatment on the structural characteristics and in vitro digestibility of waxy potato starch were investigated. The cycling times of RR ranging from 1 to 5 were designated as RR-1, RR-2, RR-3, RR-4, and RR-5, respectively. A maximum SDS content (40.41%) was obtained by RR-2 treatment with the time interval of 48h. RR-2-treated starch product exhibited a narrower melting temperature range, a higher onset temperature and a lower melting enthalpy compared with RR-1 treatment. Compared with native starch, X-ray diffraction patterns of treated starches were altered from B-type to C-type. The variation in relative crystallinity of RR-treated starch products was consistent with that in melting enthalpy. Moreover, compared with RR-1-treated starch, a large number of cavities were observed on the surface of RR-2-treated starch product with a time interval of 48h, whereas more smooth regions were found on the surface of RR-5-treated starch product. This study suggested that structural changes of waxy potato starch treated with different cycling times of RR significantly affected the digestibility.

Effect of temperature-cycled retrogradation on in vitro digestibility and structural characteristics of waxy potato starch.

The effects of temperature-cycled retrogradation treatment on the structural characteristics and in vitro digestibility of waxy potato starch were investigated in this study. The results showed that the maximum yield of slowly digestible starch (SDS) in waxy potato starch reached 38.63% by retrogradation treatment under temperature cycles of 4/25°C for 3 days with an interval of 24h. The starch products prepared under the temperature cycles of 4/25°C exhibited a narrower melting temperature range (Tc-To), a higher melting enthalpy (ΔH) and a higher IR absorbance ratio (1047cm(-1)/1022cm(-1)) than that prepared at a constant temperature of 25°C. Compared to native starch, X-ray diffraction pattern of treated starch was altered from B-type to C-type. Furthermore, the relative crystallinity of the starch products prepared under temperature-cycled retrogradation was the highest. This study suggests that more imperfect crystallites are formed in the crystalline matrix under temperature-cycled retrogradation, resulting in a high yield of SDS.

[The effects of milk and milk products on non-steroidal anti-inflammatory drug induced intestinal damage in rats].

OBJECTIVE: To investigate the effect of milk and milk products on morphological structure and epidermal growth factor (EGF) of non-steroidal anti-inflammatory drugs (NSAIDs) induced small intestinal damage in animals. METHODS: Eighty male SD rats were randomly divided into 5 groups: control group, diclofenac group, diclofenac with 10% low fat milk group, diclofenac with 10% colostrum group and diclofenac with yoghurt group. The animals with milk or colostrum or yoghurt were fed for 5 days before the administration of diclofenac with 15 mg/kg by gavage, once. Then they were observed the scores of anatomical lesion and the scores of tissue damage of mucous membrane and the height of villous at the 24(th) and 48(th) hour after making the models. Observation of the change of ultrastructural organization of mucous membrane was carried out with transmission and scanning electron microscope and immunohistochemistry of EGF. RESULTS: The scores of anatomical lesion and tissue damage of mucous membrane of the colostrum group were lower than those of the diclofenac group (P < 0.05). The heights of the pile on small intestine of the 24(th) and 48(th)hour of the colostrum group were (145.7 ± 16.5) µm and (139.2 ± 19.0) µm, respectively. They were higher than those of the diclofenac group [(119.2 ± 19.2) µm and (105.4 ± 18.4) µm, P < 0.05]. However there was no difference of the scores and the height among diclofenac group, milk group and yoghurt group. TEM and SEM of tissues showed that the cytoplasmic membrane and other cellular components of villous epithelial cells were well preserved in colostrum group, and the microvilli in the milk group and yoghurt group were ablated more obviously. The positive area of EGF of small intestine [(6170.5 ± 1483.9) µm(2)] were higher 48 h after administration of diclofenac compared with the diclofenac group (P < 0.05). The expression of EGF in milk and yoghurt group were no significant statistical difference with the diclofenac group. CONCLUSION: Bovine colostrum may have a beneficial effect in prevention of NSAIDs induced small intestinal injuries and preserve mechanical barrier of small intestinal mucosa which is probably relative to EGF.

Protective effect of isoflavones from Trifolium pratense on dopaminergic neurons.

In the present study, protective effect of five isoflavones (formononetin, daidzein, pratensein, calycosin and irilone) from Trifolium pratense on lipopolysaccharide-induced dopaminergic neurodegeneration was studied for the first time. The results showed that all five isoflavones attenuated LPS-induced decrease in dopamine uptake and the number of dopaminergic neurons in a dose-dependent manner in rat mesencephalic neuron-glia cultures. Moreover, they also significantly inhibited LPS-induced activation of microglia and production of tumor necrosis factor-alpha, nitric oxide and superoxide in mesencephalic neuron-glia cultures and microglia-enriched cultures. In addition, the rank order of protective potency of five isoflavones was: pratensein>daidzein>calycosin>formononetin>irilone. This study suggested that all five isoflavones protected dopaminergic neurons against LPS-induced injury through inhibition of microglia activation and proinflammatory factors generation.

Biochanin A protects dopaminergic neurons against lipopolysaccharide-induced damage through inhibition of microglia activation and proinflammatory factors generation.

Activation of microglia and consequent release of proinflammatory factors, are believed to contribute to neurodegeneration in Parkinson's disease (PD). Hence, identification of compounds that prevent microglial activation is highly desirable in the search for therapeutic agents for inflammation-mediated neurodegenerative diseases. In this study, we reported that biochanin A, one of the predominant isoflavones in Trifolium pratense, attenuated lipopolysaccharide (LPS)-induced decrease in dopamine uptake and the number of dopaminergic neurons in a dose-dependent manner in rat mesencephalic neuron-glia cultures. Moreover, biochanin A also significantly inhibited LPS-induced activation of microglia and production of tumor necrosis factor-alpha, nitric oxide and superoxide in mesencephalic neuron-glia cultures and microglia-enriched cultures. This study suggested for the first time that biochanin A protected dopaminergic neurons against LPS-induced damage through inhibition of microglia activation and proinflammatory factors generation.