The Leap of Inulin Fructans from Food Industry to Medical Application.

As a dietary supplement, the efficacy of prebiotics has become a hot issue in recent years. Inulin is one of internationally recognized prebiotics and belongs to a group of non-digestible and fermentable carbohydrates. Currently, the food industry is increasingly using prebiotic inulin as a health-promoting substrate, not just as food supplement. In addition, inulin has also shown great promise in the treatment of various diseases. This article reviews the application of inulin in the food industry and summarizes physiological function of inulin. Through the review and prospect of the research on obesity, diabetes and mental illness, it provides the theoretical basis for the joint development of inulin in food industry and medical application.

A DFX-based iron nanochelator for cancer therapy.

Iron as an essential element, is involved in various cellular functions and maintaining cell viability, cancer cell is more dependent on iron than normal cell due to its chief characteristic of hyper-proliferation. Despite that some of the iron chelators exhibited potent and broad antitumor activity, severe systemic toxicities have limited their clinical application. Polyaminoacids, as both drug-delivery platform and therapeutic agents, have attracted great interests owing to their different medical applications and biocompatibility. Herein, we have developed a novel iron nanochelator PL-DFX, which composed of deferasirox and hyperbranched polylysine. PL-DFX has higher cytotoxicity than DFX and this effect can be partially reversed by Fe2+ supplementation. PL-DFX also inhibited migration and invasion of cancer cells, interfere with iron metabolism, induce phase G1/S arrest and depolarize mitochondria membrane potential. Additionally, the anti-tumor potency of PL-DFX was also supported by organoids derived from clinical specimens. In this study, DFX-based iron nanochelator has provided a promising and prospective strategy for cancer therapy via iron metabolism disruption.

Acupuncture for treating chronic spinal pain: A systematic review and meta-analysis protocol.

BACKGROUND: Chronic spinal pain is one of the most leading causes of disability among adults worldwide and is associated with significant health care use. The effect of acupuncture on chronic spinal pain seems controversial based on evidence-based perspective. Thus, we performed a protocol for systematic review and meta-analysis to evaluate the effectiveness of acupuncture for treatment of chronic spinal pain. METHODS: This systematic review has been registered in PROSPERO (CRD42019120665), which will be conducted in accordance with preferred reporting items for systematic review and meta-analysis protocols 2015 statement. We will search 7 electronic databases to identify relevant studies from inception to November, 2022, which includes PubMed, MEDLINE, Embase, Cochrane Clinical Trials Database, Web of Science, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database. Cochrane "bias risk" tool is used to assess the bias risk of the quality of the included literature. RevMan V.5.3 software will be used to analyze all data. RESULTS: A synthesis of current evidence of acupuncture for treating chronic spinal pain will be provided in this protocol. CONCLUSION: This review will provide directions and recommendations for future research and clinical practices of acupuncture for treating chronic spinal pain.

"Click" preparation of a chiral macrocycle-based stationary phase for both normal-phase and reversed-phase high performance liquid chromatography enantioseparation.

Chiral polyimine macrocycles (CPMs) constitute a new family of organic macrocycles that have defined cavities, rigid shapes, inherent chirality and multiple cooperative binding sites, and have shown great potential in diverse areas. However, the application of CPMs for high performance liquid chromatography (HPLC) enantioseparation has rarely been reported. In this work, a novel chiral stationary phase (CSP) for HPLC was prepared by chemical bonding of a CPM (C54H72N6O3) onto thiolated silica via thiol-ene click reaction. The CSP exhibited good enantioselectivity in both normal- and reversed-phase HPLC. Chiral compounds included alcohols, diols, ketones, organic acids, esters, ethers, amines, and epoxides were enantioseparated on the column in normal-phase mode (17 compounds) and reversed-phase mode (20 compounds). Importantly, broader chiral resolution was observed with the column than that obtained using our previously studied chiral macrocycle H3L-based column, indicating the potential to significantly improve and broaden applicability of this novel macrocycle-type CSPs. Moreover, the CSP exhibited good complementary enantioseparation to Chiralpak AD-H and Chiralcel OD-H columns, enabling separation of some racemates that could not be separated by the two popular chiral HPLC columns. In addition, the fabricated column exhibited good stability and reproducibility. The relative standard deviations (RSDs) (n = 5) of retention time and resolution after multiple injections were < 0.20 % and < 0.39 %, respectively. The results demonstrated the great potential of this type of CPM for HPLC separation of enantiomers.

Isaacs' syndrome as the initial presentation of malignant thymoma and associated with double-positive voltage-gated potassium channel complex antibodies, a case report.

BACKGROUND: Isaacs' syndrome is a peripheral nerve hyperexcitability (PNH) syndrome due to peripheral motor nerve instability. Acquired Isaacs' syndrome is recognized as a paraneoplastic autoimmune disease with possible pathogenic voltage-gated potassium channel (VGKC) complex antibodies. However, the longitudinal correlation between clinical symptoms, VGKC antibodies level, and drug response is still unclear. CASE PRESENTATION: A 45-year-old man had progressive four limbs soreness, muscle twitching, cramps, and pain 4 months before admission. Electromyography (EMG) studies showed myokymic discharges, neuromyotonia, and an incremental response in the high-rate (50 Hz) repetitive nerve stimulation (RNS) test. Isaacs' syndrome was diagnosed based on clinical presentations and EMG reports. Serum studies showed positive VGKC complex antibodies, including leucine-rich glioma-inactivated 1 (LGI1) and contactin-associated protein-like 2 (CASPR2) antibodies. The acetylcholine receptor antibody was negative. Whole-body computed tomography (CT) and positron emission tomography revealed a mediastinal tumor with the great vessels encasement, right pleura, and diaphragm seeding. Biopsy confirmed a World Health Organization type B2 thymoma, with Masaoka stage IVa. His symptoms gradually improved and both LGI1 and CASPR2 antibodies titer became undetectable after concurrent chemoradiotherapy (CCRT) and high dose steroid treatment. However, his Isaacs' syndrome recurred after the steroid was reduced 5 months later. Follow-up chest CT showed probable thymoma progression. LGI1 antibody turned positive again while CASPR2 antibody remained undetectable. CONCLUSIONS: Our patient demonstrates that Isaacs' syndrome could be the initial and only neuromuscular manifestation of malignant thymoma. His Isaacs' syndrome is correlated well with the LGI1 antibody level. With an unresectable thymoma, long-term immunosuppressant therapy may be necessary for the management of Isaacs' syndrome in addition to CCRT for thymoma.

Shikani Optical Stylet for Awake Nasal Intubation in Patients Undergoing Head and Neck Surgery.

OBJECTIVES: To evaluate the efficacy and safety of the Shikani optical stylet (SOS) versus fiberoptic bronchoscope (FOB) for awake nasal intubation in head and neck surgery patients with an anticipated difficult airway. STUDY DESIGN: Prospective randomized clinical trial. METHODS: This study involved 50 adult patients scheduled for elective head and neck surgery and presented with an anticipated difficult airway. Patients planned for awake nasotracheal intubation were randomly divided into two groups: FOB (n = 25) and SOS (n = 25). Patients were intubated under local anesthesia and sedation using the randomly assigned intubation device by anesthetists proficient in both airway devices. The time to successful intubation was regarded as the primary endpoint. RESULTS: The median time (interquartile range) to tracheal intubation in the FOB group was 74 seconds (57-108) and 38 seconds (27-60) in the SOS group (P < .001). Intubation success rates on the first attempt in the FOB and SOS groups were 96% and 92%, respectively (P > .999). Airway assisted maneuvers were required in six (24%) SOS intubations compared to 21 (84%) FOB intubations (P < .001). There were no significant differences between the groups in the incidences of oxygen desaturation and postoperative complications related to intubation. CONCLUSION: Compared to the FOB group, awake nasal intubation in the SOS group required significantly less time and fewer airway-assisted maneuvers on adult head and neck surgery patients with anticipated difficult airway. LEVEL OF EVIDENCE: 2 Laryngoscope, 131:319-325, 2021.

Fatty Acid Metabolism is Associated With Disease Severity After H7N9 Infection.

BACKGROUND: Human infections with the H7N9 virus could lead to lung damage and even multiple organ failure, which is closely associated with a high mortality rate. However, the metabolic basis of such systemic alterations remains unknown. METHODS: This study included hospitalized patients (n = 4) with laboratory-confirmed H7N9 infection, healthy controls (n = 9), and two disease control groups comprising patients with pneumonia (n = 9) and patients with pneumonia who received steroid treatment (n = 10). One H7N9-infected patient underwent lung biopsy for histopathological analysis and expression analysis of genes associated with lung homeostasis. H7N9-induced systemic alterations were investigated using metabolomic analysis of sera collected from the four patients by using ultra-performance liquid chromatography-mass spectrometry. Chest digital radiography and laboratory tests were also conducted. FINDINGS: Two of the four patients did not survive the clinical treatments with antiviral medication, steroids, and oxygen therapy. Biopsy revealed disrupted expression of genes associated with lung epithelial integrity. Histopathological analysis demonstrated severe lung inflammation after H7N9 infection. Metabolomic analysis indicated that fatty acid metabolism may be inhibited during H7N9 infection. Serum levels of palmitic acid, erucic acid, and phytal may negatively correlate with the extent of lung inflammation after H7N9 infection. The changes in fatty acid levels may not be due to steroid treatment or pneumonia. INTERPRETATION: Altered structural and secretory properties of the lung epithelium may be associated with the severity of H7N9-infection-induced lung disease. Moreover, fatty acid metabolism level may predict a fatal outcome after H7N9 virus infection.

Gambogic acid improves non-small cell lung cancer progression by inhibition of mTOR signaling pathway.

Gambogic acid (GA) has been shown to inhibit cancer cell proliferation, induce apoptosis, and enhance reactive oxygen species accumulation. However, whether GA could improve multidrug resistance through modulating autophagy has never been explored. We demonstrated that the combination of GA and cisplatin (CDDP) resulted in a stronger growth inhibition effect on A549 and NCI-H460 cells using the MTT assay. Furthermore, treatment with GA significantly increased autophagy in these cells. More importantly, GA-induced cell death could be largely abolished by 3-methyladenine (3-MA) or chloroquine (CQ) treatment, suggesting that GA-induced cell death was dependent on autophagy. Western blot analysis showed that GA treatment suppressed the activation of Akt, mTOR, and S6. In addition, using a GA and rapamycin combination induced more cell death compared to either GA or rapamycin alone. In summary, GA may have utility as an adjunct therapy for non-small cell lung cancer (NSCLC) patients through autophagy-dependent cell death, even when cancer cells have developed resistance to apoptosis.

The application of thermophilic DNA primase TtDnaG2 to DNA amplification.

For DNA replication in vivo, DNA primase uses a complementary single-stranded DNA template to synthesize RNA primers ranging from 4 to 20 nucleotides in length, which are then elongated by DNA polymerase. Here, we report that, in the presence of double-stranded DNA, the thermophilic DNA primase TtDnaG2 synthesizes RNA primers of around 100 nucleotides with low initiation specificity at 70 °C. Analysing the structure of TtDnaG2, we identified that it adopts a compact conformation. The conserved sites in its zinc binding domain are sequestered away from its RNA polymerase domain, which might give rise to the low initiation specificity and synthesis of long RNA segments by TtDnaG2. Based on these unique features of TtDnaG2, a DNA amplification method has been developed. We utilized TtDnaG2 to synthesize RNA primers at 70 °C after 95 °C denaturation, followed by isothermal amplification with the DNA polymerase Bst3.0 or phi29. Using this method, we successfully amplified genomic DNA of a virus with 100% coverage and low copy number variation. Our data also demonstrate that this method can efficiently amplify circular DNA from a mixture of circular DNA and linear DNA, thus providing a tool to amplify low-copy-number circular DNA such as plasmids.

Toxicological Evaluation of Low Molecular Weight Fucoidan in Vitro and in Vivo.

For a long time, fucoidan has been well known for its pharmacological activities, and recently low molecular weight fucoidan (LMF) has been used in food supplements and pharmaceutical products. In the present study, LMF was extracted from Laminaria japonica by enzyme hydrolysis. The toxicity of LMF in mouse and rat models was determined by many methods, such as total arsenic content, bacterial reverse mutation assay, chromosome aberration assay, and in vivo micronucleus assay. The present findings showed that LMF at 5000 µg/mL exhibited no mutagenicity. It also produced no formatting disruption of red blood cells in vivo. At 2000 mg/kg BW/day there were no toxicological indications. LMF is expected to be used as a safe food supplement.

[Adefovir dipivoxil effects on and related factors of blood phosphorus metabolism in patients with chronic hepatitis B].

OBJECTIVE: To investigate the effects of adefovir dipivoxil (ADV) on blood phosphorus metabolism in patients with chronic hepatitis B (CHB). METHODS: Patients with hepatitis B surface antigen (HBsAg)-positive CHB were treated with ADV alone, ADV combined with interferon (IFN), or ADV combined with lamivudine (LAM). Changes in levels of calcium, phosphate, urea, and creatinine were assessed at treatment weeks 4, 12, 24, 48, 72 and 96. Statistical analysis was carried out with SPSS 16 software; influential factors were analyzed by ANOVA and non-conditional logistic regression analysis. RESULTS: During the course of treatments, 32 (42.6%) of the patients presented with low phosphorus. The highest incidence of low phosphorus was found to have occurred at treatment week 24 (25.0%, 27.5% and 36.4% respectively, with no statistical difference between three groups, x2=0.225, P>0.225). Patients with hypophosphatemia did not show a significant difference in serum phosphorus levels from the other patients (F=1.853, P=0.169). Logistic regression showed a correlation between low phosphorus and sex (x2=7.876, P<0.05), age (t=2.479, P<0.05), and serum creatinine (t =-2.256, P<0.05), but not with blood urea nitrogen or blood calcium (P>0.05). CONCLUSION: ADV antiviral treatment can decrease the blood phosphorous levels of CHB patients, particularly over extended time of treatment, and the occurrence of low phosphorus is more common than of mild phosphorus decrease.Male and elderly patients may be at greater risk of this complication. The incidence and severity of low phosphorus is not significantly different for the different ADV-based treatment regimens.

Leptin: a potential anxiolytic by facilitation of fear extinction.

AIMS: Anxiety disorders are characterized by a deficient extinction of fear memory. Evidence is growing that leptin influences numerous neuronal functions. The aims of this study were to investigate the effects and the mechanism of leptin on fear extinction. METHODS AND RESULTS: Leptin (1 mg/kg, i.p) was applied to evaluate the anxiolytic effect in rat behavioral tests. Field potentials recording were used to investigate the changes in synaptic transmission in the thalamic-lateral amygadala (LA) pathway of rat. We found that leptin produced strong anxiolytic effects under basal condition and after acute stress. Systemic administration and intra-LA infusions of leptin facilitated extinction of conditioned fear responses. The antagonist of NMDA receptor, MK-801, blocked the effect of leptin on fear extinction completely. Furthermore, these effects of leptin on fear extinction were accompanied by a reversal of conditioning-induced synaptic potentiation in the LA. Leptin facilitated NMDA receptor-mediated synaptic transmission, and reversed amygdala long-term potentiation (LTP) in a dose-dependent manner in vitro, and this LTP depotentiation effect was mediated by NMDA receptor and MAPK signaling pathway. CONCLUSIONS: These results identify a key role of leptin in dampening fear conditioning-induced synaptic potentiation in the LA through NMDA receptor and indicate a new strategy for treating anxiety disorders.

[Improvement of carbon tetrachloride drug-induced liver injury model in vitro].

OBJECTIVE: To establish an ideal CCl4 drug-induced liver injury model in vitro. METHOD: Traditional method and improved method were adopted for preparing CCl4 injury liquid and drug-induced human liver HepG2 cell injury. Cell morphological change was observed under a bright-field microscope. The level of alanine aminotransferase (ALT) in supernatant was detected by biochemical method. 4-Methyl-tetrazolium (MTT) chromatometry was adopted for determining cell activity. RESULT: The improved method showed better CCl4-induced injury effect than the traditional method. With the increase in the concentration of CCl4 injury liquid, the ALT level significantly increased, whereas the cell activity notably decreased. Particularly, 70% CCl4 injury liquid use for 4 hours could achieve the best injury effect. CONCLUSION: The improved method could be used to establish an ideal CCl4 drug-induced liver injury model in vitro, which can lay foundation for further in vitro studies.

Effects of multiple intrathecal administration of L-arginine with different doses on formalin-induced nociceptive behavioral responses in rats.

OBJECTIVE: To investigate the effects of nitric oxide (NO) with different doses on modulation of inflammatory pain, and its possible mechanisms. METHODS: NO precursor L-arginine (L-Arg) was intrathecally administered in rats at a dose of 10 microg per day (low dose group) or 250 microg per day (high dose group) for a succession of 4 d. Normal saline was applied as a control. Then the rats were subcutaneously injected with formalin (100 microL, 2%) into the right hind paw, and the nociceptive behavioral responses within 1 h were observed. At 4 h after formalin injection, neuronal NO synthase (nNOS) and c-Fos expression in spinal dorsal horn was examined with immunocytochemistry method. RESULTS: The subcutaneous injection of formalin evoked biphasic behaviors of licking or biting the injected paw. There was no difference in acute phase of formalin test among the 3 groups, while in tonic phase, the licking and biting time, and the protein levels of nNOS and c-Fos in spinal dorsal horn were significantly decreased in low dose group and increased in high dose group, compared with those in control group. CONCLUSION: These results suggest that multiple administration of NO with different doses may produce different effects. On one hand, the low dose of NO can induce antinociception. On the other hand, the high dose of NO can induce pronociception.

[Studies on fingerprinting and identification of main species of Herba Epimedii].

OBJECTIVE: To establish an effective method for the identification of Herba Epimedii. METHOD: The HPLC fingerprints of 8 officinal species including 5 species recorded in 'Chinese Pharmacopoeia', which are Epimedium brevicornu, E. sagittatum, E. pubescens, E. koreanum and E. wushanense, and the other 3 species, E. acuminatum, E. myrianthum and E. leptorrhizum, recorded in 'Guizhou Quality Criteria for Traditional Chinese Medical Material and Nationality Medical Material', and of other 24 species in genus Epimedium in China as well had been analyzed and some fingerprinting features for the identification had been pointed out. RESULT AND CONCLUSION: The fingerprinting features of E. koreanum are rather different from others and can be used for the species identification. There are some common fingerprinting features in the most samples of E. brevicornu, E. acuminatum and E. myrianthum, respectively, and these features are seldom found in the samples of other species. The HPLC fingerprints of E. pubescens and E. leptorrhizum appear steadily among all samples of the species respectively, but it is difficult to distinguish the spcecies from other species with the HPLC fingerprints only. The HPLC fingerprints of E. sagittatum and E. wushanense vary greatly within the species. It is also showed that the quality of Herba Epimedii varied significantly according to the HPLC features.

Fast quality control of Herba Epimedii by using Fourier transform infrared spectroscopy.

Herba Epimedii is a well-known traditional Chinese medicine (TCM) having the effect of nourishing the kidney and strengthening the 'Yang'. Its primary effective constituents are considered to be the 8-prenyl flavonols, which can be assorted into 4'-methoxyl-prenylflavonols (MPFs) and 4'-hydroxyl-prenylflavonols (HPFs), according to the group (methoxyl or hydroxyl) located at 4' in their structures. The Fourier transform infrared spectroscopy (FT-IR) has been widely used in the researches of TCMs. In the present study, the FT-IR was attempted to be applied in the quality control of Herba Epimedii. We compared the IR spectra of 17 pure flavonoids, of which eight were derived from Herba Epimedii, and found a characteristic absorption peak at 1259+/-1 cm(-1), corresponding to the MPFs, the major 8-prenyl flavonols in the aerial parts of the Epimedium species. This peak could also be found in the IR spectra of both the herbal samples and their 70% ethanol extracts. Moreover, the intensity of this peak was in the direct correlation with the total content of MPFs. The correlation values, representing the semblance of two spectra, of the IR spectrum of herbal sample and icariin, in the range of 1280-1200 cm(-1), had been established to be a good index for the quality control of the herbs. Accordingly, a correlation value of not less than 0.50 could be used as the essential screening criteria for the herbs. The FT-IR could be used for the fast and effective quality control of Herba Epimedii.

Effects of rhubarb extract on radiation induced lung toxicity via decreasing transforming growth factor-beta-1 and interleukin-6 in lung cancer patients treated with radiotherapy.

BACKGROUND: Radiation induced lung toxicity (RILT) is the main adverse effect in the radiation therapy of lung cancer. However, the optimal management of RILT has not been defined. In this paper, we investigated the effects of rhubarb extract on RILT, pulmonary function (PF), transforming growth factor-beta-1 (TGF-beta1), and interleukin-6 (IL-6) in lung cancer patients treated with radiotherapy. PATIENTS AND METHODS: We conducted a randomized, double-blind, placebo-controlled trial. Eighty consecutive patients were randomly enrolled into two groups: trial group and control group. The trial group received three-dimensional conformal radiation therapy (3D-CRT) plus rhubarb (at a dose of 20 mg kg(-1) once a day) for 6 weeks. The control group received 3D-CRT plus a placebo containing starch for 6 weeks. Plasma TGF-beta1 and serum IL-6 were measured in all patients before, every 2 weeks during, and at 6 weeks after the completion of the treatment. RILT and PF were evaluated at 6 weeks and 6 months after the end of the treatment, respectively. The differences of TGF-beta1, IL-6, RILT, and PF between the two groups were analysed. RESULTS: The incidence of RILT in the trial group was significantly lower than that in the control group at 6 weeks and 6 months after treatment (32.4% versus 56.7% at week 6, and 27.0% versus 52.8% at month 6, both P<0.05). The plasma TGF-beta1 levels in the trial group were significantly lower than that in the control group during and after the treatment (P<0.05 or 0.01, respectively). The serum IL-6 levels in the trial group were significantly lower than that in the control group during the treatment (all P<0.01). The forced vital capacity (FVC), forced expiratory volume at 1s (FEV1) at 6 weeks and the diffusion capacity for carbon monoxide (DLCO) at 6 months in the trial group were significantly improved compared to the control group (P<0.05 or 0.01, respectively). CONCLUSIONS: The rhubarb extract significantly attenuated RILT and improved PF, probably by decreasing the level of TGF-beta1 and IL-6. These results may be of value for the prophylaxis of RILT, but the exact mechanisms underlying these prophylactic effects remain to be further explored.

Studies on fingerprinting and identification of main species of Herba Epimedii / 中国中药杂志

<p><b>OBJECTIVE</b>To establish an effective method for the identification of Herba Epimedii.</p><p><b>METHOD</b>The HPLC fingerprints of 8 officinal species including 5 species recorded in 'Chinese Pharmacopoeia', which are Epimedium brevicornu, E. sagittatum, E. pubescens, E. koreanum and E. wushanense, and the other 3 species, E. acuminatum, E. myrianthum and E. leptorrhizum, recorded in 'Guizhou Quality Criteria for Traditional Chinese Medical Material and Nationality Medical Material', and of other 24 species in genus Epimedium in China as well had been analyzed and some fingerprinting features for the identification had been pointed out.</p><p><b>RESULT AND CONCLUSION</b>The fingerprinting features of E. koreanum are rather different from others and can be used for the species identification. There are some common fingerprinting features in the most samples of E. brevicornu, E. acuminatum and E. myrianthum, respectively, and these features are seldom found in the samples of other species. The HPLC fingerprints of E. pubescens and E. leptorrhizum appear steadily among all samples of the species respectively, but it is difficult to distinguish the spcecies from other species with the HPLC fingerprints only. The HPLC fingerprints of E. sagittatum and E. wushanense vary greatly within the species. It is also showed that the quality of Herba Epimedii varied significantly according to the HPLC features.</p>

[A review on research of raw material and cut crude drug of Herba epimedii in last ten years].

Researches on taxonomy, resources, cultivation, quality, chemicals and processing of Herba Epimedii in last ten years were reviewed. The taxonomy of Chinese species in "Flora of China (Vo1.29)" (published in 2001) and "The genus Epimedium and other herbaceous Berberidaceae" (published in 2002) were mainly introduced and commented. The quality evaluation of raw material of Herba Epimedii, and effects of distribution, growing time and medicinal part on the quality were summarized.