Tai Chi as a complementary exercise for pulmonary rehabilitation in chronic obstructive pulmonary disease: A randomised controlled trial.

OBJECTIVES: With the characteristics of mindfulness and breathing techniques, Tai Chi has been recommended with therapeutic values in chronic obstructive pulmonary disease (COPD). However, its strengths as a complementary exercise for conventional pulmonary rehabilitation (PR) remain unclear. DESIGN AND SETTING: This single-blinded randomised controlled trial recruited patients with mild to severe stable COPD. Eligible participants were randomly assigned to the group with usual care (control), total body recumbent stepper (TBRS) exercise, Tai Chi (TC), or combined TBRS exercise and Tai Chi (TBRS-TC). Patients received a two-month hospital-based supervised exercise, followed by a ten-month community- or home-based rehabilitation program. RESULTS: A total of 120 participants were recruited, and 102 were included in the per-protocol analysis. The mean changes in St George's Respiratory Questionnaire (SGRQ) total score from baseline to the post-hospital exercise in the control group, TBRS group, TC group, and TBRS-TC group was 2.62 (95 % CI -8.99 to 8.99), -9.28 (95 % CI -13.96 to -4.60), -10.19 (95 % CI -13.72 to -6.67), and -16.75 (95 % CI -20.25 to -13.24), respectively, with a statistically significant difference between groups in favor of the TBRS-TC exercise (P < 0.001). The remarkable effect of TBRS-TC exercise in improving the quality of life maintained until the end of the community- or home-based rehabilitation training (P < 0.001). Besides, a statistically better effect with the TBRS-TC exercise was also observed in the outcomes regarding exercise capacity, pulmonary function, symptom burden, and systemic inflammation after the whole process of 12-month integrative PR exercise programme. CONCLUSIONS: Based on the results, a novel integrated exercise modality combining Tai Chi and conventional pulmonary rehabilitation was developed. It might contribute to more positive effects in patients with stable COPD. REGISTRATION: The study was registered with the Chinese Clinical Trial Registry (ChiCTR-IOR-15006874) prior to commencing recruitment.

Comparative Effectiveness and Safety of Different Types of Inhaled Long-Acting ß2-Agonist Plus Inhaled Long-Acting Muscarinic Antagonist vs Inhaled Long-Acting ß2-Agonist Plus Inhaled Corticosteroid Fixed-Dose Combinations in COPD A Propensity Score-Inverse Probability of Treatment Weighting Cohort Study.

BACKGROUND: Despite multiple available fixed-dose combinations (FDCs) of inhaled long-acting ß2-agonists (LABAs) plus long-acting muscarinic antagonists (LAMAs) and LABAs plus inhaled corticosteroids (ICS) for COPD, uncertainty remains regarding their comparative effects. RESEARCH QUESTION: Can comparative effectiveness and safety of LABA plus LAMA (LABA/LAMA) and LABA plus ICS (LABA/ICS) FDCs vary by different individual components of the dual combinations in COPD? STUDY DESIGN AND METHODS: We conducted a new user, propensity score-inverse probability of treatment weighting cohort study to compare the effectiveness and safety of two frequently used LABA/LAMA FDCs (indacaterol plus glycopyrronium [IND/GLY] and vilanterol plus umeclidinium [VI/UMEC]) vs three commonly prescribed LABA/ICS FDCs (salmeterol plus fluticasone propionate [SAL/FP], formoterol fumarate plus budesonide [FF/BUD], and formoterol fumarate plus beclomethasone dipropionate [FF/BDP]) using the Taiwanese nationwide health care claims from 2014 through 2017. The primary effectiveness outcome was the annual moderate to severe exacerbation rate, and safety outcomes included risks of severe pneumonia and cardiovascular disease requiring hospitalization. Weighted generalized linear mixed models and Cox proportional hazard models were used to assess the effectiveness and safety outcomes, respectively. RESULTS: Patients with COPD initiating IND/GLY and VI/UMEC showed an 11% (incidence rate ratio [IRR], 0.89; 95% CI, 0.80-0.98) and 20% (IRR, 0.80; 95% CI, 0.71-0.90) reduced annual rate of moderate to severe exacerbations, respectively, than those initiating SAL/FP, but showed a similar rate as those initiating FF/BUD or FF/BDP. Both LABA/LAMA FDCs, compared with SAL/FP and VI/UMEC vs FF/BDP, were associated with a 27% (hazard ratio [HR], 0.73; 95% CI, 0.59-0.90) to 42% (HR, 0.58; 95% CI, 0.48-0.70) reduced pneumonia risk. Cardiovascular risk was comparable in five groups. An intraclass difference existed in rates of moderate to severe COPD exacerbation and risks of pneumonia among LABA/ICS FDCs, but not between LABA/LAMA FDCs. INTERPRETATION: Both LABA/LAMAs vs SAL/FP are associated with a lower exacerbation rate and pneumonia risk, but exhibit similar effectiveness and safety outcomes compared with FF/BDP or FF/BUD, suggesting that comparative effects may differ by individual components of the dual therapies in COPD.

Djulis (Chenopodium formosanum Koidz.) Water Extract and Its Bioactive Components Ameliorate Dermal Damage in UVB-Irradiated Skin Models.

Dermal photoaging is a condition of skin suffering inappropriate ultraviolet (UV) exposure and exerts inflammation, tissue alterations, redness, swelling, and uncomfortable feelings. Djulis (Chenopodium formosanum Koidz.) is a cereal food and its antioxidant and pigment constituents may provide skin protection from photoaging, but it still lacks proved experiments. In this study, protective effects of djulis extract (CFE) on UVB-irradiated skin were explored. The results showed that HaCaT cells with 150 µg/mL CFE treatment had higher survival and less production of interleukin- (IL-) 6, matrix metalloprotease- (MMP-) 1, and reactive oxygen species (ROS) in UVB-irradiated conditions. Subsequently, in animal studies, mice supplemented with CFE (100 mg/kg BW) were under UVB irradiation and had thinner epidermis and lower IL-6 levels in skin layer. These data demonstrate that bioactive compounds possessing the potency of antiphotoaging exist in CFE. Following that, we found rutin and chlorogenic acid (10-100 µM) could significantly increase cell viability and decrease the production of IL-6 in UVB models. Additionally, djulis pigment-betanin has no effect of increasing cell viability in this study. Our findings suggest CFE can protect skin against UV-induced damage and this protection is mainly from contributions of rutin and chlorogenic acid.

Water-insoluble fiber-rich fraction from pineapple peel improves intestinal function in hamsters: evidence from cecal and fecal indicators.

Pineapple peel, a byproduct of agricultural processing, contains high levels of water-insoluble fiber-rich fraction (WIFF) (~42%, wt/wt). Our previous work has demonstrated that cellulose, hemicellulose (xylan and xyloglucan), and pectic substances are the major polysaccharides of pineapple-peel WIFF. Based on its chemical composition and unique characteristics, we hypothesized that daily consumption of WIFF would improve intestinal function in hamsters. Male Golden Syrian hamsters were fed a diet supplemented with either 5% cellulose or various amounts of WIFF (2.5%, 5%, or 10%). Activities of fecal bacterial enzymes, short-chain fatty acid concentrations, and microbial number in the cecal content, and also biochemical indicators in the cecal and feces of hamsters, were evaluated in all groups. The supplementation of WIFF in a diet at a level of 2.5% significantly (P < .05) decreased the daily fecal ammonia output; shortened the gastrointestinal transit time; reduced the activities of ß-D-glucosidase, ß-D-glucuronidase, mucinase, and urease in feces; and also enhanced the total amounts of short-chain fatty acid in the cecal content and the growth of gut microflora such as Lactobacillus spp and Bifidobacterium spp. These results indicate that WIFF could improve cecal ecosystem function of hamsters by reducing the toxic compounds excreted by intestinal microflora. Therefore, pineapple-peel WIFF could be a promising candidate for a functional ingredient beneficial to human intestinal function and health.

Intestinal health benefits of the water-soluble carbohydrate concentrate of wild grape ( Vitis thunbergii ) in hamsters.

The dose-response relationship of the water-soluble carbohydrate concentrate (WSCC) from wild grape ( Vitis thunbergii Sieb. & Zucc.) on intestinal health was investigated in this study. WSCC contained carbohydrates up to 71.9 g/100 g, including arabinose-rich pectic polysaccharide, hemicelluloses, glucose, and fructose. The consumption of WSCC (0.5 and 1.5 g/100 g of diet) effectively (P < 0.05) shortened gastrointestinal transit time (-62.3 to -63.0%), decreased toxic cecal ammonia (-59.3 to -63.0%) and daily fecal ammonia output (-29.7 to -41.4%), decreased the activities of fecal ß-glucuronidase (-78.6%), ß-glucosidase (-80.5 to -87.5%), mucinase (-64.6 to -72.7%), and urease (-83.2 to -86.0%), increased fecal moisture content (116-129%), and also increased short-chain fatty acid levels in cecal contents (1.8-3.3-fold). These findings suggested that consumption of wild grape WSCC might diminish the exposure of intestinal mucosa to toxic ammonia and other detrimental compounds and, hence exert, favorable effects on improving gastrointestinal milieu.

Phyllanthus urinaria Induces Apoptosis in Human Osteosarcoma 143B Cells via Activation of Fas/FasL- and Mitochondria-Mediated Pathways.

Phyllanthus urinaria (P. urinaria), in this study, was used for the treatment of human osteosarcoma cells, which is one of the tough malignancies with few therapeutic modalities. Herein, we demonstrated that P. urinaria inhibited human osteosarcoma 143B cells growth through an apoptotic extrinsic pathway to activate Fas receptor/ligand expression. Both intracellular and mitochondrial reactive oxygen species were increased to lead to alterations of mitochondrial membrane permeability and Bcl-2 family including upregulation of Bid, tBid, and Bax and downregulation of Bcl-2. P. urinaria triggered an intrinsic pathway and amplified the caspase cascade to induce apoptosis of 143B cells. However, upregulation of both intracellular and mitochondrial reactive oxygen species and the sequential membrane potential change were less pronounced in the mitochondrial respiratory-defective 143Bρ(0) cells compared with the 143B cells. This study offers the evidence that mitochondria are essential for the anticancer mechanism induced by P. urinaria through both extrinsic and intrinsic pathways.

Composition, characteristics, and in-vitro physiological effects of the water-soluble polysaccharides from Cassia seed.

The popular beverage ingredients Cassia obtusifolia and Cassia tora were found to have considerable amounts of water-soluble polysaccharides (WSPs) (58.5 and 55.9/100g of dried extract). The composition, characteristics, and in-vitro physiological effects of these polysaccharides and their possible health benefits were investigated. The major polysaccharide components in the WSP of C. obtusifolia were possibly pectic polysaccharides and hemicellulose, while C. tora WSP was mainly composed of arabinoglucan and pectic polysaccharides. These WSPs had inhibitory effects on the activities of α-amylase and pancreatic lipase, while they rendered an increase in protease activity. These WSPs also had the ability to bind bile acids and reduce the amount of cholesterol available for absorption. This suggested that these WSPs had potential application as herbal ingredients in beverages. Further investigations on their in-vivo hypocholesterolaemic effects and intestinal functions using animal-feeding experiments are under way.

Signaling pathways for induction of platelet aggregation by SAS tongue cancer cells--a mechanism of hematogenous metastasis.

BACKGROUND: Tongue cancer metastasis is mainly through blood stream and possibly associated with tumor cell-induced platelet aggregation (TCIPA). METHODS: Platelet aggregation was induced by different amounts of SAS tongue cancer cells with/without inhibitors and the latent period for induction of platelet aggregation was recorded. Gene expression was analyzed by reverse transcriptase-polymerase chain reaction. RESULTS: SAS cells (4 x 10(4) to 1 x 10(6) cells/ml) induced platelet aggregation in a cell density-dependent manner. The latent period for induction of platelet aggregation reduced from 11.3 min (2 x 10(5) cells/ml) to 0.9 min (5 x 10(5) cells/ml). The extent of platelet aggregation increased from 39% to 76% by 2 x 10(5) and 5 x 10(5) SAS cells. Pre-treatment of SAS cells with aspirin showed little effect on its induction of platelet aggregation. SAS cells expressed tissue factor (TF) mRNA and the SAS cells-induced TCIPA was inhibited by TF neutralization antibody (5-20 microg/ml), heparin (5-10 U/ml), Hirudin fragment 54-65 (50 microg/ml) and D-Phenylalanyl-L-prolyl-L-arginine chloromethyl ketone. But areca nut (AN, a betel quid component known to generate reactive oxygen species (ROS)) extract showed little effect on TF expression in SAS cells. Pre-treatment with U73122 and 2-aminoethoxydiphenylborate inhibited SAS-induced TCIPA. Interestingly, catalase suppressed SAS cells-induced TCIPA, whereas AN extract enhanced this event. CONCLUSIONS: These results suggest that tongue cancer cells may induce TCIPA and enhance tumor metastasis. SAS-induced TCIPA is related to TF secretion, thrombin generation and associated with Phospholipase C-Inositol triphosphate signaling and ROS production. Betel quid chewing may potentially promote tongue cancer metastasis.

Dose effects of the food spice cardamom on aspects of hamster gut physiology.

The dose effects of pectic polysaccharide-rich extract from the food spice cardamom (Amomum villosum Lour.) on intestinal environment were investigated. The results showed that pectic polysaccharides and hemicellulose were the major polysaccharides in the cardamom extract. The administration of cardamom extract (0.5 and 1.5 g/100 g diet) effectively (p < 0.05) shortened hamster gastrointestinal transit time by approximately 58%, increased fecal moisture contents (148-174%), increased SCFA concentrations in hindgut (4.0- to 7.8-fold), decreased the activities of beta-D-glucuronidase (by 71.4-85.7%), beta-D-glucosidase (by 24.3-51.5%), mucinase (by 63.6-72.7%), and urease (by 88.8-90.4%) in feces, and reduced the production of toxic ammonia (by 16.1-64.5%). These findings suggested that the consumption of cardamom extract (at least 0.5 g/100 g diet or 40 mg/day) might exert a favorable effect on improving the gastrointestinal milieu, and also provide a clue to substantiate its traditional therapeutic uses and dosage for intestinal health improvement.

In vitro hypoglycemic effects of different insoluble fiber-rich fractions prepared from the peel of Citrus sinensis L. cv. Liucheng.

Insoluble fiber-rich fractions (FRFs), including insoluble dietary fiber, alcohol-insoluble solid, and water-insoluble solid, were isolated from the peel of Citrus sinensis L. cv. Liucheng. We found that these three FRFs could effectively adsorb glucose, retard glucose diffusion, and inhibit the activity of alpha-amylase to different extents. These mechanisms might create a concerted benefit in decreasing the rate of glucose absorption and eventually lower the concentration of postprandial serum glucose. The potential hypoglycemic effects of these FRFs suggested that they could be incorporated as low-calorie bulk ingredients in high-fiber foods to reduce calorie level and control blood glucose level.

Comparison of the chemical composition and physicochemical properties of different fibers prepared from the peel of Citrus sinensis L. Cv. Liucheng.

Fiber-rich fractions (FRFs) including soluble and insoluble dietary fibers (SDF and IDF), alcohol-insoluble solid (AIS), and water-insoluble solid (WIS) were isolated from the peel of Citrus sinensis L. cv. Liucheng for analysis and tests. The peel was rich in insoluble FRFs (IDF, AIS, and WIS; 476-515 g kg(-1) of peel), which were mainly composed of pectic substances and cellulose, and also contained pectic polysaccharide-rich SDF (94.1 g kg(-1) of peel). These insoluble FRFs had water-holding capacities (15.5-16.7 mL g(-1)), oil-holding capacities (2.35-5.09 g g(-1)), cation-exchange capacities (454-997 mequiv kg(-1)), and swelling properties (14.6-21.1 mL g(-1)) much higher than those of cellulose. These results recommended the consumption of these peel insoluble FRFs of desired physicochemical properties as sources of food fibers or low-calorie bulk ingredients in food applications requiring oil and moisture retention. Further investigations on the physiological functions of these peel FRFs using animal-feeding experiments are underway.