Covalent organic framework based nanoagent for enhanced mild-temperature photothermal therapy.

Photothermal therapy effectively ablates tumors by hyperthermia (>50 °C) under laser irradiation. However, the hyperthermia may inevitably diffuse to the surrounding healthy tissues to induce additional damage. Thus, effective cancer therapy by mild photothermal therapy at low temperatures is greatly desirable. In this study, a nanoagent (COF-GA) was designed to inhibit HSP90 for enhanced photothermal therapy against cancer at low temperatures. The nanoscale covalent organic frameworks (COFs) were able to increase the temperature of the tumor tissue under laser irradiation, which can transfer the energy of laser into heat for cancer cell killing. Gambogic acid (GA), as an inhibitor of HSP90, was used to overcome the heat resistance of tumor, achieving efficient mild-temperature photothermal therapy. As an excellent candidate for the photothermal therapy agent, COF-GA can induce the temperature to elevate as the exposure time increased when irradiated with laser. In vivo tests further demonstrated that the tumor growth was able to be significantly suppressed after being treated with COF-GA. The mild-temperature photothermal therapy exhibits an excellent antitumor efficacy at a relatively low temperature and minimizes the nonspecific thermal damage to normal tissues. This COF-GA nanoagent also enriches our understanding towards the various applications of COFs, particularly in the biomedicine field.

Selenium-engineered covalent organic frameworks for high-efficiency and long-acting cancer therapy.

A porphyrin-containing covalent organic framework (COF) was synthesized as a substrate for decorating selenium nanoparticles (Se NPs) via in situ reduction. Se NP-mediated therapy (SeT) was carried out in conjunction with photodynamic therapy (PDT) to provide an increased anticancer effect and remedy the constrained efficacy of PDT.

Effectiveness of Chinese herbal medicine combined with Western medicine on deferring dialysis initiation for nondialysis chronic kidney disease stage 5 patients: a multicenter prospective nonrandomized controlled study.

BACKGROUND: In clinical practice, Chinese herbal medicine (CHM) purportedly has beneficial therapeutic effects for chronic kidney disease (CKD), which include delaying disease progression and dialysis initiation. However, there is a lack of high-quality evidence-based results to support this. Therefore, this study aimed to evaluate the efficacy of CHM combined with Western medicine in the treatment of stage 5 CKD. METHODS: This was a prospective nonrandomized controlled study. Stage 5 CKD (nondialysis) patients were recruited form 29 AAA class hospitals across China from July 2014 to April 2019. According to doctors' advice and the patients' wishes, patients were assigned to the CHM group (Western medicine + CHM) and the non-CHM group (Western medicine). Patient demographic data, primary disease, blood pressure, Chinese and Western medical drugs, clinical test results, and time of dialysis initiation were collected during follow-up. RESULTS: A total of 908 patients were recruited in this study, and 814 patients were finally included for further analysis, including 747 patients in the CHM group and 67 patients in the non-CHM group. 482 patients in the CHM group and 52 patients in the non-CHM group initiated dialysis. The median time of initiating dialysis was 9 (7.90, 10.10) and 3 (0.98,5.02) months in the CHM group and non-CHM group, respectively. The multivariate Cox regression analysis showed that patients in the CHM group had a significantly lower risk of dialysis [adjusted hazard ratio (aHR): 0.38; 95% confidence interval (CI): 0.28, 0.53] compared to those in the non-CHM group. After 1:2 matching, the outcomes of 160 patients were analyzed. The multivariate Cox regression analysis showed that patients in the CHM group had a significantly lower risk of dialysis (aHR: 0.32; 95% CI: 0.21, 0.48) compared to patients in the non-CHM group. Also, the Kaplan-Meier analysis demonstrated that the cumulative incidence of dialysis in the CHM group was significantly lower than that in the non-CHM group (log-rank test, P<0.001) before and after matching. CONCLUSIONS: This study suggest that the combination of CHM and Western medicine could effectively reduce the incidence of dialysis and delay the time of dialysis initiation in stage 5 CKD patients.

Efficacy and safety of Shenyankangfu Tablet, a Chinese patent medicine, for primary glomerulonephritis: A multicenter randomized controlled trial.

BACKGROUND: Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease. OBJECTIVE: This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m2, and 24-hour proteinuria level of 0.5-3.0 g, were recruited in 41 hospitals across 19 provinces in China and were randomly divided into five groups: SYKFT, losartan potassium 50 mg or 100 mg, SYKFT plus losartan potassium 50 mg or 100 mg. MAIN OUTCOME MEASURES: The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment. RESULTS: A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group. CONCLUSION: SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone. TRIAL REGISTRATION NUMBER: NCT02063100 on ClinicalTrials.gov.

[Exploration on the acupoint selection rule for the treatment of postpartum hypogalactia with acupuncture and moxibustion based on the set visualization analysis system].

Based on the set visualization analysis system and Apriori algorithm, the acupoint selection rule for the treatment of postpartum hypogalactia with acupuncture and moxibustion was explored. The clinical research articles relevant with postpartum hypogalactia treated with acupuncture and moxibustion were retrieved from CNKI, Wanfang and VIP databases till July 15, 2019 since the database establishment. According to the inclusion and exclusion criteria, the articles were screened and the acupoint prescriptions were extracted. On the base of the set visualization analysis system and Apriori algorithm, the characteristics of acupoints and the common acupoint combination were analyzed for the treatment of postpartum hypogalactia with acupuncture and moxibustion. Totally, 120 articles are included and 72 acupoints are extracted for the treatment of postpartum hypogalactia with acupuncture and moxibustion, of which, the conception vessel and the stomach meridian of foot-yangming are the most commonly used and the combination of Danzhong (CV 17), Rugen (ST 18), Zusanli (ST 36), Shaoze (SI 1) and Taichong (LR 3) is of the high frequency. The analyses of set visualization, acupoint association rule and acupoint combination network consistently indicate that the above mentioned 5 acupoints are the basic combination for the treatment of postpartum hypogalactia with acupuncture and moxibustion, co-acting on tonifying and nourishing qi and blood, smoothing liver qi and relieving stagnation, activating circulation and promoting lactation. This combination effectively treats postpartum hypogalactia caused by the source insufficiency of transformation of qi and blood and qi stagnation.