Persistent clinical symptoms and their association with CM syndromes in post-COVID-19 rehabilitation patients in Hong Kong.

Background: Heterogeneous clinical conditions were observed in individuals who had recovered from COVID-19 and some symptoms were found to persist for an extended period post-COVID. Given the non-specific nature of the symptoms, Chinese medicine (CM) is advantageous in providing holistic medical assessment for individuals experiencing persisting problems. Chinese medicine is a type of treatment that involves prescribing regimens based on CM Syndromes diagnosed by CM practitioners. However, inadequate research on CM elements behind the practice has faced scrutiny. Methods: This study analysed 1058 CM medical records from 150 post-COVID-19 individuals via a semi-text-mining approach. A logistic model with MCMCglmm was then utilised to analyse the associations between the indicated factors and identified conditions. Calculations were performed using R Studio and related libraries. Results: With the semi-text-mining approach, three common CM Syndromes (Qi and Yin Deficiency, Lung and Spleen Deficiency, Qi Deficiency of both Spleen and Lung) and nine clinical conditions (fatigue, poor sleep, dry mouth, shortness of breath, cough, headache, tiredness, sweating, coughing phlegm) were identified in the CM clinical records. Analysis via MCMCglmm revealed that the occurrence of persisting clinical conditions was significantly associated with female gender, existing chronic conditions (hypertension, high cholesterol, and diabetes mellitus), and the three persisting CM Syndromes. The current study triangulated the findings from our previous observational study, further showing that patients with certain post-COVID CM Syndromes had significantly increased log-odds of having persisting clinical conditions. Furthermore, this study elucidated that the presence of chronic conditions in the patients would also significantly increase the log-odds of having persistent post-COVID clinical conditions. Conclusion: This study provided insights on mining text-based CM clinical records to identify persistent post-COVID clinical conditions and the factors associated with their occurrence. Future studies could examine the integration of integrating exercise modules, such as health qigong Liuzijue, into multidisciplinary rehabilitation programmes.

Non-toxic agarose/gelatin-based microencapsulation system containing gallic acid for antifungal application.

Aspergillus niger (A. niger) is a common species of Aspergillus molds. Cutaneous aspergillosis usually occurs in skin sites near intravenous injection and approximately 6% of cutaneous aspergillosis cases which do not involve burn or HIV-infected patients are caused by A. niger. Biomaterials and biopharmaceuticals produced from microparticle-based drug delivery systems have received much attention as microencapsulated drugs offer an improvement in therapeutic efficacy due to better human absorption. The frequently used crosslinker, glutaraldehyde, in gelatin-based microencapsulation systems is considered harmful to human beings. In order to tackle the potential risks, agarose has become an alternative polymer to be used with gelatin as wall matrix materials of microcapsules. In the present study, we report the eco-friendly use of an agarose/gelatin-based microencapsulation system to enhance the antifungal activity of gallic acid and reduce its potential cytotoxic effects towards human skin keratinocytes. We used optimal parameter combinations, such as an agarose/gelatin ratio of 1:1, a polymer/oil ratio of 1:60, a surfactant volume of 1% w/w and a stirring speed of 900 rpm. The minimum inhibitory concentration of microencapsulated gallic acid (62.5 µg/ml) was significantly improved when compared with that of the original drug (>750 µg/ml). The anti-A. niger activity of gallic acid -containing microcapsules was much stronger than that of the original drug. Following 48 h of treatment, skin cell survival was approximately 90% with agarose/gelatin microcapsules containing gallic acid, whereas cell viability was only 25-35% with free gallic acid. Our results demonstrate that agarose/gelatin-based microcapsules containing gallic acid may prove to be helpful in the treatment of A. niger-induced skin infections near intravenous injection sites.

Effects of the modified Huanglian Jiedu decoction on the disease resistance in grey mullet (Mugil cephalus) to Lactococcus garvieae.

Lactococcosis is prevalent on grey mullet (Mugil cephalus) in Hong Kong aquaculture resulting in serious economic loss. A compound formulation of Traditional Chinese Medicines (TCM) (modified Huanglian Jiedu decoction (HLJDD)) comprising Rhizoma coptidis, Radix scutellaria, Cortex phellodendri, Fructus gardeniae, Fructus forsythiae and Flos lonicerae japonicae (in a ratio of 3:2:2:3:3:5) were applied as feed supplements to deal with the disease. The Nitroblue tetrazolium activity in blood, bactericidal activity and total immunoglobulin in plasma were significantly enhanced after feeding 1% of this TCM for 28 days. The disease resistances to Lactococcus garvieae in 1% and 2% TCM feeding groups were significantly enhanced. In the in vitro study, the modified HLJDD also activated the plasma bactericidal activities (p<0.01). Based on this study, 1% modified HLJDD feeding for 28 days may be an optimal dose to prevent L. garvieae infection and could be used in aquaculture industries.

D-Glucose as a modifying agent in gelatin/collagen matrix and reservoir nanoparticles for Calendula officinalis delivery.

Gelatin/Collagen-based matrix and reservoir nanoparticles require crosslinkers to stabilize the formed nanosuspensions, considering that physical instability is the main challenge of nanoparticulate systems. The use of crosslinkers improves the physical integrity of nanoformulations under the-host environment. Aldehyde-based fixatives, such as formaldehyde and glutaraldehyde, have been widely applied to the crosslinking process of polymeric nanoparticles. However, their potential toxicity towards human beings has been demonstrated in many previous studies. In order to tackle this problem, D-glucose was used during nanoparticle formation to stabilize the gelatin/collagen-based matrix wall and reservoir wall for the deliveries of Calendula officinalis powder and oil, respectively. In addition, therapeutic selectivity between malignant and normal cells could be observed. The C. officinalis powder loaded nanoparticles significantly strengthened the anti-cancer effect towards human breast adenocarcinoma MCF7 cells and human hepatoma SKHep1 cells when compared with the free powder. On the contrary, the nanoparticles did not show significant cytotoxicity towards normal esophageal epithelial NE3 cells and human skin keratinocyte HaCaT cells. On the basis of these evidences, D-glucose modified gelatin/collagen matrix nanoparticles containing C. officinalis powder might be proposed as a safer alternative vehicle for anti-cancer treatments.

Chinese herbal medicine for functional constipation: a randomised controlled trial.

1. This was an 18-week prospective, randomised, double-blind, placebo-controlled clinical study on a Chinese herbal medicine--ma zi ren wan (MZRW)--for the treatment of functional constipation. 2. 120 subjects with functional constipation (Rome III criteria) were randomised (60 per arm) into the MZRW and placebo groups. Respective responder rates for the two groups were 43.3% and 8.3% during treatment, and 30.0% and 15.0% in the follow-up period (p<0.05). The MZRW group was superior to the placebo group in terms of increased complete spontaneous bowel movement as well as reduction in severity of constipation, straining at evacuation, and use of rescue therapy. No serious adverse effects were reported. 3. The dose of MZRW (7.5 g bid) was determined in a separate clinical trial. This study entailed a dose determination study and then a placebo-controlled clinical trial and can be a good reference for future studies.

Electroacupuncture versus celecoxib for neuropathic pain in rat SNL model.

Though acupuncture has long been used to treat various kinds of pain, its mechanisms remain partly understood. Our recent study has shown that it may inhibit cyclooxygenase-2 (COX-2) in the spinal dorsal horn where COX-2 is upregulated after the development of neuropathic pain following spinal nerve ligation (SNL). The current study directly compared the effect of acupuncture with COX-2 inhibitor celecoxib in the spinal cord after SNL in rats. After L5 SNL, the rats were treated either with acupuncture applied to Zusanli (ST36) and Sanyinjiao (SP6) bilaterally with or without electrical stimulation (2 Hz, 0.5-1-2 mA) four times over 22 days, and/or celecoxib fed daily. Paw-withdrawal-threshold to mechanical stimulation and paw-withdrawal-latency to thermal test were tested for neuropathic pain at four intervals following the treatments in comparison with the pre-treatment and non-treatment controls. The results demonstrate that electroacupuncture (EA) had a long lasting and better analgesic effect than celecoxib in reducing neuropathic hypersensitivity. Though COX-2 expression in the spinal L4-L6 dorsal horn by immunostaining was significantly reduced by acupuncture just as well as by celecoxib, the superior analgesic mechanism of acupuncture appears well beyond COX-2 inhibition alone.