Evaluation on quality consistency of Ganoderma lucidum dietary supplements collected in the United States.

Ganoderma lucidum is a well-known medicinal mushroom. At present, numerous G. lucidum products have emerged in the form of dietary supplements in the United States due to its various benefits. However, the quality consistency of these products based on their label ingredients has seldom been evaluated due to the lack of a suitable toolkit. In this study, 19 batches of products of G. lucidum (Red Reishi, Reishi), herbal/mushroom supplements purchased in the United States, were evaluated based on their bioactive components including triterpenes and polysaccharides by using chromatographic methods and saccharide mapping. The results showed that the measured ingredients of only 5 tested samples (26.3%) were in accordance with their labels, which suggested the quality consistency of G. lucidum dietary supplements in the U.S. market was poor, which should be carefully investigated.

Qualitative and quantitative analysis of specific polysaccharides in Dendrobium huoshanense by using saccharide mapping and chromatographic methods.

Qualitative and quantitative analysis of specific polysaccharides from ten batches of Dendrobium huoshanense were performed using high performance size exclusion chromatography coupled with multi-angle laser light scattering and refractive index detector (HPSEC-MALLS-RID), gas chromatography-mass spectrometry (GC-MS), nuclear magnetic resonance (NMR) and saccharide mapping based on polysaccharides analysis by using carbohydrate gel electrophoresis (PACE) and high performance thin layer chromatography (HPTLC). Results showed that molecular weights, the radius of gyrations, and contents of specific polysaccharides in D. huoshanense were ranging from 1.16×10(5) to 2.17×10(5)Da, 38.8 to 52.1nm, and 9.9% to 19.9%, respectively. Furthermore, the main monosaccharide compositions were Man and Glc. Indeed, the main glycosidic linkages were ß-1,4-Manp and ß-1,4-Glcp, and substituted with acetyl groups at O-2 and O-3 of 1,4-linked Manp. Moreover, results showed that PACE and HPTLC fingerprints of partial acidic and enzymatic hydrolysates of specific polysaccharides were similar, which are helpful to better understand the specific polysaccharides in D. huoshanense and beneficial to improve their quality control. These approaches could also be routinely used for quality control of polysaccharides in other medicinal plants.

Rivaroxaban for thromboprophylaxis after total hip or knee arthroplasty: a meta-analysis with trial sequential analysis of randomized controlled trials.

Venous thromboembolism (VTE) is the most widespread severe complication after total hip arthroplasty (THA) and total knee arthroplasty (TKA). We conducted this meta-analysis to further validate the benefits and harms of rivaroxaban use for thromboprophylaxis after THA or TKA. We thoroughly searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. Trial sequential analysis (TSA) was applied to test the robustness of our findings and to obtain a more conservative estimation. Of 316 articles screened, nine studies were included. Compared with enoxaparin, rivaroxaban significantly reduced symptomatic VTE (P = 0.0001) and symptomatic deep vein thrombosis (DVT; P = 0.0001) but not symptomatic pulmonary embolism (P = 0.57). Furthermore, rivaroxaban was not associated with an increase in all-cause mortality, clinically relevant non-major bleeding and postoperative wound infection. However, the findings were accompanied by an increase in major bleeding (P = 0.02). The TSA demonstrated that the cumulative z-curve crossed the traditional boundary but not the trial sequential monitoring boundary and did not reach the required information size for major bleeding. Rivaroxaban was more beneficial than enoxaparin for preventing symptomatic DVT but increased the risk of major bleeding. According to the TSA results, more evidence is needed to verify the risk of major bleeding with rivaroxaban.

SUSTAINABLE DEVELOPMENT OF AMOMUM VILLOSUM: A SYSTEMATIC INVESTIGATION ON THREE DIFFERENT PRODUCTION MODES.

BACKGROUND: Amomum Villosum (A. Villosum), called Chunsharen in Chinese, is widely used in treating gastrointestinal disease. Its clinical benefits have been confirmed by both in vitro and in vivo studies. Facing the shortage of wild A. Villosum, artificial cultivating and natural fostering have been practiced in recent years. Therefore, it would be wondered whether the three different types of A. Villosum are comparable or not, particularly the herbal qualities, technological challenges, ecological impacts and economic benefits. MATERIAL AND METHODS: In this study, we combined quality research by using GC-MS, and field investigation to provide a systematic assessment about the three types of A. Villosum from these four aspects. RESULTS: It found that the wild type had low output and was in an endangered situation. The artificial cultivation had larger agriculturing area with higher productivity, but faced the ecological challenges. Lastly, the natural fostering type generated the highest economic benefit and relatively low ecological impact. In addition, the natural fostering type had relatively better quality than the other types. CONCLUSION: Therefore, it suggests that natural fostering can be applied for long-term sustainable development of A. Villosum.

Transcutaneous Electrical Nerve Stimulation in Patients With Knee Osteoarthritis: Evidence From Randomized-controlled Trials.

OBJECTIVES: Transcutaneous electrical nerve stimulation (TENS) has been reported to relieve pain and improve function in patients with knee osteoarthritis. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of TENS for the management of knee osteoarthritis. METHODS: We searched Embase, PubMed, CENTRAL, SIGLE, PEDro, and clinicaltrials.gov, up to June 2014 for literature related to TENS used for the treatment of knee osteoarthritis. Two authors independently screened the searched records based on the title and abstract. Information including the authors, study design, mean age, sex, study population, stimulation frequency (of TENS), outcome measures, and follow-up periods were extracted by the 2 authors. RESULTS: Eighteen trials were included in the qualitative systematic review, and 14 were included in the meta-analysis. TENS significantly decreased pain (standard mean difference, -0.79; 95% confidence interval [CI], -1.31 to -0.27; P<0.00001) compared with control groups. There was no significant difference in the Western Ontario and McMaster Universities Osteoarthritis Index (standard mean differences, -0.13; 95% CI, -0.35 to 0.1; P=0.09) or the rate of all-cause discontinuation (risk ratio, 0.77; 95% CI, 0.48 to 1.22; P=0.94) between the TENS and control groups. DISCUSSION: TENS might relieve pain due to knee osteoarthritis. Further randomized-controlled trials should focus on large-scale studies and a longer duration of follow-up.