Short-Term Effect of Modified Kaijie Huatantang on Chronic Rhinosinusitis with Nasal Polyp Due to Qi Stagnation Phlegm Syndrome / 中国实验方剂学杂志

Objective:To observe the short-term effect of modified Kaijie Huatantang on chronic rhinosinusitis with nasal polyp due to qi stagnation phlegm syndrome. Method:A total of 90 cases were divided into control group and observation group，with 45 cases in each group. The control group was given mometasone furoate，and the observation group was given modified Kaijie Huatantang after nasal endoscopy surgery for 4 weeks. After treatment and follow-up for 1 years，the sino-nasal outcome test-20（SNOT-20），Lund-Kennedy and traditional Chinese medicine（TCM） syndrome were observed. The serum and nasal secretions tumor necrosis factor-alpha（TNF-<italic>α</italic>），interleukin（IL）-1<italic>β</italic>，IL-8，IL-17，eosinophilic cationic protein（ECP） and immunoglobulin E（IgE） were detected before and after treatment. The safety，clinical efficacy after treatment and follow-up for 1 years were compared between two groups. Result:After treatment and follow-up for 1 years，the total control rates were 97.7%，93.0% in observation group， which were higher than 87.8%，75.6% in control group（<italic>P</italic><0.05）. Compared with the control group after treatment and follow-up for 1 years，SNOT-20，Lund-Kennedy and TCM syndrome scores in the observation group decreased in the same period（<italic>P</italic><0.05）. Compared with the control group after treatment，the serum and nasal secretions TNF-<italic>α</italic>，IL-1<italic>β</italic>，IL-8，IL-17，ECP and IgE in the observation group were significantly decreased（<italic>P</italic><0.05）. The incidence of postoperative complications was 2.3% in the observation group， which was lower than 17.1% in the control group（<italic>P</italic><0.05）. The incidence of adverse reactions was 4.7% in the observation group， which was lower than 41.5% in the control group（<italic>P</italic><0.05）. Conclusion:Modified Kaijie Huatantang can significantly improve the short-term clinical efficacy of patients with chronic rhinosinusitis and nasal polyp due to Qi stagnation phlegm obstruction，with a low incidence of adverse reactions.

Effect of Modified Huading Loulutang on Postoperative Recovery of Chronic Rhinosinusitis with Secretory Otitis Media Due to Toxic Heat Syndromes / 中国实验方剂学杂志

Objective:To observe the efficacy of modified Huading Loulutang on postoperative recovery of chronic rhinosinusitis with secretory otitis media due to toxic heat syndromes and the effect of eosinophil cationic protein (ECP), immunoglobulin E (IgE) and intercellular adhesion molecule-1 (ICAM-1) in serum, nasal secretion and otitis media. Method:According to the random number table method, 90 cases were divided into control group and observation group, with 45 cases in each group. All patients were given ceftriaxone sodium + hydroxymezoline after nasal endoscopy. In addition, control group was given Biyuan Tongqiao granule, while observation group was given modified Huading Loulutang for 6 weeks. Lund-Kennedy nasal assessment scale, traditional Chinese medicine symptoms and threshold of hearing at different frequencies were observed in two groups before and after treatment and during 6-week and 18-week follow-up visits. The levels of ECP, IgE and ICAM-1 in serum, nasal and ear secretions were detected before and after treatment. Clinical symptoms, adverse reactions and 12-month recurrence rate were compared. Result:Total control rate was 97.7% (43/44, 95%CI [95.6，98.6]) in observation group, which was higher than 78.6% (33/42, 95%CI [72.4，83.5]) in control group (χ2=6.946, P<0.05). During the 12-month follow-up visit, the recurrence rate was 4.5% (2/44, 95%CI [3.7，5.8]) in observation group, which was lower than 19.0% (8/42, 95%CI[16.8，21.3]) in control group (P<0.05). After treatment, Lund-Kennedy and traditional Chinese medicine symptoms score during 6-week and 18-week follow-up visits in observation group were significantly lower than those in control group (P<0.05). Hearing threshold in observation group at different frequencies was significantly lower than that in control group (P<0.05). ECP, IgE and ICAM-1 levels in serum, nasal and auricular secretions in observation group were significantly lower than those in control group (P<0.05). The incidence of adverse reactions was 6.8% (3/44, 95%CI [5.3，8.1]) in observation group, which was lower than 28.6% (12/42,95%CI [25.3，30.2]) in control group (P<0.05). Conclusion:Modified Huading Loulutang can significantly improve postoperative clinical symptoms of chronic rhinosinusitis and otitis media due to toxic heat syndromes with secretion, with a low recurrence rate and fewer complications.

The Associations between the Duration of Folic Acid Supplementation, Gestational Diabetes Mellitus, and Adverse Birth Outcomes based on a Birth Cohort.

This study aimed to examine the associations between the duration of folic acid (FA) supplementation, gestational diabetes mellitus (GDM), and adverse birth outcomes. A total of 950 mother-offspring pairs participated in the cohort study during 2015 in Changsha, China. The data were collected through home visits and perfected by maternal and child healthcare handbooks. Generalized linear models and stratified analyses were used for statistical analyses. The incidence of GDM in our cohort was 10.2%. FA supplementation for ≥3 months before pregnancy was associated with an increased risk of GDM (adjusted relative risk (aRR): 1.72; 95% CI: 1.17-2.53) and decreased risk of small-for-gestational-age (SGA) birth (aRR: 0.40; 95% CI: 0.18-0.88). In the group of FA supplementation for ≥3 months during pregnancy, GDM was associated with an increased risk of cesarean delivery (aRR: 1.36; 95% CI: 1.06-1.75) and macrosomia (aRR: 2.11; 95% CI: 1.06, 4.20), but the aRRs were lower than the RRMH 1.53 (95% CI: 1.01-2.34) and 2.43 (95% CI: 1.27-4.66). Our study suggested that the longer duration of FA supplementation before pregnancy might increase the risk of GDM, but decrease the risk of SGA birth. Longer duration of FA supplementation during pregnancy had beneficial effects on birth outcomes in women with GDM. Further studies should consider a larger sample size to confirm these findings.

Changes of nutritional status and the variations of serum indicators of patients with chronic kidney disease accompanied by hypothyroidism taking thyroid hormone replacement therapy as the therapeutic models.

This study aimed to analyze the incidence of malnutrition in patients with chronic kidney disease (CKD) at stage III-IV accompanied by hypothyroidism and indicate the improvement in nutritional status and kidney disease of CKD patients after undergoing thyroid hormone replacement (THR) therapy as therapeutic models. The included 156 CKD patients in stage III-IV were divided into the CKD stage III group (CKD-III group) (n = 80) and CKD stage IV group (CKD-IV group) (n = 76), and the clinical indicators of all the patients were collected. Based on changes in thyroid function, the included patients were again divided into the following groups: subclinical hypothyroidism group (the experimental group, hereinafter referred to Y-group, n = 78) and non-subclinical hypothyroidism group (the control group, hereinafter referred to N-group, n = 78), in which the CKD-III group was divided into CKD-IIIN group (n = 38) and CKD-IIIY group (n = 42), and also the CKD-IV group was divided into CKD-IVN group (n = 40) and CKD-IVY group (n = 36). At the beginning, patients in the Y-group was orally given 25 µg/dL of levothyroxine; based on the progression of the disease, the dosage was regulated; the concentration of serum thyroid stimulating hormone (TSH) was assessed once per month, as well as changes in tri-iodothyronine (T3) and tetraiodothyronine (T4). Estimated glomerular filtration rate (eGFR) in the CKD-IIIY group was significantly changed compared with that of the CKD-IVY group after THR therapy. Comparison of nutrition-based indicators between the N-group and the Y-group showed that the serum albumin (ALB) level, the hemoglobin (HGB) level, and the grip strength of both the left and right hand were notably decreased (P < 0.05). After THR therapy, the indicators related to CKD patients were accompanied by subclinical hypothyroidism changes; the levels of ALB and HGB, as well as the grip strength of both the left and right hand were notably increased compared with before undergoing THR therapy (P < 0.05). In conclusion, malnutrition of chronic kidney disease caused by subclinical hypothyroidism could be partially recovered after THR therapy as therapeutic models.

Responses of root architecture development to low phosphorus availability: a review.

BACKGROUND: Phosphorus (P) is an essential element for plant growth and development but it is often a limiting nutrient in soils. Hence, P acquisition from soil by plant roots is a subject of considerable interest in agriculture, ecology and plant root biology. Root architecture, with its shape and structured development, can be considered as an evolutionary response to scarcity of resources. SCOPE: This review discusses the significance of root architecture development in response to low P availability and its beneficial effects on alleviation of P stress. It also focuses on recent progress in unravelling cellular, physiological and molecular mechanisms in root developmental adaptation to P starvation. The progress in a more detailed understanding of these mechanisms might be used for developing strategies that build upon the observed explorative behaviour of plant roots. CONCLUSIONS: The role of root architecture in alleviation of P stress is well documented. However, this paper describes how plants adjust their root architecture to low-P conditions through inhibition of primary root growth, promotion of lateral root growth, enhancement of root hair development and cluster root formation, which all promote P acquisition by plants. The mechanisms for activating alterations in root architecture in response to P deprivation depend on changes in the localized P concentration, and transport of or sensitivity to growth regulators such as sugars, auxins, ethylene, cytokinins, nitric oxide (NO), reactive oxygen species (ROS) and abscisic acid (ABA). In the process, many genes are activated, which in turn trigger changes in molecular, physiological and cellular processes. As a result, root architecture is modified, allowing plants to adapt effectively to the low-P environment. This review provides a framework for understanding how P deficiency alters root architecture, with a focus on integrated physiological and molecular signalling.

Nitric oxide is the shared signalling molecule in phosphorus- and iron-deficiency-induced formation of cluster roots in white lupin (Lupinus albus).

BACKGROUND AND AIMS: Formation of cluster roots is one of the most specific root adaptations to nutrient deficiency. In white lupin (Lupinus albus), cluster roots can be induced by phosphorus (P) or iron (Fe) deficiency. The aim of the present work was to investigate the potential shared signalling pathway in P- and Fe-deficiency-induced cluster root formation. METHODS: Measurements were made of the internal concentration of nutrients, levels of nitric oxide (NO), citrate exudation and expression of some specific genes under four P × Fe combinations, namely (1) 50 µm P and 10 µm Fe (+P + Fe); (2) 0 P and 10 µm Fe (-P + Fe); (3) 50 µm P and 0 Fe (+P-Fe); and (4) 0 P and 0 Fe (-P-Fe), and these were examined in relation to the formation of cluster roots. KEY RESULTS: The deficiency of P, Fe or both increased the cluster root number and cluster zones. It also enhanced NO accumulation in pericycle cells and rootlet primordia at various stages of cluster root development. The formation of cluster roots and rootlet primordia, together with the expression of LaSCR1 and LaSCR2 which is crucial in cluster root formation, were induced by the exogenous NO donor S-nitrosoglutathione (GSNO) under the +P + Fe condition, but were inhibited by the NO-specific endogenous scavenger 2-(4-carboxyphenyl)-4, 4, 5, 5-tetramethylimidazoline-1-oxyl- 3-oxide (cPTIO) under -P + Fe, +P-Fe and -P-Fe conditions. However, cluster roots induced by an exogenous supply of the NO donor did not secrete citrate, unlike those formed under -P or -Fe conditions. CONCLUSIONS: NO plays an important role in the shared signalling pathway of the P- and Fe-deficiency-induced formation of cluster roots in white lupin.