[The efficacy and safety of intravenous sucrose iron therapy for recurrent iron deficiency anemia].

Objective: To evaluate the efficacy and safety of intravenous iron supplementation in patients with recurrent iron deficiency anemia (IDA) . Methods: This retrospective analysis of 90 patients with recurrent IDA from May 2012 to December 2021 was conducted, comparing the efficacy and safety of the intravenous iron therapy group and the oral iron therapy group. Results: Among the 90 patients with recurrent IDA, 20 were males and 70 were females, with a median age of 40 (range: 14-85) years. A total of 60 patients received intravenous iron supplementation and 30 received oral iron supplementation. The hematologic response rates in the intravenous iron group were significantly higher than those in the oral iron group at 4 and 8 weeks after treatment [80.0% (48/60) vs 3.3% (1/30) and 96.7% (58/60) vs 46.7% (14/30), all P<0.001, respectively]. The median increase in hemoglobin levels was also significantly higher in the intravenous iron group than in the oral iron group [38 (4, 66) g/L vs 7 (1, 22) g/L at week 4 and 44.5 (18, 80) g/L vs 19 (3, 53) g/L at week 8, all P<0.001]. The intravenous iron group had a significantly higher proportion of patients who achieved normal hemoglobin levels than the oral iron group (55.0% vs 0 and 90% vs 43.3%, all P<0.001, respectively). Iron metabolism indicators were tested before and after 8 weeks of treatment in 26 and 7 patients in the intravenous and oral iron groups, respectively. The median increase in serum ferritin (SF) levels in the intravenous iron group 8 weeks after treatment was 113.7 (49.7, 413.5) µg/L, and 54% (14/26) of these patients had SF levels of ≥100 µg/L, which was significantly higher than the median increase in SF levels in the oral iron group [14.0 (5.8, 84.2) µg/L, t=4.760, P<0.001] and the proportion of patients with SF levels of ≥100 µg/L (P=0.013). The incidence of adverse reactions was 3.3% (2/60) in the intravenous iron group, which was significantly lower than that in the oral iron group [20.0% (6/30), P=0.015]. Conclusion: Intravenous iron supplementation is more effective for hematologic response, faster hemoglobin increase, and higher iron storage replenishment rates compared with oral iron supplementation in patients with recurrent IDA, and it is well tolerated by patients.

Comparative effectiveness of urine drug screening strategies alongside opioid agonist treatment in British Columbia, Canada: a population-based observational study protocol.

INTRODUCTION: Urine drug tests (UDTs) are commonly used for monitoring opioid agonist treatment (OAT) responses, supporting the clinical decision for take-home doses and monitoring potential diversion. However, there is limited evidence supporting the utility of mandatory UDTs-particularly the impact of UDT frequency on OAT retention. Real-world evidence can inform patient-centred approaches to OAT and improve current strategies to address the ongoing opioid public health emergency. Our objective is to determine the safety and comparative effectiveness of alternative UDT monitoring strategies as observed in clinical practice among OAT clients in British Columbia, Canada from 2010 to 2020. METHODS AND ANALYSIS: We propose a population-level retrospective cohort study of all individuals 18 years of age or older who initiated OAT from 1 January 2010 to 17 March 2020. The study will draw on eight linked health administrative databases from British Columbia. Our primary outcomes include OAT discontinuation and all-cause mortality. To determine the effectiveness of the intervention, we will emulate a 'per-protocol' target trial using a clone censoring approach to compare fixed and dynamic UDT monitoring strategies. A range of sensitivity analyses will be executed to determine the robustness of our results. ETHICS AND DISSEMINATION: The protocol, cohort creation and analysis plan have been classified and approved as a quality improvement initiative by Providence Health Care Research Ethics Board and the Simon Fraser University Office of Research Ethics. Results will be disseminated to local advocacy groups and decision-makers, national and international clinical guideline developers, presented at international conferences and published in peer-reviewed journals electronically and in print.

[Preliminary analysis of seasonal pollen allergens of allergic rhinitis in a hospital of Nanchang City].

The study was aimed to analyze the seasonal pollen allergen spectrum of patients with allergic rhinitis (AR) in Nanchang city, and to provide evidence for improving the clinical diagnosis, treatment, prevention and epidemiology of seasonal AR. A retrospective analysis was conducted on the results of skin prick test (SPT) among 1 752 patients with AR in outpatient at Department of Otolaryngology, the First Affiliated Hospital of Nanchang University from September 2020 to August 2021 (a total of 1 069 males and 683 females, age ranged from 2 to 84 years old). SPSS 22.0 software was used to analyze the positive rates of main allergens and their differences in gender, age, and month of visit. Differences among groups were compared by student t test, Wilcox rank sum test, or χ2 test. The results showed that among 1 752 SPT-positive patients, the number of simple seasonal AR and the number of perennial combined seasonal AR were 102 (5.82%) and 281 (16.04%), respectively. There was no significant difference between male and female patients in positive seasonal pollen allergens (χ2=2.181, P>0.05), but the positive rate of indoor seasonal pollen allergens in males was higher than that in females (χ2=7.901, P<0.05). The seasonal pollen allergens ranking top 5 of the positive rates were willow (6.62%, 116/1 752), humulus scandens (5.71%, 100/1 752), rape (5.54%, 97/1 752), grey pigweed (4.62%, 81/1 752) and birch (3.60%, 63/1 752). The positive rates of indoor and seasonal pollen allergens increased first and then decreased in different age groups, and the highest positive rates of seasonal pollen allergens were in the age group of 31-40 years old, with statistical significance compared with other groups (χ2=61.269, P<0.05). The seasonal allergen positive rate showed two peaks in time: March to May and September to November. The positive rate of pollen in spring was 60.27% (132/219), which was significantly higher than that in autumn (39.73%,87/219) (χ2=9.247, P<0.05). The positive rate of pollen combination in spring and autumn was 68.29% (112/164), which was significantly higher than that in spring and autumn alone (18.9%,31/164) and (12.8%, 21/164) (χ2=14.731, P<0.05). In summary, pollen allergy in Nanchang City cannot be ignored, accounting for more than 20% of the total number of AR. The incidence of seasonal AR in Nanchang City showed two peaks (March to May and September to November). The common allergens for seasonal AR in Nanchang City were willow, humulus scandens, rape, grey chenopods and birch.

Clinical efficacy of targeted therapy, immunotherapy combined with hepatic artery infusion chemotherapy (FOLFOX), and lipiodol embolization in the treatment of unresectable hepatocarcinoma.

To evaluate the clinical efficacy of targeted therapy and immunotherapy combined with hepatic arterial infusion chemotherapy (HAIC) of FOLFOX and lipiodol embolization in the treatment of unresectable hepatocellular carcinoma. Patients included in the study were those who received targeted therapy and immunotherapy combined with HAIC of FOLFOX and lipiodol embolization in Zhongshan People's Hospital from December 2020 to June 2021 for unresectable hepatocellular carcinoma. Evaluation indicators included objective response rate (ORR), median progression-free survival (mPFS), median duration of response (mDOR), 1-year overall survival rate (OS), surgical conversion rate, and adverse events. Treatment response was assessed using Response Evaluation Criteria in Solid Tumors (mRECIST and RECIST v1.1). A total of 35 patients were included in this study, 30 of whom completed treatment evaluation. According to mRECIST evaluation criteria, the objective response rate (ORR) was 83.3% (25/30); the complete response (CR) was 60% (18/30); the partial response (PR) was 23.3% (7/30), and stable disease (SD) was 16.7% (5/30). The mDOR was 10.3 months (95% Cl: 8.27-NE), and the mPFS was 13.2 months (95% CI: 10.3-NE); the surgical conversion rate was 30.0% (9/30). The 1-year OS was 96.7%. There were no serious surgical complications and grade 4 or 5 adverse events of targeted therapy, immunotherapy and HAIC. Some patients had grade 3 adverse reactions in gastrointestinal toxicity or hepatotoxicity, and the adverse reactions were improved after corresponding symptomatic treatment. We concluded that HAIC of FOLFOX and lipiodol embolization combined with targeted therapy and immunotherapy had a significant curative effect in the treatment of unresectable hepatocellular carcinoma, with no serious adverse reactions and a high rate of surgical conversion rate.

Acupuncture for menopausal symptoms in Chinese women: a systematic review.

Menopause-related symptoms are common problems of middle-aged women that can seriously affect their quality of life. Menopausal hormone therapy (MHT) for climacteric symptoms is the first choice recommended by the International Menopause Society and likewise by other societies and institutions covering this field. However, non-hormonal therapies can be an alternative effective option, especially for women who are not suitable for MHT. Acupuncture is one of the most important methods. With deepening experience of the use of traditional Chinese acupuncture and moxibustion in the improvement of menopause symptoms, more clinical evidence has been obtained to support the effectiveness and safety of this treatment concept that is very often used in China. This review summarizes the evidence for effective treatment of climacteric complaints by acupuncture in recent years, shares the clinical experience of the authors of this review, all of whom head or work in units with daily large numbers of outpatients, and includes, in particular, results from studies performed in the Department of Acupuncture--Moxibustion of Tsinghua University Chuiyangliu Hospital, Beijing, China. In addition, there is a summary about the safety of acupuncture treatment in traditional Chinese medicine.

[A multicenter randomized prospective study of concurrent chemoradiation with 60 Gy versus 50 Gy for inoperable esophageal squamous cell carcinoma].

Objective: To determine whether 60 Gy is superior to standard 50 Gy for definitive concurrent chemoradiation(CCRT) in esophageal squamous cell carcinoma (ESCC) using modern radiation technology in a phase Ⅲ prospective randomized trial. Methods: From April 2013 to May 2017, 331 patients from 22 hospitals who were pathologically confirmed with stage ⅢA-ⅣA ESCC were randomized to 60 Gy or 50 Gy with random number table. Total of 305 patients were analyzed, including 152 in 60 Gy group and 153 in 50 Gy group. The median age was 63 years, 242(79.3%) males and 63(20.7%) females. The median length of primary tumor was 5.6 cm. The clinical characteristics between two groups were comparable. All patients were delivered 2 Gy per fraction, 5 fractions per week. Concurrent weekly chemotherapy with docetaxel (25 mg/m(2)) and cisplatin (25 mg/m(2)) and 2 cycles consolidation chemotherapy with docetaxel (70 mg/m(2)) and cisplatin (25 mg/m(2), d1-3) were administrated. The primary endpoint was local/regional progression-free survival (LRPFS). The data were compared with Pearson chi-square test or Fisher's exact test. Results: At a median follow-up of 27.3 months, the disease progression rate was 37.5% (57/152), 43.8% (67/153) in the high and standard-dose group, respectively (χ(2)=1.251, P=0.263). The 1, 2, 3-year LRPFS rate was 75.4%, 56.8%, 52.1% and 74.2%, 58.4%, 50.1%, respectively (HR: 0.95, 95%CI: 0.69-1.31, P=0.761). The 1, 2, 3-year overall survival rate was 84.1%, 64.8%, 54.1% and 85.4%, 62.9%, 54.0%, respectively (HR: 0.98, 95%CI: 0.71-1.38, P=0.927). The 1, 2, 3-year progression-free survival rate was 70.8%, 54.2%, 48.5% and 65.5%, 51.9%, 45.1%, respectively (HR: 0.93, 95%CI: 0.68-1.26, P=0.621). The incidence rates in toxicities between the two groups were similar except for higher rate of severe pneumonitis in high dose group (χ(2)=11.596, P=0.021). Conclusions: The efficacy in disease control is similar between 60 Gy and 50 Gy using modern radiation technology concurrent with chemotherapy for ESCC. The 50 Gy should be recommended as the regular radiation dose with CCRT for ESCC.

Effect of phosphorus efficiency on elemental stoichiometry of two shrubs.

Phosphorus (P) is an important nutrient that can restrict plant growth. However, the influence of P deficiency on elemental homeostasis and application of the growth rate hypothesis in higher plants remain to be assessed. Two shrubs, Zygophyllum xanthoxylum and Nitraria tangutorum, were used as experiment material and subjected to five P addition treatments: 0, 17.5, 35.0, 52.5 and 70.0 mg P·kg-1 soil. The biomass and relative growth rate of Z. xanthoxylum did not change with altered P supply. There was no significant difference in P concentration among the treatments for Z. xanthoxylum, but N. tangutorum showed an upward trend. The P stoichiometric homeostasis of Z. xanthoxylum was higher than that of N. tangutorum. For Z. xanthoxylum, available P in the rhizosphere improved significantly under extreme P deficiency conditions, and P concentrations in all treatments were lower than in N. tangutorum, showing that Z. xanthoxylum had stronger P absorption and P utilization capacity. No relationships between growth rate and C:N:P ratios were found in Z. xanthoxylum. The strong P efficiency, and high and stable dry matter accumulation, are likely contributors in maintaining stoichiometric homeostasis. In addition, the relatively high biomass accumulation and high P utilization efficiency for Z. xanthoxylum does not support the growth rate hypothesis for this species.

Effects of milk powder intervention on bone mineral density and indicators related to bone metabolism in Chinese adolescents.

The study is to determine the effects of milk powder on bone density and metabolism in healthy adolescents. Vitamin D and calcium supplements increased IGF-1 but did not affect bone mineralization or turnover. Higher vitamin D in combination with sufficient calcium supplementation in such populations requires attention. INTRODUCTION: Both calcium and vitamin D play an important role in bone mineralization in adolescents. METHODS: In this one and a half-year randomized controlled trial, 232 participants (aged 12-15 years) were randomly assigned to three intervention groups receiving milk powder fortified with vitamin D 400 IU plus calcium 300, or 600, or 900 mg [Ca3D (n = 54), Ca6D (n = 56), and Ca9D (n = 49)], or one control group maintaining habitual diet [control (n = 73)]. Bone turnover markers, serum intact PTH, 25(OH)D, and IGF-1 levels were measured at baseline and one and a half years, and bone mineral contents and bone areal mineral density were measured by Dual-energy X-ray absorptiometry (DXA) at baseline, one year, and one and a half years. RESULTS: Baseline average serum 25(OH)D level and calcium intake were 29.4 nmol/L and 363.5 mg/day, respectively. There was a significant increase in bone turnover, total body, hip, lumbar spine bone mineral density (BMD), and total body BMC as well as slight fluctuations in 25(OH)D levels over one and a half years without between-group differences. Significantly decreased serum PTH level was only observed in the Ca6D group (31%, p < 0.0001), in which the intervention effect was also significant (p = 0.0029) compared with the control group. IGF-1 levels increased significantly in all intervention groups (18.5 to 22.8%, p < 0.05) but decreased in the control group (16.5%, p < 0.05), and the group by time interaction was also significant (p = 0.0029). CONCLUSIONS: Our study showed that in healthy adolescents with low vitamin D status and calcium intake, mild vitamin D and mild to modest calcium supplements increased IGF-1 but did not affect bone mineralization or turnover. Higher vitamin D in combination with sufficient calcium supplementation in such populations requires attention.

Effects of fat type and emulsifier in feed on growth performance, slaughter traits, and lipid metabolism of Cherry Valley ducks.

A 2-factor test design was used to investigate the effect of an emulsifier (Aldo®, Lonza, America) (200 g/t) in the diet of Cherry Valley meat ducks to replace some of 2 different oils (animal fat and vegetable oil) on meat production performance, slaughter traits, and fat metabolism. The 900 healthy 18-day-old ducks were grouped into 6 treatments, each with 5 replicates and 30 meat ducks per replicate. The 2 fat sources were established as a positive control group, a negative control group (positive control group-some oil (equivalent to metabolic energy of 50 kcal/ton)), and an emulsifier group (negative control group + 200 g/ton Aldo). The results showed that addition of different fat sources in feed had no significant effect on growth performance, carcass properties, and fat metabolism of 18- to 42-day-old meat ducks (P > 0.05). Reducing the amount of oil used in the feed lowered the growth performance, carcass properties, and affected fat metabolism of meat ducks. However, in feeds with 2 fat sources, some oils were replaced by adding Aldo without affecting growth performance and carcass properties of meat ducks, and improved their fat metabolism, reduced triglycerides (TG) in serum, and increased activity of lipoprotein and hepatic lipases in liver and of pancreatic lipase. Thus, addition of Aldo to a low fat diet could improve growth performance, carcass quality, and lipid metabolism, and promote digestion and absorption of fat for meat ducks.

[Cognitive level of first aid knowledge regarding small area burn among 2 723 child caregivers in Shanghai: a cross-sectional survey and analysis].

Objective: To assess the cognitive level of first aid knowledge regarding the small area burn among the child caregivers in Shanghai and improve the level of first aid for small area burn in children. Methods: From November 2017 to March 2018, 7 municipal districts in Shanghai were selected according to the random number table, from which 2 750 students of 4 nurseries, 5 kindergartens, 6 primary schools, and 2 junior middle schools were selected by adopting the convenience sampling method. Each student was limited to one caregiver as the research object. A cross-sectional survey was conducted on the cognitive level of first aid knowledge regarding small area burn among the caregivers with self-designed questionnaire through WeChat and Tencent QQ. The age, burn experience, and scarring after burns in children, the prevalence rate of burn in children of different age groups, the educational background of caregivers and their social relationship with their children, and the measures taken by caregivers firstly after small area burn occurred among their children were recorded. The choices of applying the folk prescription drugs to the wounds of their children made by caregivers and those with different educational backgrounds were recorded. The choices of applying daily necessities to the wound of their children made by caregivers were recorded. The caregivers' knowledge of standard first aid measures for small area burn, and the knowledge of caregivers with different educational backgrounds of all standard first aid measures for small area burn were recorded. The caregivers' choices of hospitals for treatment the first time, and the choices of going to the Grade Ⅲ Level A hospital with burn specialty for treatment made by caregivers with different knowledge levels about first aid measures for small area burn and those by caregivers whose children did or didn't have burn experience were recorded. The caregivers' choices of different types of medical institutions with burn specialty or specialized in burn treatment, and choices of going to burn department of comprehensive Grade Ⅲ Level A hospital for treatment made by caregivers with different knowledge levels about first aid measures for small area burn were recorded. Data were processed with Pearson chi-square test and partitions of chi-square test. Results: The effective recovery rate of questionnaire was 99.0% (2 723/2 750). The ages of children were mainly 6-11 years [64.7% (1 762/2 723)]The prevalence of burn in children was 19.4% (527/2 723). There was no statistically significant difference in the overall comparison of burn prevalence of children among the age groups (χ(2)=1.424, P>0.05). The percentage of scar formation after burn in children was 27.3% (144/527). The education backgrounds of caregivers were mainly undergraduate [40.2% (1 094/2 723)], and their social relationships with children were mainly children's mothers [74.6% (2 030/2 723)]. Assuming that their children suffered from minor burns, the measures firstly taken by 74.0% (2 016/2 723) of the caregivers was to immediately access cool running water and remove clothing on the wound of children. Totally 19.2% (523/2 723) of the caregivers chose to apply folk prescription drugs for their burn children by themselves, and the percentage of caregivers with education background of junior middle school choosing to apply folk prescription drugs for their burn children by themselves was significantly higher than that of caregivers with education background of junior college, undergraduate, or graduate (χ(2)=18.502, 20.642, 13.319, P<0.05). Totally 49.2% (1 340/2 723) of caregivers chose to daub many kinds of daily necessities for their burn children by themselves. Totally 39.2% (1 068/2 723) of caregivers knew all standard first aid measures for small area burn, the percentage of caregivers with education background of undergraduate knowing all standard first aid measures for small area burn was significantly higher than that of caregivers with education background of senior high school and secondary specialized school (χ(2)=11.234, P<0.05). Assuming that their children suffered from minor burns, 39.0% (1 063/2 723) of the caregivers chose to go to the nearest hospital for treatment the first time, the percentage of caregivers who knew all standard first aid measures for small area burn choosing to go to Grade Ⅲ Level A hospital with burn specialty for treatment the first time was similar with that of caregivers who did not know/did not fully know (χ(2)=3.528, P>0.05), and the percentage of caregivers whose children had burn experience choosing to go to Grade Ⅲ Level A hospital with burn specialty for treatment in the first time was similar with that of caregivers whose children didn't have burn experience (χ(2)=3.521, P>0.05). Among all medical institutions with burn specialty or specialized in burn treatment, 28.0% (762/2 723) of the caregivers chose to go to comprehensive Grade Ⅲ Level A hospital for treatment, and the percentage of caregivers who knew all standard first aid measures for small area burn choosing to go to comprehensive Grade Ⅲ Level A hospital for treatment was significantly higher than that of caregivers who did not know/did not fully know (χ(2)=4.890, P<0.05). Conclusions: The caregivers of children are mainly children's mothers with education background of undergraduate in Shanghai, and caregivers' cognitive levels of first aid knowledge regarding the small area burn are low. Only a few caregivers know all standard first aid measures for small area burn, and there are still some caregivers who have the wrong idea of applying folk prescription drugs or daily necessities for children by themselves. The publicity and education of basic first aid knowledge of burn should be strengthened through various channels such as burn simulation exercise and network, and caregivers should be guided to take their children to hospitals with burn specialty for treatment after occurrence of burn in children, so as to obtain more professional medical treatment.

Anti-epidermal growth factor receptor (EGFR) monoclonal antibody combined with cisplatin and 5-fluorouracil in patients with metastatic nasopharyngeal carcinoma after radical radiotherapy: a multicentre, open-label, phase II clinical trial.

BACKGROUND: We conducted a single-arm phase II trial to evaluate the efficacy and adverse effects (AEs) of an anti-epidermal growth factor receptor monoclonal antibody, nimotuzumab, combined with cisplatin and 5-fluorouracil (PF) as first-line treatment in recurrent metastatic nasopharyngeal carcinoma after radical radiotherapy. METHODS: Patients who met the eligibility criteria were recruited from ten institutions (ClinicalTrials.gov; NCT01616849). A Simon optimal two-stage design was used to calculate the sample size. All patients received weekly nimotuzumab (200 mg) added to cisplatin (100 mg/m2 D1) and 5-fluorouracil (4 g/m2 continuous infusion D1-4) every 3-weekly for a maximum of six cycles. Primary end point was objective response rate (ORR). Secondary end points included disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and AEs. RESULTS: A total of 35 patients were enrolled (13 in stage 1 and 22 in stage 2). Overall ORR and DCR were 71.4% (25/35) and 85.7% (30/35), respectively. Median PFS and OS were 7.0 (95% CI 5.8-8.2) months and 16.3 (95% CI 11.4-21.3) months, respectively. Unplanned exploratory analyses suggest that patients who received ≥2400 mg nimotuzumab and ≥4 cycles of PF had superior ORR, PFS and OS than those who did not (88.9% versus 12.5%, P < 0.001; 7.4 versus 2.7 months, P = 0.081; 17.0 versus 8.0 months, P = 0.202). Favourable subgroups included patients with lung metastasis [HROS 0.324 (95% CI 0.146-0.717), P = 0.008] and disease-free interval of >12 months [HROS 0.307 (95% CI 0.131-0.724), P = 0.004], but no difference was observed for metastatic burden. The only major grade 3/4 AE was leukopenia (62.9%). CONCLUSION: Combination nimotuzumab-PF chemotherapy demonstrates potential efficacy, and is well tolerated as first-line chemotherapy regimen in recurrent metastatic nasopharyngeal carcinoma.

[Contesting Remedies: The Debate on STD Treatment Therapies in the early PRC].

During the early years of the People's Republic of China, sexually transmitted diseases (STD) were almost eliminated nationwide for a period. In the STDs eradication campaign, "political correctness" became a ruling policy. During the prevention and treatment of the STDs, the choice of therapy depended on the "political correctness" policy rather than medical effectiveness. With this political background, three competing treatments of STDs emerged (especially for syphilis): penicillin treatment, arsenic and bismuth mixed and intermittent treatment, and traditional Chinese medicine treatments. The argument between treatments was a vivid microcosm of the love-hate political relationship between China and the Union of Soviet Socialist Republics (USSR). The traditional Chinese medicine treatments for syphilis were used as a tool by the authorities to prevent the national medical system becoming more and more westernized. The penicillin treatment, the winner of this battle, won because it catered to the political themes of the time, the "Great Leap Forward" . Overwhelming state power had a strong influence and control over the medical system and medical practice, with the initiative and independence of doctors being limited in an unprecedented fashion.

[Types and characteristics of advertising images in Chinese medicine works during the Republic of China].

The emergence of advertising images in Chinese medicine works during the period of China is the inevitable outcome of the development of commercial society. In the 237 advertising images, there are 106 pictures, 130 ink lines and 1 color photograph. It can be divided into 8 categories: chemist's shop, hospital, medical products, Chinese medicine school and organizations, book, book publishers, commodity and public service. It can reflect the popular themes of the society and social atmosphere at that time, having vivid characteristics of the times and artistry. Advertising image is a unique phenomenon in the books of the Republic of China.

[Intervention effects of Dan-fang capsule in rats with hepatic fibrosis].

Objective: To investigate the interventional effect of Dan-fang capsule on liver fibrosis in rats. Methods: Sixty one-week aged male healthy SD rats [weight (180±20) g] were randomly divided into normal control group (group A), hepatic fibrosis model group (group B), Fu-Fang-Bie-Jia-Ruan-Gan tablet group (group C), Dan-fang capsule groups at high, middle and low dose group (group D, E, F, respectively). Except for the normal control group, hepatic fibrosis was induced in other groups by intraperitoneal injection of porcine serum.Simultaneously, rats in Dan-fang capsule groups were administered by gavage with Dan-fang capsule at doses of 4.32, 2.16, 0.54 g/kg, respectively.Rats in Fu-Fang-Bie-Jia-Ruan-Gan tablet group were orally administered by gavage with Fu-Fang-Bie-Jia-Ruan-Gan tablet (0.54 g/kg) every day and the normal control group received saline alone.All rats were killed at the end of the 12th week. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and PⅢnp clia (PⅢNP) were measured in the groups.Pathology changes of hepatic tissue were evaluated by hematoxylin-eosin (HE) and Masson staining.The proteinic expressions of alpha-smooth muscle actin (α-SMA), collagen-Ⅰ (COL-Ⅰ) and collagen-Ⅲ (COL-Ⅲ) were observed with the method of immunohistochemistry.Analysis of variance was applied when data were compared among groups. Results: Compared with those in the group A, the levels of ALT, AST and PⅢNP in serum and the expressions of α-SMA, COL-Ⅰ and COL-Ⅲ in liver tissues were significantly higher in group B [(68.3±3.4) vs (51.5±6.3) U/L, (205±52) vs (135±24) U/L, (3.1±1.4) vs (1.6±0.6) µg/L and 0.35±0.02 vs 0.13±0.02, 0.37±0.02 vs 0.13±0.02, 0.43±0.13 vs 0.13±0.01, t=17.020, 71.053, 1.552, 0.214, 0.241, 0.292, all P<0.01], and the degree of liver fibrosis significantly increased in group B than that in group A. Compared with those in group B, the levels of ALT, AST, PⅢNP and the expressions of α-SMA, COL-Ⅰ, COL-Ⅲ were all significantly lower in group D, E and F (t=-58.232--0.104, all P<0.01). The degree of liver fibrosis significantly reduced in group D, E and F than that in group B (Z=3.82, 3.76, 3.90, all P<0.05). Conclusion: Dan-fang capsule has certain preventive effect on liver fibrosis that caused by porcine serum in rats.

[Textual research on P. t.1061, a Tibetan veterinary medical scroll fragment of Dunhuang literature preserved in France].

P. t.1061 preserved at the Manuscripts Department of the Bibiothèque Nationle de France, is a Dunhuang Tibetan veterinary medical manuscript that focuses on the surgical therapy of equine rhinopathy. The method of blowing a small quantity of ammonium chloride through a bamboo tube to treat horse nasal sinus diseases was described in the original scroll; if not effective, burn with a proper cauterization apparatus; if still ineffective, prick with a fine bloodletting needle; if still not effective, operate frontal trephination. The frontal trephination documented in P. t.1061 is by far the earliest record in Tibetan language of relative operation so far discovered.

Levothyroxine monotherapy versus levothyroxine and selenium combination therapy in chronic lymphocytic thyroiditis.

PURPOSE: New strategies are needed for prevention and treatment of chronic lymphocytic thyroiditis (CLT). This study aimed to assess whether combination of levothyroxine treatment and selenium (Se) supplementation results in improved therapeutic effects in CLT compared with levothyroxine monotherapy. METHODS: An open-label, randomized controlled study was performed in 60 CLT patients assigned to two groups. Levothyroxine group (LT) patients (n = 24) received levothyroxine alone for 3 months; meanwhile, the combination (LTSS) group (n = 36) was administered levothyroxine with selenium yeast capsule. Blood selenium concentrations, anti-thyroid peroxidase (TPO) and anti-thyroglobulin (Tg) antibody levels, and inflammatory cytokine amounts were compared between both groups before and after treatment. RESULTS: At baseline, similar values were obtained in both groups for all the parameters assessed (p > 0.05). After treatment, significantly increased blood selenium levels (µg/L) [90.05 (80.69, 107.76) vs. 39.64 (29.42, 51.10), p < 0.001] and decreased anti-TPO antibody (23.63 ± 9.31 vs. 32.00 ± 10.41%, p = 0.002), anti-Tg antibody (35.84 ± 15.21 vs. 45.47 ± 14.24%, p = 0.015) and IL-2 amounts (pg/mL) [159.29 (124.54, 189.70) vs. 226.48 (190.74, 266.56), p < 0.001] were observed in the LTSS group compared with the LT group post-treatment; meanwhile, similar IL-10 concentrations [23.14 (21.65, 28.56) pg/mL vs. 24.68 (21.71, 29.67) pg/mL] were obtained in both groups. Subgroup analysis of patients with hypothyroidism showed the same trend observed in the whole population; in patients with normal thyroid function, only Se and IL-2 amounts differed between the two treatment groups. Correlation analysis of of the indexes: in HT patients, the basal serum selenium concentration was positively correlated with TT4 (r = 0.294, p < 0.05), significantly negatively correlated with TSH (r = -0.343, p < 0.01), and had no significant correlation with TT3 (p > 0.05). CONCLUSIONS: These findings indicated that levothyroxine and selenium combination results in improved therapeutic effects than the levothyroxine monotherapy in preventing CLT progression.

Low-dose hyperthermia enhances the antitumor effects of chemotherapy in squamous cell carcinoma.

Esophageal squamous cell carcinoma is a highly aggressive neoplasm and the sixth leading cause of global cancer-related death; the 5-year survival rate for esophageal cancer is only about 20%-25% for all stages. Therefore, improving the therapeutic effect is important. This study assessed whether low-dose hyperthermia (LDH) enhances the antitumor effects of chemotherapy. The antitumor effect of chemotherapy with/without LDH in the squamous cell carcinoma cell line SCCVII was evaluated. A comprehensive analysis was performed with real-time polymerase chain reaction (PCR) to study the hyperthermia-induced changes in the gene expression of SCCVII cell lines. In addition, the cytotoxic and apoptotic changes in the cells treated with LDH combined with/without 5-fluorouracil (5-FU) were measured. LDH combined with 5-FU (10 nM) strongly inhibited the cell growth of SCCVII, with flow cytometry showing an increased population of apoptotic cells. PCR showed that LDH promoted a 25.22-fold increase of p53 mRNA and 18.08-fold increase of Bax mRNA in vitro. MDR1 expression was decreased to 28.7% after LDH. This treatment can result in much higher efficacy of antitumor drugs. After LDH, the expressions of TS decreased to 12.06%, OPRT increased by 4.17-fold, and DPD did not change (1.03-fold). This transformations will induce susceptibility to 5-FU. LDH may be a useful enhancer of chemotherapy drugs for squamous cell carcinoma.

Associations between serum vitamin E concentration and bone mineral density in the US elderly population.

Mixed findings regarding effects of vitamin E on bone metabolism existed. We were the first to find a negative association between serum α-tocopherol concentration and bone mineral density in the US elderly population. Using vitamin E supplement as α-tocopherol to promote bone health was not warranted at this time. INTRODUCTION: The aim of the study is to examine the associations between serum vitamin E (α-tocopherol and γ-tocopherol) status and bone mineral density (BMD) among the US elderly population. METHODS: We used data from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. This cross-sectional study finally included 989 subjects who were not having liver diseases, kidney diseases, rheumatoid arthritis, or cancers; were not treated for osteoporosis; and were not taking steroids or female hormones. Multivariable linear regression models were employed to examine the associations between serum vitamin E (α-tocopherol and γ-tocopherol) concentration and BMDs of total spine and femoral neck after adjusting for covariates and potential confounders. RESULTS: Significant differences in serum α-tocopherol and γ-tocopherol levels, dietary intake of vitamin E as α-tocopherol, and BMDs of total spine and femoral neck were presented between male and female participants. Serum α-tocopherol and γ-tocopherol concentrations were found to be inversely correlated (r = -0.169, P < 0.001). In univariable linear models, significant negative associations between serum α-tocopherol and both total spine BMD (ß = -0.0014, P = 0.002) and femoral neck BMD (ß = -0.0017, P < 0.001) were found. Accounting for covariates, serum α-tocopherol level was negatively associated with femoral neck BMD (ß = -0.0007, P = 0.028). CONCLUSIONS: This study found a negative association between serum α-tocopherol concentration and femoral neck BMD in the US elderly population, suggesting a harmful effect of α-tocopherol on bone health. Future studies are warranted to further examine the dose-response relationships between individual vitamin E isomers and bone metabolism.

Anti-nociceptive effects of Paecilomyces hepiali via multiple pathways in mouse models.

Paecilomyces hepiali (PH), a well-known medicinal fungus, has various pharmacological efficacies. In our study, the antinociceptive effects of PH and underlying mechanisms were evaluated using various mouse models. An acetic acid-induced writhing test, hot plate test, and formalin test were employed to evaluate the antinociceptive activities of PH. The levels of neuronal nitric oxide synthase (nNOS) in the hypothalamus and monoamine neurotransmitters in the serum and hypothalamus of experimental mice were examined. Additionally, hot plate tests using mice pretreated with various antagonists were used to determine the mechanisms of PH-mediated antinociception. The PH-enhanced latency period of mice in the hot plate test was significantly blocked by pretreatment with atropine and glibenclamide. PH shortened the phase I and phase II reaction times of formalin-treated mice. Strongly reduced writhing and stretching induced by acetic acid were observed in PH-treated mice, indicating that PH mainly exerts antinociceptive activity on neurogenic pain. After thermal pain stimulation for 30 s, compared to control mice, 7-day PH-treated mice had lower nNOS and dopamine levels, and increased levels of serotonin in both the serum and hypothalamus. Collectively, our data showed that PH mediated antinociceptive activities via multiple pathways, including monoamines, nNOS/ATP-sensitive K+ channels, and M-type acetylcholine receptors.

Antimicrobial and antitumor activity and diversity of endophytic fungi from traditional Chinese medicinal plant Cephalotaxus hainanensis Li.

Endophytes from Cephalotaxus hainanensis Li, an important source of anti-leukemia drugs, have not been widely explored. In this study, 265 endophytic fungal isolates from C. hainanensis Li were screened for antimicrobial activities against tilapia, banana, rice, and rape and for antitumor activities against human leukemia cell lines (K562, NB4, and HL-60). Diversity was also analyzed. The results showed that 17.7% of the endophytic fungi had antimicrobial activities against at least three different test microbes, and activity against Fusarium oxysporum RKY102 was the highest at 15.8%. Cytotoxicity against at least one tumor cell line tested was observed in 18.5% of the endophytic fungi; with the highest value of 10.6% against K562. The endophytic fungal strains also showed relatively high activities against K562, NB4, and HL-60 while relatively fewer strains were cytotoxic against the human hepatic Hep-G2 and colon LoVo cancer cell lines. Thirty endophytic fungal strains showed both high antimicrobial and antitumor activities. Moreover, the analyses of the diversity of the 30 highly active strains showed they belonged to 20 species from 14 genera, and this is the first report of endophytic fungi Albonectria rigidiuscula, Colletotrichum magnisporum, and Nemania diffusa being isolated from Cephalotaxus plants. These findings suggest that natural antibacterial products for humans and tilapia; antifungal compounds for rice, rape, and banana; and antitumor compounds for leukemia therapy could be isolated from fungal strains derived from C. hainanensis Li.