[Cost-benefit analysis on the intervention of application iron-fortified soy sauce for anemia in Deqing 15-54 years women, Zhejiang].

OBJECTIVE: To make a cost-benefit analysis on anemia intervention with iron-fortified soy sauce in 15-54 years old women. METHODS: The study was conducted in Deqing county, Zhejiang province in 2012-2013. A total 585 women as sampling size were estimated with statistical model and randomly selected by probability proportionate to size sampling. Hemoglobin were measured before intervention and after 15 months. The cost of the intervention project were collected with manpower, communication and other invest. The benefit was estimated with profiling model. RESULTS: After the intervention, the anemia prevalence of sampled women decreased from 31.1% to 21.9%(P<0.01). The major cost of the project was 156 400 RMB, and total benefits result ing from projects were 1 448 485 RMB. The cost-benefit ratio of the project is 1∶9.49. If investing one yuan can produce economic benefits of nearly 9.49 yuan, therefore, the intervention projectis worth to be scaling up. Sensitivity analysis showed the result of this study was stable. CONCLUSION: The intervention can significantly reduce the prevalence of anemia in women, and reduce the economic burden of the diseases. .

Whether Syndrome Differentiation Affects Treatment Result: Study Protocol of MaZiRenWan () for Functional Constipation in A Randomized Controlled Trial.

BACKGROUND: Syndrome is one of the most important concepts in Chinese medicine (CM) theory. However, it was not well accounted in most of randomized controlled trials (RCTs). OBJECTIVES: To determine whether CM syndrome differentiation affects the treatment results, functional constipation (FC) was selected as a target disease, and MaZiRenWan (, MZRW), a classic CM formula commonly used for constipation with excessive heat syndrome, was selected for study. METHODS: It is an 18-week prospective double-blinded, doubledummy RCT, including 2-week run-in, 8-week treatment and 8-week post treatment follow-up. A total of 120 FC patients diagnosed as excessive heat syndrome will be recruited from the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and the Baokang Affiliated Hospital of Tianjin University of Traditional Chinese Medicine. Patients will be randomly allocated into fixed MZRW (f_MZRW) granule group, modified MZRW (m_MZRW) granule group or bisacodyl group. For m_MZRW group, no more than two herbal granules can be added according to the syndrome differentiation for individual participants. The primary end point is the mean of complete spontaneous bowel movements (CSBMs) per week during the treatment period. Secondary end points include mean of CSBMs per week during follow-up, stool form, global symptom improvement, constipation and constipation-related symptoms assessment, CM syndrome change, and reported adverse events. DISCUSSION: This trial is designed to evaluate the effectiveness of these three interventions for FC patients with the CM syndrome of excessive heat, and to determine the change of CM syndrome and the progress of disease during the treatment course. The results are important to explore whether syndrome differentiation is important for the therapeutic effect of a formula on a disease. [Trial registration: Chinese Clinical Trial Registry (Reg No. ChiCTR-TRC-13003742); protocol version: MZRW/NSFC-81173363 (2015.05.04)].

Effect of Yang-activating and stasis-eliminating decoction from Traditional Chinese Medicine on intestinal mucosal permeability in rats with ulcerative colitis induced by dextran sulfate sodium.

OBJECTIVE: To evaluate the effect of decoction prepared with Yang-activating and stasis-eliminating medicinals from Traditional Chinese Medicine (TCM) on the intestinal mucosal permeability in rats with ulcerative colitis induced by dextran sulfate sodium (DSS). METHODS: Totally 55 male Wistar rats (body weight of 170-190 g) were randomly divided into the blank group (n = 10) and the model duplication group (n = 45). The blank group was not intervened, while the other was modeled with 5% dextran sulfate sodium by gavaging in a dosage of 4 mL per day to induce ulcerative colitis, a total of 7 days. Then, the model rats were divided into model blank group, mesalazine group and TCM group, and each group was consisted of 15 rats. They were given retention enema 10 min with normal saline, mesalazine enema (0.036 g/mL), and Yang-activating and stasis-eliminating decoction [0.54 g/mL of a decoction boiled by Puhuang (Pollen Typhae), Xiebai (Bulbus Allii Macrostemonis) and Wulingzhi (Faeces Trogopteri)] for 10 days respectively. Afterwards, all of the rats were evaluated by disease activity index (DAI), histological changes of distal colon, expression of occludin protein and ultrastructure of intestinal epithelial cells. Furthermore, ratio of lactulose to mannitol (L/M) discharged in urine was evaluated. RESULTS: Comparing the results between TCM and model control groups, scores of DAI and histological lesions decreased significantly (P = 0.000 < 0.01), ultrastructures of intestinal epithelial cells and tight junctions were more complete. The expression of occludin protein (P = 0.001 < 0.01) increased while the L/M value decreased significantly (P = 0.000 < 0.01) in TCM group. There was no statistical difference between the TCM and mesalazine groups in results of each item (P > 0.05). CONCLUSION: The decoction prepared with Yang-activating and stasis-eliminating TCM medicianls can restore intestinal mucosal epithelial cells and tight junctions the model rats with ulcerative colitis; it can reduce histological lesions and protect the permeability of intestinal mucosa barrier in the rats as well.

Dietary protein's and dietary acid load's influence on bone health.

A variety of genetic, mechano-response-related, endocrine-metabolic, and nutritional determinants impact bone health. Among the nutritional influences, protein intake and dietary acid load are two of the factors most controversially discussed. Although in the past high protein intake was often assumed to exert a primarily detrimental impact on bone mass and skeletal health, the majority of recent studies indicates the opposite and suggests a bone-anabolic influence. Studies examining the influence of alkalizing diets or alkalizing supplement provision on skeletal outcomes are less consistent, which raises doubts about the role of acid-base status in bone health. The present review critically evaluates relevant key issues such as acid-base terminology, influencing factors of intestinal calcium absorption, calcium balance, the endocrine-metabolic milieu related to metabolic acidosis, and some methodological aspects of dietary exposure and bone outcome examinations. It becomes apparent that for an adequate identification and characterization of either dietary acid load's or protein's impact on bone, the combined assessment of both nutritional influences is necessary.

Urinary isoflavone phytoestrogens in German children and adolescents--a longitudinal examination in the DONALD cohort.

SCOPE: In light of concerns about hormonally active agents, it is important to assess human exposure to such compounds, especially in children as a susceptible subgroup. Estrogenic plant constituents are present in the human diet in varying levels, in particular the isoflavones daidzein (DAI) and genistein (GEN). We aimed to examine age-dependent and secular trends in phytoestrogen exposures and to investigate equol (EQ) excretion of German children using biomarker analysis in 24-h urine samples from a longitudinally designed study. METHODS AND RESULTS: The concentrations of DAI, its metabolite EQ and GEN were determined by GC-MS analysis in 24-h urines (510 samples) collected between 1985 and 2000 in 90 (47 boys) German children (6-18 years old), who are participants in the Dortmund Nutritional and Anthropometric Longitudinally Designed study. The results from the urinary biomarker analysis indicate isoflavone exposures at quite variable levels in German children: Analyte concentrations in over 500 urine samples cover the range reported previously in adults on typical German diet and with soy intake. EQ, the DAI metabolite produced by the gastrointestinal microflora, was detected in a high fraction of all samples, with 28/90 children (31%) excreting EQ in all their urines, and 62/90 children (68%) in at least one sample. Interestingly, when multiple urines obtained from individuals at different ages (6-18 years) were analyzed, EQ formation did not appear to be a constant trait over time. When stratified by sex, DAI, EQ and GEN concentrations (ng/mL) in urines and excretion rates (µg/day) were similar in boys and girls. Total isoflavone excretion rates (µg/day) increased during childhood (6-12 years) (p=0.02) and were constant during adolescence (13-18 years) (p=0.6). No clear trend for changes in dietary isoflavone exposure over the total study period was seen (p=0.7). CONCLUSIONS: In conclusion, biomarkers in urine of German children and adolescents indicate a frequent, but widely variable dietary isoflavone intake and suggest no secular increase (1985-2000) in the exposure to isoflavone phytoestrogens among German children and adolescents.