Side Chain Programming Synchronously Enhances the Photothermal Conversion Efficiency and Photodynamic Activity of A-D-A Photosensitizers.

Synchronously improving the photothermal conversion efficiency and photodynamic activity of organic small molecule photosensitizers is crucial for their further wide application in cancer treatment. Recently, the emerging A-D-A photosensitizer-based phototherapy systems have attracted great interest due to their plentiful inherent merits. Herein, we propose a design strategy for A-D-A photosensitizers with synchronously enhanced photothermal conversion and reactive oxygen species (ROS) generation efficiencies. Side chain programming is carried out to design three A-D-A photosensitizers (IDT-H, IDT-Br, IDT-I) containing hexyl, bromohexyl, and iodohexyl side chains, respectively. Theoretical calculations confirm that a bulky iodine atom could weaken the intermolecular π-π stacking and enhance spin-orbit coupling constants of IDT-I. These molecular mechanisms enable IDT-I nanoparticles (NPs) to exhibit 2.4-fold and 1.7-fold higher ROS generation efficiency than that of IDT-H NPs and IDT-Br NPs, respectively, as well as the highest photothermal conversion efficiency. Both the experimental results in vitro and in vivo verify that IDT-I NPs are perfectly qualified for the mission of photothermal and photodynamic synergistic therapy. Therefore, in this contribution, we provide a promising perspective for the design of A-D-A photosensitizers with simultaneously improved photothermal and photodynamic therapy ability.

Synthesis of Ottonia anisum Extract Mediated ZnO NPs and Their Local Anesthetic, Analgesic and HCl­induced Acute Lung Injury Activities.

In this study, we outlined the green synthesis of Zinc oxide nanoparticles (ZnO NPs) using the plant-mediated method. Employing the nitrate derivative of Zinc and the extract from the native medicinal plant, Ottonia anisum, the nanoparticles were effectively produced. After obtaining a yellow-colored paste, it was meticulously dried, gathered, and set aside for subsequent examination. The UV-visible spectrometry analysis indicated an absorption peak at 320 nm, which is indicative of ZnO NPs. Characterization techniques, such as XRD and HR-TEM, confirmed the existence of agglomerated ZnO NPs with an average diameter of 40 nm. Through EDS analysis, distinct energy signals for both Zinc and Oxygen were observed, confirming their composition. Furthermore, FT-IR spectroscopy highlighted an absorption peak for Zn-O bonding in the range of 400 to 600 cm -1 . Further, we employed three distinct pain models in mice to evaluate the influence of ZnO NPs on the nociceptive threshold. Our findings revealed that, when orally administered, ZnO NPs at concentrations ranging from 5-20 mg/kg exerted a dose-dependent analgesic effect in both the hot-plate and the acetic acid-induced writhing tests. Moreover, when ZnO NPs were administered at doses between 2.5-10 mg/kg, there was a notable reduction in pain responses during both the initial and subsequent phases of the formalin test, but no change in PGE 2 production within the mice's hind paw was found. On the other hand, acute lung injury studies revealed that the administration of ZnO NPs orally 90 minutes prior to HCl instillation decreased the neutrophil infiltration into the lungs in a doseresponsive manner. This reduction in pulmonary inflammation was paralleled by a significant decrease in lung edema, as evidenced by the reduced total protein content in the BALF. Additionally, the ZnO NPs appeared to recalibrate the lung's redox equilibrium following HCl exposure, which was determined through measurements of ROS, malondialdehyde, glutathione, and catalase activity. All these results further indicated the potential of biofabricated ZnO NPs for future applications in analgesics and acute lung injury treatments.

Bimetallic capture sites on porous La/Bi hydroxyl double salts for efficient phosphate adsorption: Multiple active centers and excellent selective properties.

The rapid development of modern agriculture aggravated water eutrophication. Therein, efficient and selective removal of phosphorus in water is the key to alleviating eutrophication. It is well known that lanthanum (La)-based material is a kind of outstanding phosphorus-locking agent. Therefore, improving the property of La-based adsorbents is a hot topic in this field. Herein, novel porous hydroxyl double salts (La/Bi-HDS) with bimetallic capture sites were prepared. The experimental result shows that La/Bi-HDS could maintain the high removal rate in the solution with a higher concentration of competing ions and the maximum P adsorption quantity of La/Bi-HDS attains 168.12 mg/g. Mechanistic studies supported by density functional theory (DFT) calculation demonstrate that introducing Bi3+ optimizes the electronic structure of La, reducing adsorption energy. In addition, the surface analysis shows that the introduction of Bi, which increases the pore size and volume of the material, improves the utilization efficiency of the active site. In a word, the introduction of Bi element as a strategy of killing two birds with one stone successfully improved the performance of La-based adsorbent. It provided a new direction for developing an efficient phosphorus-locking agent.

Mitochondria-Targeting Multimodal Phototheranostics Based on Triphenylphosphonium Cation Modified Amphiphilic Pillararenes and A-D-A Fused-Ring Photosensitizers.

Tumor-targeting phototheranostics has gradually developed as a powerful tool for the precise diagnosis and treatment of cancer. However, the designs of tumor-targeting phototheranostics agents with excellent multimodal phototherapy and fluorescence imaging (FLI) capability, as well as very few components, are still scarce and challenging for cancer treatment. Herein, a mitochondria-targeting multimodal phototheranostics system has been constructed by combining a designed amphiphilic pillararene WP5-2PEG-2TPP and the A-D-A fused-ring photosensitizer F8CA5. WP5-2PEG-2TPP is constructed by attaching the triphenylphosphonium cations to our previously reported dual PEG-functionalized amphiphilic pillararene, which can self-assemble into regular spherical nanocarriers with outstanding mitochondria targeting and water solubility. The A-D-A photosensitizer F8CA5 containing two methyl cyanoacetate group modified end groups displays superior photothermal conversion ability and dual type I/II photodynamic activity as well as strong NIR fluorescence emission. Through their strong union, multifunctional mitochondria-targeting phototheranostics agent F8CA5 NPs were obtained to be applied into FLI-guided synergistic photothermal and type I/II photodynamic therapy. As a result, F8CA5 NPs show good mitochondria-targeting and phototherapy effects in various tumor cells. Not only that, they can combat tumor hypoxia, which hinders the efficacy of photodynamic therapy. Therefore, this work provides a creative ideal for the construction of multifunctional tumor-targeting phototheranostic agents with excellent performance.

The design strategy for pillararene based active targeted drug delivery systems.

Pillararenes have columnar architectures with electron-rich cavities to endow themselves with unique host-guest complexation capability. Easy structural modifiability facilitates them to be used in many applications. Currently, pillararene based drug delivery systems (DDSs) have been developed as a powerful tool for precise diagnosis and treatment of cancer. Various functional guest molecules could be integrated with pillararenes to construct nanomaterials for cancer chemotherapy, phototherapy and chemodynamic therapy. In order to improve cancer therapy efficacy, active targeted DDSs have become particularly important. Benefiting from the good host-guest properties and structural variability of pillararenes, tumor targeting groups could be easily introduced into pillararene based DDSs to realize precise drug delivery at tumor sites. In this feature article, we provide a comprehensive summary of the present design strategy for pillararene based active targeted DDSs, which can be classified into three types namely host-guest complexation, charge reversal and targeted group modified pillararenes. Some important examples are selected to for a detailed discussion on their respective strengths and weaknesses.

End Group Nonplanarization Enhances Phototherapy Efficacy of A-D-A Fused-Ring Photosensitizer for Tumor Phototherapy.

Enhancing the phototherapy efficacy of organic photosensitizers through molecular design is a fascinating but challenging task. Herein, we propose a simple design strategy to first realize the generation of superoxide anion radical (O2•-) by A-D-A fused-ring photosensitizers. Through replacing one cyano group of traditional end group with an ester group, we designed a novel nonplanar end group (A unit) to synthesize a novel A-D-A photosensitizer F8CA. In a comparison with its counterpart F8CN with the traditional end group, F8CA displays more loose packing and larger spin-orbit coupling constants. The F8CA nanoparticles showed higher photodynamic activities with the generation capability of singlet oxygen (1O2), hydroxyl radical (•OH), and O2•-, while F8CN nanoparticles could only generate 1O2 and •OH. In addition, F8CA nanoparticles still remain high photothermal conversion efficiency (61%). As a result, F8CA nanoparticles perform well in hypoxia-tolerant tumor phototherapy. This study brings an effective design thought for A-D-A photosensitizers.

[Guideline for clinical comprehensive evaluation of Chinese patent medicine (2022 version)].

Currently,the research or publications related to the clinical comprehensive evaluation of Chinese patent medicine are increasing,which attracts the broad attention of all circles. According to the completed clinical evaluation report on Chinese patent medicine,there are still practical problems and technical difficulties such as unclear responsibility of the evaluation organization,unclear evaluation subject,miscellaneous evaluation objects,and incomplete and nonstandard evaluation process. In terms of evaluation standards and specifications,there are different types of specifications or guidelines with different emphases issued by different academic groups or relevant institutions. The professional guideline is required to guide the standardized and efficient clinical comprehensive evaluation of Chinese patent medicine and further improve the authority and quality of evaluation. In combination with the characteristics of Chinese patent medicine and the latest research achievement at home and abroad,the detailed specifications were formulated from six aspects including design,theme selection,content and index,outcome,application and appraisal,and quality control. The guideline was developed based on the guideline development requirements of China Assoication of Chinese medicine. After several rounds of expert consensus and public consultation,the current version of the guideline has been developed.

Alkaloids isolated from the endophytic fungus Fusarium concentricum.

Endophytic fungi are an important resource for bioactive natural products. In this study, a new tryptophan derivative fusaconate A (1) and three pyridone alkaloids, including one new pyridone derivative 1'-methoxy-6'-epi-oxysporidinone (2) and two known ones (3-4), were identified from the endophytic fungus Fusarium concentricum which was isolated from the medicinal plant Anoectochilus roxburghii. Their structures were elucidated through extensive spectroscopic analysis, including HR-ESI-MS, 1 D and 2 D NMR. Compound 4 exhibited moderate cytotoxicities against HT29 and PC3 cells with IC50 values of 7.60 and 4.99 µM, respectively.

Efficacy and Safety of Modified Yupingfeng Nasal Spray in Controlling the Recurrence of Persistent and Moderate-Severe Allergic Rhinitis: Study Protocol for a Multicenter, Open-Label, Randomized, and Parallel-Arm Trial.

Background: Recurrent episode of allergic rhinitis (AR) is one of the leading illnesses that affects patients. However, there is little research evidence to support pharmacotherapy for AR recurrence. Therefore, this study was designed to explore the efficacy of pharmacotherapy in the control of the recurrence of AR. Methods: In this study, a multicenter, open-label, randomized, and parallel-arm trial will be conducted at three study centers. A total of 190 subjects aged 18-65 with persistent and moderate-severe AR (Qi deficiency and blood stasis syndrome) will be randomly assigned to receive the modified Yupingfeng nasal spray or mometasone furoate aqueous nasal spray. When subjects' rhinitis control assessment test (RCAT) score is >21 for two weeks, they will stop taking the medication and enter the follow-up. Once a relapse occurs, the time point will be recorded, and the follow-up stops. The primary outcome is the six-month recurrence rate of AR after intervention withdrawal. The secondary outcomes are the one-month recurrence rate of AR, the RCAT score, the duration of follow-up, the duration of medication, the nasal endoscopic results, and questionnaires to evaluate symptoms, signs, and quality of life. The mechanism outcomes include some indicators that may be associated with AR recurrence. In addition, electrocardiograms and other safety indicators will be applied to evaluate the drug's safety. Discussion. This is the first study to explore the efficacy of traditional Chinese medicine nasal spray on AR from the perspective of controlling recurrence. The results of this trial may provide valuable clinical evidence for controlling the recurrence of this disease by pharmacotherapy. Trial Registration. This study was registered with registration number ChiCTR2100047053 (Chinese Clinical Trial Registry, https://www.chictr.org.cn/showproj.aspx?proj=127432 on June 7, 2021).

A nanoplatform for mild-temperature photothermal and type I & II photodynamic therapy in the NIR-II biowindow.

In the current work, we synthesized an A-D-A smallmolecule photosensitizer, denoted as DPTTIC, and a dual PEG-functionalized pillararene, denoted as WP5-8C-2PEG, and used them to construct novel DPTTIC nanoparticles (NPs) displaying NIR II absorption. Under 980 nm-wavelength laser irradiation, DPTTIC NPs performed well in mild-temperature photothermal and type I & II photodynamic anti-tumor therapy.

Nitric oxide-containing supramolecular polypeptide nanomedicine based on [2]biphenyl-extended-pillar[6]arenes for drug resistance reversal.

A kind of supramolecular polypeptide nanomedicine (BPC/DOX-ICG) was constructed with an anionic water-soluble [2]biphenyl-extended-pillar[6]arene (AWBpP6), and pyridinium-terminal- and S-nitrosothiol (SNO)-modified polypeptide (PPNC) via host-guest interactions to co-deliver doxorubicin (DOX) and indocyanine green (ICG) for drug resistance reversal. Upon near-infrared (NIR) irradiation, the NO generation could down-regulate the P-glycoprotein (P-gp) expression level to reverse multidrug resistance (MDR). Subsequently, the resulting reverse MDR could sensitize the free DOX and assist photothermal therapy (PTT) to enhance the tumoricidal potential. This supramolecular polypeptide nanomedicine provides an effective strategy for the multimodal synergistic therapies of photothermal therapy, NO generation therapy, and chemotherapy (i.e., PTT-NO-CT) to overcome MDR.

Effect of Electroacupuncture on Insomnia in Patients With Depression: A Randomized Clinical Trial.

Importance: Electroacupuncture (EA) is a widely recognized therapy for depression and sleep disorders in clinical practice, but its efficacy in the treatment of comorbid insomnia and depression remains uncertain. Objective: To assess the efficacy and safety of EA as an alternative therapy in improving sleep quality and mental state for patients with insomnia and depression. Design, Setting, and Participants: A 32-week patient- and assessor-blinded, randomized, sham-controlled clinical trial (8-week intervention plus 24-week observational follow-up) was conducted from September 1, 2016, to July 30, 2019, at 3 tertiary hospitals in Shanghai, China. Patients were randomized to receive EA treatment and standard care, sham acupuncture (SA) treatment and standard care, or standard care only as control. Patients were 18 to 70 years of age, had insomnia, and met the criteria for depression as classified in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Data were analyzed from May 4 to September 13, 2020. Interventions: All patients in the 3 groups were provided with standard care guided by psychiatrists. Patients in the EA and SA groups received real or sham acupuncture treatment, 3 sessions per week for 8 weeks, for a total of 24 sessions. Main Outcomes and Measures: The primary outcome was change in Pittsburgh Sleep Quality Index (PSQI) from baseline to week 8. Secondary outcomes included PSQI at 12, 20, and 32 weeks of follow-up; sleep parameters recorded in actigraphy; Insomnia Severity Index; 17-item Hamilton Depression Rating Scale score; and Self-rating Anxiety Scale score. Results: Among the 270 patients (194 women [71.9%] and 76 men [28.1%]; mean [SD] age, 50.3 [14.2] years) included in the intention-to-treat analysis, 247 (91.5%) completed all outcome measurements at week 32, and 23 (8.5%) dropped out of the trial. The mean difference in PSQI from baseline to week 8 within the EA group was -6.2 (95% CI, -6.9 to -5.6). At week 8, the difference in PSQI score was -3.6 (95% CI, -4.4 to -2.8; P < .001) between the EA and SA groups and -5.1 (95% CI, -6.0 to -4.2; P < .001) between the EA and control groups. The efficacy of EA in treating insomnia was sustained during the 24-week postintervention follow-up. Significant improvement in the 17-item Hamilton Depression Rating Scale (-10.7 [95% CI, -11.8 to -9.7]), Insomnia Severity Index (-7.6 [95% CI, -8.5 to -6.7]), and Self-rating Anxiety Scale (-2.9 [95% CI, -4.1 to -1.7]) scores and the total sleep time recorded in the actigraphy (29.1 [95% CI, 21.5-36.7] minutes) was observed in the EA group during the 8-week intervention period (P < .001 for all). No between-group differences were found in the frequency of sleep awakenings. No serious adverse events were reported. Conclusions and Relevance: In this randomized clinical trial of EA treatment for insomnia in patients with depression, quality of sleep improved significantly in the EA group compared with the SA or control group at week 8 and was sustained at week 32. Trial Registration: ClinicalTrials.gov Identifier: NCT03122080.

Facile synthesis of low-cost MnPO4 with hollow grape-like clusters for rapid removal uranium from wastewater.

In order to deal with the environmental resource problems caused by nuclear pollution and uranium mine wastewater, it is particularly important to develop uranium removal adsorbent materials with low cost, high efficiency and controllable rapid preparation. In this work, the hollow grape-like manganese phosphate clusters (h-MnPO4) were synthesized in 4 h by in-situ etching without template at room temperature, which can quickly and effectively remove uranium ions from wastewater. Due to the reasonable hollow structure, more effective adsorption sites are exposed. The obtained sample h-MnPO4-200 reaches adsorption equilibrium in 1 h and can remove 97.20% uranyl ions (initial concentration is 100 mg L-1). Under the condition of 25 â„ƒ and pH= 4, the maximum adsorption capacity of h-MnPO4-200 for uranium was 751.88 mg g-1. The FT-IR, XPS and XRD analysis showed that -OH and PO43- groups played a key role in the adsorption process. Thanks to the synergistic adsorption mechanism of surface complexation and dissolution-precipitation, h-MnPO4-200 maintained a high removal rate in the presence of competitive anions and cations. In a word, h-MnPO4-200 can be rapidly synthesized through a facile and low-cost method and has a great application prospect in the practical emergency treatment of uranium-containing wastewater.

Polydopamine-drug conjugate nanocomposites based on ZIF-8 for targeted cancer photothermal-chemotherapy.

Stimuli-responsive prodrug-based nanoplatform with synergistic antitumor activity is of central importance to the development of promising nanomedicines for cancer therapy. Here, we describe a polydopamine-drug conjugate nanocomposite (ZP-PDA-DOX) with targeted cancer photothermal-chemotherapy (PTT-CT), which constructed by a gradual copolymerization of dopamine (DA) and pH-sensitive dopamine-derived prodrug (DA-DOX) into the porous channels of zeolite imidazolate frameworks-8 (ZIF-8), followed by PEGylation with amino-terminated folic acid-polyethylene glycol (NH2 -PEG-FA) to acquire the high biocompatibility, specificity, and excellent tumor-targeting property. The incorporation of polydopamine strengthened the stability and dispersion of ZIF-8, and also conferred photothermal conversion effect. In the tumor acidic microenvironment, the acid-labile hydrazone linker of DA-DOX and ZIF-8 promptly degraded to release activated DOX. Moreover, the generated hyperthermia due to the high photothermal conversion efficiency of PDA component could accelerate drug release, and simultaneously thermally ablate tumor tissue to maximize the DOX-induced CT, which could also assist PTT to eradicate tumor cells. This study provides a promising strategy for targeted cancer PTT-CT with synergistic anti-tumor effect.

The Association of Sleep Duration With Vision Impairment in Middle-Aged and Elderly Adults: Evidence From the China Health and Retirement Longitudinal Study.

Objective: This study aims to investigate the association of sleep duration with vision impairment (VI) in middle-aged and elderly adults. Methods: This cross-sectional study used the data from the baseline survey of the China Health and Retirement Longitudinal Study (CHARLS) 2011-2012, a national survey of adults aged 45 years or older. Weighted multilevel logistic regression models were used to evaluate the association between self-reported sleep duration and VI. Results: Of the 13,959 survey respondents, a total of 4,776 (34.2%) reported VI. The prevalence of short (≤6 h/night) and long (>8 h/night) sleep durations was higher among respondents with VI than those without VI (P < 0.001). Multilevel logistic regression models showed that compared with a sleep duration of 6-8 h/night, a sleep duration of ≤6 h/night was associated with a 1.45-fold [95% confidence interval (CI) = 1.34-1.56] higher VI risk, and a sleep duration of >8 h/night was associated with a 1.18-fold (95% CI = 1.03-1.34) higher VI risk, after adjusting for sociodemographic data, lifestyle factors, and health conditions. Vision impairment was associated with short sleep duration in respondents from all age or gender categories. However, VI was associated with long sleep duration in respondents from the elderly or female categories. The association between VI and long sleep duration disappeared in respondents of middle-aged or male categories. Conclusions: The potential impact of sleep on the risk of visual functions requires further attention. A more comprehensive and integrated health care and rehabilitation system covering vision and sleep is also needed.

Methods and Influencing Factors for the Simple and Rapid Identification of Depleted Uranium Weapon Use under Battlefield Conditions.

The purpose of this paper is to explore how to rapidly and easily identify depleted uranium (DU) samples under battlefield conditions and to study the factors that influence their measurement. The air-absorbed dose rate and surface contamination levels for DU samples of 2-330 g were measured using a patrol instrument and portable energy spectrometer. The results were analyzed in accordance with IAEA standards for judging radioactive substances. The energy spectra of 5-g quantities of DU samples were analyzed using a high-purity germanium gamma spectrometer, and the uranium content of 100 mg DU samples was determined with an inductively coupled plasma mass spectrometer to clarify the type and composition of the uranium. The same batches of DU samples were identified using a portable gamma-ray spectrometer. We added 0-5 g environmental soil powders at different proportions. After sealing, the spectra were collected with a detection distance of 1-5 cm for 10 min. The activities of U and U nuclides in the samples were detected with an NaI(TI) scintillation detector. The U and U mass abundances in samples were calculated from measured specific activities. The sample was determined to contain DU if the U to U ratio was below 0.00723. It is found that for detecting DU materials with a low activity, surface contamination level measurements are more effective than calculating the air-absorbed external irradiation dose rate. Hence, for low-activity samples suspected to be radioactive, a radiometer with a high sensitivity for surface contamination is recommended, and the optimal measurement distance is 1-3 cm. Under all detection conditions, U can be identified using a portable gamma spectrometer, whereas U can only be detected under certain conditions. If these nuclides can be detected simultaneously, a U to U ratio of below 0.00723 indicates the presence of DU. The main factors affecting this identification include the sample mass, sample purity, measurement distance, and measurement time. For the rapid identification of DU with a portable gamma-ray spectrometer, the mass of uranium in the sample must be more than 1 g, the measuring distance needs to be less than 1 cm, and the measuring time must be 1-10 min. It is feasible to use a portable gamma-ray spectrometer to rapidly identify the types and composition of nuclides in DU samples. The detection of U activity is a precondition for the identification of DU.

Combination and distribution characteristics of syndromes related to traditional Chinese medicine in patients with chronic heart failure: Protocol for a clinical study.

INTRODUCTION: Chronic heart failure has become one of the main diseases endangering human health in the 21st century. It is characterized by high morbidity and high mortality. With the continuous in-depth study of Traditional Chinese medicine, the treatment of heart failure by Tradional Chinese medicine has made significant progress, especially in improving the clinical symptoms of patients, controlling the development of the disease, and improving the quality of life of patients. METHODS/DESIGN: This will be a retrospective, single-blind clinical observational study. All participants will receive chronic heart failure routine treatment and care. The researcher will fill in the case information collection form and collect multiple clinical diagnosis and treatment information. DISCUSSION: At present, there is very little research on the elements of chronic heart failure syndrome, and more exploration and excavation in this area are needed. So we designed this program. We aim to explore the distribution characteristics of Traditional Chinese medicine syndrome elements and combinations of chronic heart failure patients, and analyze the relationship between syndrome elements and related influencing factors. TRIAL REGISTRATION: ClinicalTrials.gov,ChiCTR2000034555, Registered on 18 May 2020.

Distribution of traditional Chinese medicine syndromes in type 2 diabetes mellitus with chronic heart failure: A clinical study.

INTRODUCTION: The incidence of type 2 diabetes has been increasing year by year in recent years. Type 2 diabetes is an important risk factor in the occurrence and development of heart failure, and it is the second potential risk factor after coronary artery disease. At present, there is no unified etiology, pathogenesis, and syndrome differentiation criteria for type 2 diabetes with chronic heart failure, and it is susceptible to subjective factors. Therefore, standardized, objective, and standardized research is needed to provide reference and guidance for clinical diagnosis and treatment. In this study, the theory of syndrome differentiation is used to initially explore the distribution of traditional Chinese medicine syndromes in patients with type 2 diabetes and chronic heart failure through case data collection, syndrome extraction, and clinical data analysis. METHODS/DESIGN: In this study, we will collect at least 500 cases of type 2 diabetes with chronic heart failure that meet the standard outpatient and hospitalization, and fill out the case information collection form. Then we will collect a number of clinical diagnosis and treatment information, and judge the syndrome based on the sum of the contribution of each syndrome to the relevant syndrome. We will use Microsoft Excel to establish a database, enter the relevant diagnosis and treatment, and syndrome information of the case information collection table, and verify and correct in time to ensure the accuracy of the data. DISCUSSION: This study will provide reference and guidance for the clinical diagnosis and treatment of type 2 diabetes with chronic heart failure. TRIAL REGISTRATION: ClinicalTrials.gov, ChiCTR2000033010, Registered on May 18, 2020.

Adefovir Dipivoxil plus Chinese Medicine in HBeAg-Positive Chronic Hepatitis B Patients: A Randomized Controlled 48-Week Trial.

OBJECTIVE: To evaluate the effects of a 48-week course of adefovir dipivoxil (ADV) plus Chinese medicine (CM) therapy, namely Tiaogan Jianpi Hexue () and Tiaogan Jiedu Huashi () fomulae, in hepatitis B e antigen (HBeAg)-positive Chinese patients. METHODS: A total of 605 HBeAg-positive Chinese CHB patients were screened and 590 eligible participants were randomly assigned to 2 groups in 1:1 ratio including experimental group (EG, received ADV plus CM) and control group (CG, received ADV plus CM-placebo) for 48 weeks. The major study outcomes were the rates of HBeAg and HBV-DNA loss on week 12, 24, 36, 48, respectively. Secondary endpoints including liver functions (enzymes and bilirubin readings) were evaluated every 4 weeks at the beginning of week 24, 36, and 48. Routine blood, urine, and stool analyses in addition to electrocardiogram and abdominal B scan were monitored as safety evaluations. Adverse events (AEs) were documented. RESULTS: The combination therapy demonstrated superior HBeAg loss at 48 weeks, without additional AEs. The full analysis population was 560 and 280 in each group. In the EG, population achieved HBeAg loss on week 12, 24, 36, and 48 were 25 (8.90%), 34 (12.14%), 52 (18.57%), and 83 (29.64%), respectively; the equivalent numbers in the CG were 20 (7.14%), 41 (14.64%), 54 (19.29%), and 50 (17.86%), respectively. There was a statistically significant difference between these group values on week 48 (P<0.01). No additional AEs were found in EG. Subgroup analysis suggested different outcomes among treatment patterns. CONCLUSION: Combination of CM and ADV therapy demonstrated superior HBeAg clearance compared with ADV monotherapy. The finding indicates that this combination therapy may provide an improved therapeutic effect and safety profile (ChiCTR-TRC-11001263).

Association of Dietary Magnesium Intake with Fatal Coronary Heart Disease and Sudden Cardiac Death.

Background: Postmenopausal women represent the highest population-based burden of cardiovascular disease, including sudden cardiac death (SCD). Our understanding of the etiology and risk factors contributing to fatal coronary heart disease (CHD) and SCD, particularly among women, is limited. This study examines the association between dietary magnesium intake and fatal CHD and SCD. Materials and Methods: We examined 153,569 postmenopausal women who participated in the Women's Health Initiative recruited between 1993 and 1998. Magnesium intake at baseline was assessed using a validated food frequency questionnaire, adjusting for energy via the residual method. Fatal CHD and SCD were identified over an average follow-up of 10.5 years. Results: For every standard deviation increase in magnesium intake, there was statistically significant risk reduction, after adjustment for confounders, of 7% for fatal CHD (hazard ratio [HR] 0.93, 95% confidence interval [CI] 0.89-0.97), and 18% risk reduction for SCD (HR 0.82, 95% CI 0.58-1.15) the latter of which did not reach statistical significance. In age-adjusted quartile analysis, women with the lowest magnesium intake (189 mg/day) had the greatest risk for fatal CHD (HR 1.54, 95% CI 1.40-1.69) and SCD (HR 1.70, 95% CI 0.94-3.07). This association was attenuated in the fully adjusted model, with HRs of 1.19 (95% CI 1.06-1.34) for CHD and 1.24 (95% CI 0.58-2.65) for SCD for the lowest quartile of magnesium intake. Conclusions: This study provides evidence of a potential inverse association between dietary magnesium and fatal CHD and a trend of magnesium with SCD in postmenopausal women. Future studies should confirm this association and consider clinical trials to test whether magnesium supplementation could reduce fatal CHD in high-risk individuals.