Mulberry and Hippophae-based solid beverage promotes weight loss in rats by antagonizing white adipose tissue PPARγ and FGFR1 signaling.

Obesity, a multifactorial disease with many complications, has become a global epidemic. Weight management, including dietary supplementation, has been confirmed to provide relevant health benefits. However, experimental evidence and mechanistic elucidation of dietary supplements in this regard are limited. Here, the weight loss efficacy of MHP, a commercial solid beverage consisting of mulberry leaf aqueous extract and Hippophae protein peptides, was evaluated in a high-fat high-fructose (HFF) diet-induced rat model of obesity. Body component analysis and histopathologic examination confirmed that MHP was effective to facilitate weight loss and adiposity decrease. Pathway enrichment analysis with differential metabolites generated by serum metabolomic profiling suggests that PPAR signal pathway was significantly altered when the rats were challenged by HFF diet but it was rectified after MHP intervention. RNA-Seq based transcriptome data also indicates that MHP intervention rectified the alterations of white adipose tissue mRNA expressions in HFF-induced obese rats. Integrated omics reveals that the efficacy of MHP against obesogenic adipogenesis was potentially associated with its regulation of PPARγ and FGFR1 signaling pathway. Collectively, our findings suggest that MHP could improve obesity, providing an insight into the use of MHP in body weight management.

[Bioinformatics analysis and validation of key genes in transformation of idiopathic membranous nephropathy to end-stage renal disease and traditional Chinese medicines for prevention and treatment].

This study used bioinformatics analysis to screen out key genes involved in the transformation of idiopathic membranous nephropathy to end-stage renal disease and to predict targeted Chinese herbs and medicines and active ingredients with preventive and curative effects. The GSE108113 microarray of idiopathic membranous nephropathy and GSE37171 microarray of were downloaded from the comprehensive gene expression database, and 8 homozygous differentially expressed genes for the transformation of idiopathic membranous nephropathy into end-stage renal disease of were screened out by R software. GraphPad Prism was used to verify the expression of homozygous differentially expressed genes in GSE115857 microarray of idiopathic membranous nephropathy and GSE66494 microarray of chronic kidney disease, and 7 key genes(FOS, OGT, CLK1, TIA1, TTC14, CHORDC1, and ANKRD36B) were finally obtained. The Gene Ontology(GO) analysis was performed. There were 209 functions of encoded proteins, mainly involved in regulation of RNA splicing, cytoplasmic stress granule, poly(A) binding, etc. Thirteen traditional Chinese medicines with the effect of preventing the transformation of idiopathic membranous nephropathy to end-stage renal disease were screened out from Coremine Medical database, including Ginseng Radix et Rhizoma, Lycopi Herba, and Gardeniae Fructus, which were included in the Chinese Pharmacopoeia(2020 edition). The active ingredient quercetin mined from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) had ability to dock with the key gene FOS-encoded protein molecule, which provided targets and research ideas for the development of new traditional Chinese medicines.

Bioinformatics analysis and validation of key genes in transformation of idiopathic membranous nephropathy to end-stage renal disease and traditional Chinese medicines for prevention and treatment / 中国中药杂志

This study used bioinformatics analysis to screen out key genes involved in the transformation of idiopathic membranous nephropathy to end-stage renal disease and to predict targeted Chinese herbs and medicines and active ingredients with preventive and curative effects. The GSE108113 microarray of idiopathic membranous nephropathy and GSE37171 microarray of were downloaded from the comprehensive gene expression database, and 8 homozygous differentially expressed genes for the transformation of idiopathic membranous nephropathy into end-stage renal disease of were screened out by R software. GraphPad Prism was used to verify the expression of homozygous differentially expressed genes in GSE115857 microarray of idiopathic membranous nephropathy and GSE66494 microarray of chronic kidney disease, and 7 key genes(FOS, OGT, CLK1, TIA1, TTC14, CHORDC1, and ANKRD36B) were finally obtained. The Gene Ontology(GO) analysis was performed. There were 209 functions of encoded proteins, mainly involved in regulation of RNA splicing, cytoplasmic stress granule, poly(A) binding, etc. Thirteen traditional Chinese medicines with the effect of preventing the transformation of idiopathic membranous nephropathy to end-stage renal disease were screened out from Coremine Medical database, including Ginseng Radix et Rhizoma, Lycopi Herba, and Gardeniae Fructus, which were included in the Chinese Pharmacopoeia(2020 edition). The active ingredient quercetin mined from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) had ability to dock with the key gene FOS-encoded protein molecule, which provided targets and research ideas for the development of new traditional Chinese medicines.

Comparison of high-dose dual therapy with bismuth-containing quadruple therapy in Helicobacter pylori-infected treatment-naive patients: An open-label, multicenter, randomized controlled trial.

OBJECTIVE: Bismuth-containing quadruple therapy for Helicobacter pylori (H. pylori) eradication has a relatively high rate of side effects and high cost, thus the option of a high-dose dual therapy with a high eradication rate and fewer adverse events is a consideration. However, studies of dual therapy are still scarce and are mostly single-center studies with limited generalizability. Large-scale, multicenter studies are required. Our study investigated and compared the effectiveness, adverse events, patient compliance, and costs of high-dose dual therapy with those of bismuth-containing quadruple therapy in H. pylori-infected treatment-naive patients in a prospective, multicenter, open-label, randomized controlled trial. METHOD: Treatment-naive patients infected with H. pylori were randomly assigned to receive high-dose dual therapy (esomeprazole 20 mg 4 times daily and amoxicillin 1000 mg 3 times daily, for 14 days) or bismuth-containing quadruple therapy (esomeprazole 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and bismuth potassium citrate 220 mg, all twice daily for 14 days). The effectiveness, adverse events, patient compliance, and costs of both groups were compared. RESULTS: A total of 700 patients were enrolled. The high-dose dual therapy group (N = 350) achieved eradication rates of 89.4% (intention-to-treat), 90.4% (modified intention-to-treat), and 90.6% (per-protocol), which were similar to rates in the bismuth-containing quadruple therapy group (N = 350), 84.6%, 88.0%, and 88.2%, respectively (p > 0.05). The high-dose dual therapy group had a lower rate of adverse events (12.9% vs. 28.1%, p < 0.001) and lower costs (¥590.2 vs. ¥723.22) compared with the quadruple therapy group, respectively. The compliance of both groups was satisfactory (97.7% high-dose dual vs. 96.8% quadruple, p > 0.05). CONCLUSION: High-dose dual therapy for H. pylori eradication had similar efficacy and compliance, fewer adverse events, and lower costs than bismuth-containing quadruple therapy for treatment-naive patients.

Life, death, and spirituality: A conceptual analysis for educational research development.

Life education, also known as life and death education, is an important subject in Taiwan. Life education is more than just the study of a person's development throughout the lifespan (e.g., cognitive development). Within the learning and sociocultural contexts of Taiwan, interestingly, the study of life and death education is concerned with the premise of the promotion and fulfillment of life qualities (e.g., a person's state of contentment), and the meaningful understanding of the nature of death. To facilitate appreciation and deep, meaningful understanding of the subject, and to emphasize its uniqueness, educators have included in their teaching the importance of Eastern-derived philosophical beliefs and religious faiths (e.g., Buddhism). For example, relatively significant in its emphasis, the teaching of this subject involves detailed examination of theoretical accounts of spiritual cultivation and its positive effect on a person's interpretation and enlightenment of life wisdom. The study of life education, or life and death education, we contend, is of significance as it provides life-related insights and theoretical understanding into the intricate nature of life and death. One notable aspect of the subject entails a person's acquired life wisdom, which in turn may shape his/her life practice on a daily basis (e.g., the proactive engagement in Buddhist meditation). Importantly, the study of life education may assist individuals with their coping of grief, and to approach death with a sense of peace, calmness, and dignity. In this analysis, coupled with Buddhist faith (or any other religious faith for that matter) and facilitated by spiritual cultivation (e.g., the belief in the notion of transcendence experience), a person may overcome grief by believing in the possibility that there is some form of post-death experience and the presence of a loved one's spiritual being. Given this emphasis, we consider an important focus for discussion in this article: to explore the significance of life and death education and to determine how its 'positive nature' could potentially yield two comparable implications for development: (i) to engage in appropriate pedagogical practices that would encourage and promote the study of life and death education, and (ii) to advance innovative research inquiries, theoretical, methodological, and/or empirical, which could highlight the significance of life education for life purposes (e.g., the significance of Chinese ideograms, such as ).

Hepatic targeting of glycyrrhetinic acid via nanomicelles based on stearic acid-modified fenugreek gum.

This study aimed to increase the solubility of glycyrrhetinic acid (GA) in water and enhance its liver-targeting ability using self-assembling nanomicelles (NMs) based on stearic acid-modified fenugreek gum (FG-C18). The GA/FG-C18 NMs were prepared by an ultrasonication dispersion method. The nanomicelles were spherical particles with a particle size of 198.61 ± 1.58 nm and a zeta potential of -30.12 ± 0.28 mV. The drug loading and encapsulation efficiency were 13.34 ± 0.24% and 80.07 ± 1.44%, respectively. The results of differential scanning calorimetry (DSC) and X-ray powder diffraction (XRD) indicated that GA was successfully encapsulated into the nanomicelles in a molecularly dispersed state. An in vitro release test showed that GA/FG-C18 NMs possessed a slow drug release profile in PBS (pH 7.4) over 200 h. The cytotoxicity assay indicated that GA/FG-C18 NMs showed much higher inhibitory efficacy in HepG2 cells than in MCF-7 cells. Tissue section studies indicated that the accumulation of DiR-loaded FG-C18 nanomicelles in the liver of mice was higher than that of the DiR solution, and the fluorescence intensity decreased over time. GA/FG-C18 NMs showed a larger area under the curve (AUC) and mean residence time (MRT) compared with free GA after intravenous administration in mice. The in vivo studies showed that GA mainly accumulated in the liver after encapsulation by FG-C18 NMs, and the drug concentration was higher than that of free GA. These results suggested that FG-C18 NMs could serve as a potential drug delivery system for targeting GA to liver tissue.

Advancing the Study of Positive Psychology: The Use of a Multifaceted Structure of Mindfulness for Development.

Positive psychology, as a distinctive paradigm, focuses on the remedy of pathologies and, by contrast, the promotion of positive experiences and conditions in life (e.g., encouraging a state of flourishing). Positive psychology, in its simplistic form, may provide evidence and insightful understanding into the proactivity of human agency (Seligman, 1999; Seligman and Csíkszentmihályi, 2000). Drawing from this emphasis, we have developed the theory of optimization, which attempts to explain the achievement of optimal functioning in life (e.g., optimal cognitive functioning: academic performance). By the same token, in the course of our research development into the theory of optimization, we have also delved into a comparable theoretical orientation, namely: the multifaceted nature of mindfulness, consisting of three interrelated components - the psychological component of mindfulness, the philosophical component of mindfulness, and the spiritual component of mindfulness. This conceptualization of mindfulness is rather unique for its incorporation of both Western and Eastern knowledge, philosophical viewpoints, and epistemologies into one holistic framework. The main premise of this conceptual analysis article is to advance the study of positive psychology by specifically introducing our recently developed model of mindfulness, in this case, the multifaceted structure of mindfulness with its three distinct components. Importantly, we make attempts to highlight the significance of this multifaceted model by situating it within the theory of optimization for academic learning. Using philosophical psychology and personal-based teaching and research reasoning, we provide a valid rationale as to how aspects of our proposed model of mindfulness (e.g., reaching a state of enlightenment) could act to facilitate and optimize a person's state of functioning (e.g., cognitive functioning). Moreover, we posit that our rationale regarding mindfulness as a potential "optimizing agent" for the purpose of optimal functioning could, indeed, emphasize and reflect the salient nature of positive psychology. In other words, we contend that an explanatory account of mindfulness from the perspectives of Confucianism and Buddhism could, in this analysis, coincide with and support the meaningful understanding and appreciation for the study of positive psychology in educational and non-educational contexts. We conclude the article by exploring the complex issue of methodology - that is, for example, how would a researcher measure, assess, and/or empirically validate the multifaceted nature of mindfulness?

[Effect of elongated-needle by Hui-puncture method on piriformis syndrome].

OBJECTIVE: To observe the clinical effect of elongated needle by Hui-puncture method in the treatment of piriformis syndrome. METHODS: A total of 100 piriformis syndrome patients were randomly divided into routine acupuncture group (n＝50) and elongated needle by Hui-puncture method (Hui-puncture) group (n＝50). For patients of the routine acupuncture group, Huantiao (GB30), Juliao (GB29), Zhibian (BL54), Weizhong (BL40), Yanglingquan (GB34), Juegu (GB39) and Ashi-point on the affected side of the body were punctured with filiform needles for 30 min. And for those of the Hui-puncture group, elongated needles were respectively inserted into GB30 and Ashi-point. The treatment was conducted once every other day for 10 times. The visual analog scale (VAS) pain score and the severity scores of symptoms (hip pain, lower limb pain, walking ability, straight leg elevation test, piriformis muscle tension test, piriformis muscle tenderness, 0-15 points) were measured before and after the treatment. The therapeutic effect was assessed by Criteria for Diagnosis and Assessment of Therapeutic Effect of Syndromes or Illnesses of Traditional Chinese Medicine (1994). RESULTS: After the treatment, the scores of symptoms and VAS scores of both routine acupuncture and Hui-puncture groups were significantly decreased in comparison with their own pre-treatment (P<0.05), and the scores of the two indexes of the Hui-puncture group were evidently lower than those of the routine acupuncture group (P<0.05). Of the two 50 cases in the routine acupuncture and Hui-puncture groups, 39 and 47 were effective, with the effective rate being 78.00% and 94.00%, respectively. The comprehensive therapeutic effect of the Hui-puncture group was significantly superior to that of the routine acupuncture group (P<0.05). CONCLUSION: Elongated-needle by Hui-puncture method has significant effect in treating piriformis syndrome patients and is worthy of promotion.

Effect of elongated-needle by Hui-puncture method on piriformis syndrome / 针刺研究

OBJECTIVE: To observe the clinical effect of elongated needle by Hui-puncture method in the treatment of piriformis syndrome. METHODS: A total of 100 piriformis syndrome patients were randomly divided into routine acupuncture group (n＝50) and elongated needle by Hui-puncture method (Hui-puncture) group (n＝50). For patients of the routine acupuncture group, Huantiao (GB30), Juliao (GB29), Zhibian (BL54), Weizhong (BL40), Yanglingquan (GB34), Juegu (GB39) and Ashi-point on the affected side of the body were punctured with filiform needles for 30 min. And for those of the Hui-puncture group, elongated needles were respectively inserted into GB30 and Ashi-point. The treatment was conducted once every other day for 10 times. The visual analog scale (VAS) pain score and the severity scores of symptoms (hip pain, lower limb pain, walking ability, straight leg elevation test, piriformis muscle tension test, piriformis muscle tenderness, 0-15 points) were measured before and after the treatment. The therapeutic effect was assessed by Criteria for Diagnosis and Assessment of Therapeutic Effect of Syndromes or Illnesses of Traditional Chinese Medicine (1994). RESULTS: After the treatment, the scores of symptoms and VAS scores of both routine acupuncture and Hui-puncture groups were significantly decreased in comparison with their own pre-treatment (P<0.05), and the scores of the two indexes of the Hui-puncture group were evidently lower than those of the routine acupuncture group (P<0.05). Of the two 50 cases in the routine acupuncture and Hui-puncture groups, 39 and 47 were effective, with the effective rate being 78.00% and 94.00%, respectively. The comprehensive therapeutic effect of the Hui-puncture group was significantly superior to that of the routine acupuncture group (P<0.05). CONCLUSION: Elongated-needle by Hui-puncture method has significant effect in treating piriformis syndrome patients and is worthy of promotion.

[Acupressure with activating blood and dissipating blood stasis prescription for early swelling of calcaneal fractures].

OBJECTIVE: To observe clinical effects of acupressure combined with activating blood and dissipating blood stasis prescription for the treatment of early swelling of calcaneal fractures. METHODS: From June 2016 to April 2018, 78 patients with calcaneus were divided into observation group and control group. There were 39 patients in observation group, including 36 males and 3 females aged from 28 to 61 years old with an average of(41.7±13.3) years old; 20 patients were caused by falling down, 10 patients were caused by traffic accident and 9 patients were caused by other injuries; The time from injury to medical treatment ranged from 0.5 to 10.5 h with an average of(4.6±3.2) h; 15 patients were type II, 17 patients were type III and 7 patients were type IV according to Sanders classification; the patients began to be pressed the three points of "Xuehai(SP 10)" "Sanyinjiao(SP 6)" "Zusanli(ST 36)" for 10 min from the day of hospital admission to the day of operation, 3 times a day, and taken prescription of activating blood and dissipating blood stasis prescription orally for 5 days, one dose per day and twice a day. There were 39 patients in control group, including 34 males and 5 females aged from 26 to 62 years old with an average of (43.3±12.3) years old; 19 patients were caused by falling down, 12 patients were caused by traffic accident and 8 patients were caused by other injuries; the time from injury to medical treatment ranged from 1 to 11 h with an average of (4.4±3.7) h; 15 patients were typeII, 18 patients were type III and 6 patients were type IV according to Sanders classification; patients were given 20% mannitol intravenously for 5 days, twice a day, 125 ml each time from hospital admission. During the 5 days of admission, the degree of swelling of the affected ankle was measured and calculated by water spillover method every day. The result which was measured and calculated on the first day of admission without treatment was the degree of swelling before treatment, compared degree of swelling before operation and 1st, 2nd, 3rd and 4th day after treatment; the time needed for the first positive skin fold sign in the affected ankle and the number of cases of tension blisters between two groups before operation were observed. RESULTS: The swelling of the affected ankle on the1st, 2nd, 3rd and 4th day after treatment in the observation group separately were(12.67±0.82)%, (11.87±0.88)%, (10.65±0.92)%, (9.47±0.96)%, and lower than control group which separately were(13.31±0.98)%, (13.51±0.84)%, (12.22±0.94)%, (11.38±1.01)%; The time for the first appearance of the skin fold sign was (6.41±1.74) days in the observation group was earlier than that of the control group (8.15±2.01) days; There was no significant difference in occurrence of tension blisters between observation group(3 patients) and control group(9 patients). CONCLUSIONS: Acupressure combined with activating blood and dissipating blood stasis prescription for the treatment of early swelling of calcaneal fractures could accelerate the decline of swelling of the affected ankle, shorten the time of the first skin fold sign, reduce the incidence of tension blisters in the ankle, shorten the waiting time of operation, and the surgical treatment as soon as possible.

UPLC-Q-TOF/MS Based Metabolomics Approach to Study the Hepatotoxicity of Cantharidin on Mice.

Cantharidin is the major bioactive compound extracted from the blister beetle, a traditional Chinese medicine, and has been proved to be a natural component with widely antitumor activity. However, clinical application of cantharidin is relatively restricted due to its potential toxic effects, especially hepatotoxicity. Although cantharidin-induced liver injury has been reported, the underlying molecular mechanisms remain unclear. In the present study, an UPLC-Q-TOF/MS based metabolomics approach combined with blood biochemical analysis, histopathological examination, and cell apoptosis assay were used to investigate the mechanisms of cantharidin-induced hepatotoxicity. A total of 54 significantly changed metabolites and 14 disturbed metabolic pathways were identified in the cantharidin exposed groups. Among them, four metabolites (oxidized glutathione, glutathione, 3-sulfinoalanine, and deoxycholic acid 3-glucuronide) were selected based on their high impact value and potential biological function in the process of liver injury post cantharidin treatment. Our study provides a deeper understanding of the mechanisms of cantharidin-induced hepatotoxicity and may contribute to reduce the liver injury and gain more effective and safe clinical use of cantharidin. In addition, our results also demonstrated that cantharidin could impair multiple biological processes in liver, and future studies will be necessary to reveal the detailed molecular mechanisms of cantharidin-induced hepatotoxicity.

Selenium-doped hydroxyapatite biopapers with an anti-bone tumor effect by inducing apoptosis.

One-dimensional hydroxyapatite (HA) particularly mimics the structure of mineralized collagen fibrils and displays superior mechanical properties such as toughness. Herein, we report Se-doped HA/chitosan (Se-HA/CS) biopapers constructed with self-assembled Se-doped HA nanowires and chitosan. The Se-HA/CS biopapers with high flexibility and manufacturability can not only be further processed into arbitrary shapes by folding or using scissors but also display high performances in in vitro/vivo anti-bone tumor studies. The Se-HA/CS biopapers are more inclined to inhibit the growth of tumor cells (HCS 2/8 and SJSA cells) than that of normal human bone marrow stromal cells (hBMSCs). The potential mechanisms of this meaningful anti-tumor effect were investigated, such as reactive oxygen species accumulation and the activation of apoptosis and the underlying signal pathway involved (including caspase family, Bcl-2 family and JNK/STAT3). The results demonstrate that Se-HA/CS biopapers may inhibit the growth of HCS 2/8 and SJSA cells by synchronously inducing JNK activation and STAT3 inhibition and consequently promote the apoptosis of these cells. Furthermore, the in vivo anti-tumor studies confirm that the Se-HA/CS biopapers obviously suppress the growth of patient-derived xenograft tumor models.

Total knee arthroplasty for treatment of rheumatoid arthritis: A protocol for a systematic review of randomized controlled trial.

BACKGROUND: Rheumatoid arthritis (RA) is a very tricky orthopedic condition. If it can not be treated fairly well, it may greatly affect quality of life in patients with RA, and even can cause disability. Total knee arthroplasty (TKA) has reported to treat patients with RA effectively. However, no study has systematically explored its efficacy and complications for patients with RA. METHODS: Seven databases will be searched from their inceptions to the present without any language restrictions: MEDICINE, EMBASE, Cochrane Library, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. Two authors will carry out all study selection, data extraction, and risk of bias assessment independently. RESULTS: The primary outcome of joint pain will be measured by any pain scales, such as visual analogue scale. The secondary outcomes will include joint function, quality of life, and postoperative adverse events. The joint function will be measured by The Western Ontario and McMaster Universities Arthritis Index, Knee Injury and Osteoarthritis Outcome Score, or other relevant scales. The quality of life will be assessed by the 36-Item Short Form Health Survey or any related tools. In addition, postoperative adverse events will also be analyzed. CONCLUSIONS: The findings of this study will summarize the latest existing evidence on the efficacy and safety of TKA for patients with RA. ETHICS AND DISSEMINATION: This study does not need ethical approval, because it will not analyze individual data. The results of this study are expected to be disseminated at peer-reviewed journals. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019133274.

Effectiveness of vitamin D for irritable bowel syndrome: A protocol for a systematic review of randomized controlled trial.

BACKGROUND: Irritable bowel syndrome (IBS) is a prevalent and debilitating condition for patients who experience this disorder. Clinical researches indicate that vitamin D (VD) can help relief the symptoms of IBS. However, no systematic review has addressed this issue yet. Thus, this systematic review aims to investigate the effectiveness and safety of VD for patients with IBS. METHODS: We will retrieve the following databases for randomized controlled trials to assess the effectiveness and safety of VD for patients with IBS: Cochrane Library, EMBASE, MEDICINE, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. Each database will be retrieved from its inception to January 31, 2019. Two researchers will independently selection studies, extract data and assess methodological quality. RevMan 5.3 software will be used to pool the data, and carry out the meta-analysis if it is possible. RESULTS: This systematic review will evaluate the effectiveness and safety of VD for patients with IBS. The primary outcomes include stool frequency and abdominal pain. The secondary outcomes consist of stool status, quality of life, and adverse effects. CONCLUSIONS: The findings of this systematic review may provide the existing evidence on the effectiveness and safety of VD for patients with IBS. ETHICS AND DISSEMINATION: This systematic review will not require ethical approval, because all data will be extracted from the published literature. The findings of this study will be disseminated at peer-reviewed journals.PROSPERO registration number: PROSPERO CRD42019122641.

Observations on the Efficacy of Scalp Acupuncture with Strong Stimulation in Treating Intractable Hiccup / 上海针灸杂志

Objective To investigate the efficacy of scalp acupuncture with strong stimulation plus oral hiccup decoction in treating intractable hiccup. Method One hundred patients with intractable hiccup were allocated, using a random number table, to treatment and control groups, 50 cases each. In addition to oral hiccup decoction in the two groups, the treatment group received scalp acupuncture with strong stimulation at the stomach and chest areas and the control group, electroacupuncture, for two courses of treatment. The times to produce the effect and the symptom frequency scores were compared between the two groups. Result After one course of treatment, the cure rate, the cure and marked efficacy rate and the total efficacy rate were 42％, 66％ and 78％, respectively, in the treatment group and 24％, 40％ and 68％, respectively, in the control group. There were statistically significant difference in the cure rate and the cure and marked efficacy rate (P<0.05) but no in the total efficacy rate (P>0.05) between the two groups. After two courses of treatment, the cure rate, the cure and marked efficacy rate and the total efficacy rate were 68％, 78％ and 88％, respectively, in the treatment group and 40％, 60％ and 74％, respectively, in the control group. There were statistically significant difference in the cure rate (P<0.05) but no in the cure and marked efficacy rate and the total efficacy rate (P>0.05) between the two groups. After one and two courses of treatment, there was a statistically significant difference in the hiccup frequency score between the treatment and control groups (P<0.05). The time to produce the effect was 2-5 hrs in the treatment group and 5-8 hrs in the control group. Conclusion The total efficacy rate of scalp acupuncture with strong stimulation for intractable hiccup is not significantly different from that of electroacupuncture, but the cure rate of the former was significantly higher than that of the latter. Scalp acupuncture with strong stimulation can produce a quick effect, reduce the frequency of hiccups and relieve symptoms accompanying hiccup.

Concurrence of Multiple Cutaneous Malignancies on Sun-exposed Vitiligo Skin of a Patient: A Case Report and Review of the Literature.

There are very few published studies in the literature examining the association between vitiligo and skin cancers and only some anecdotal reports about phototherapy-associated nonmelanoma skin carcinoma (NMSC) in patients with vitiligo. Herein, we report a case of an 84-year-old male with widespread vitiligo with concurrent onset of two primary cutaneous malignancies in sun-exposed vitiligo skin. The association between vitiligo and NMSC deserves further assessment. Chronic sun damage might be a possible causative factor for the development of NMSC in the vitiligo patient.

Comparison of the effects of nicotinic acid and nicotinamide degradation on plasma betaine and choline levels.

AIM: The present study was to compare the effects of nicotinic acid and nicotinamide on the plasma methyl donors, choline and betaine. METHODS: Thirty adult subjects were randomly divided into three groups of equal size, and orally received purified water (C group), nicotinic acid (300 mg, NA group) or nicotinamide (300 mg, NM group). Plasma nicotinamide, N1-methylnicotinamide, homocysteine, betaine and choline levels before and 1.5-h and 3-h post-dosing, plasma normetanephrine and metanephrine concentrations at 3-h post-dosing, and the urinary excretion of N1-methyl-2-pyridone-5-carboxamide during the test period were examined. RESULTS: The level of 3-h plasma nicotinamide, N1-methylnicotinamide, homocysteine, the urinary excretion of N1-methyl-2-pyridone-5-carboxamide and pulse pressure (PP) in the NM group was 221%, 3972%, 61%, 1728% and 21.2% higher than that of the control group (P < 0.01, except homocysteine and PP P < 0.05), while the 3-h plasma betaine, normetanephrine and metanephrine level in the NM group was 24.4%, 9.4% and 11.7% lower (P < 0.05, except betaine P < 0.01), without significant difference in choline levels. Similar but less pronounced changes were observed in the NA group, with a lower level of 3-h plasma N1-methylnicotinamide (1.90 ± 0.20 µmol/l vs. 3.62 ± 0.27 µmol/l, P < 0.01) and homocysteine (12.85 ± 1.39 µmol/l vs. 18.08 ± 1.02 µmol/l, P < 0.05) but a higher level of betaine (27.44 ± 0.71 µmol/l vs. 23.52 ± 0.61 µmol/l, P < 0.05) than that of the NM group. CONCLUSION: The degradation of nicotinamide consumes more betaine than that of nicotinic acid at identical doses. This difference should be taken into consideration in niacin fortification.

Determination of urea content in urea cream by centrifugal partition chromatography.

The objective of this study is to establish a centrifugal partition chromatography (CPC) method for determination of the urea ingredient in urea cream. The mechanism of this method is that urea is determined by UV detector at 430 nm after being extracted from the cream and derivatized on line via Ehrlich reaction in rotor of CPC, where the reaction products dissolve in the mobile phase and the cream matrix retains in the stationary phase. The mixed solvent consisting of n-hexane, methanol, hydrochloric acid and p-dimethylaminobenzaldehyde with a ratio of 1000 mL:1000 mL:18 mL:2.0 g is used for solvent system of CPC. The CPC method proposed offers good precision and convenience without complex sample pretreatment processes.

Vitamin paradox in obesity: Deficiency or excess?

Since synthetic vitamins were used to fortify food and as supplements in the late 1930s, vitamin intake has significantly increased. This has been accompanied by an increased prevalence of obesity, a condition associated with diabetes, hypertension, cardiovascular disease, asthma and cancer. Paradoxically, obesity is often associated with low levels of fasting serum vitamins, such as folate and vitamin D. Recent studies on folic acid fortification have revealed another paradoxical phenomenon: obesity exhibits low fasting serum but high erythrocyte folate concentrations, with high levels of serum folate oxidation products. High erythrocyte folate status is known to reflect long-term excess folic acid intake, while increased folate oxidation products suggest an increased folate degradation because obesity shows an increased activity of cytochrome P450 2E1, a monooxygenase enzyme that can use folic acid as a substrate. There is also evidence that obesity increases niacin degradation, manifested by increased activity/expression of niacin-degrading enzymes and high levels of niacin metabolites. Moreover, obesity most commonly occurs in those with a low excretory reserve capacity (e.g., due to low birth weight/preterm birth) and/or a low sweat gland activity (black race and physical inactivity). These lines of evidence raise the possibility that low fasting serum vitamin status in obesity may be a compensatory response to chronic excess vitamin intake, rather than vitamin deficiency, and that obesity could be one of the manifestations of chronic vitamin poisoning. In this article, we discuss vitamin paradox in obesity from the perspective of vitamin homeostasis.

Moxifloxacin plus standard first-line therapy in the treatment of pulmonary tuberculosis: A meta-analysis.

The fluoroquinolone moxifloxacin has potent activity against Mycobacterium tuberculosis and has been recommended by the guidelines for the treatment of pulmonary tuberculosis (TB). Monotherapy is not recommended by the guidelines and only a few studies have evaluated the efficacy and safety of moxifloxacin plus standard first-line therapy in treating TB. The purpose of this meta-analysis was to further investigate the efficacy and safety of moxifloxacin plus standard therapy compared with standard therapy alone in treating patients with pulmonary TB. Medline, Cochrane, EMBASE and Google Scholar (until February 12, 2015) were searched for studies that evaluated the clinical efficacy and tolerability of moxifloxacin in the treatment of pulmonary TB. Rate of culture conversion and serious adverse events (SAEs) were assessed. Risk of bias and sensitivity analysis, using the leave-one-out approach, was used to assess the robustness of the findings. Six studies were included in the meta-analysis which covered 2056 patients with pulmonary TB. For all included studies, the drug regimens at least contained rifampicin and pyrazinamide and the length of treatment was at least eight weeks. The odds ratio (OR) for the negative culture rate for moxifloxacin plus first-line medications compared first-line medications alone (the control group) was 1.60 with 95% CI in 0.93-2.74 (P = 0.089), indicating the moxifloxacin plus first-line medications had no significantly greater rate of culture conversion compared with first-line medication alone. The odds ratio of SAEs for moxifloxacin plus first-line medications compared with first-line medications alone found no difference in rate of SAEs between treatment groups (OR = 0.94, P = 0.862). In conclusion, our meta-analysis suggests that there was a trend for the addition of moxifloxacin to standard first-line therapy for non-drug resistant TB resulted to increase the rate of culture conversion but this effect requires confirmation in more randomized control trials.