Tree frog-inspired nanopillar arrays for enhancement of adhesion and friction.

Bioinspired structure adhesives have received increasing interest for many applications, such as climbing robots and medical devices. Inspired by the closely packed keratin nanopillars on the toe pads of tree frogs, tightly arranged polycaprolactone nanorod arrays are prepared by mold process and chemical modification. Nanorod arrays show enhanced adhesion and friction on both smooth and rough surfaces compared to the arrays with hexagonal micropillars. The bonding of nanorods results in a larger stiffness of the nanorod surface, contributing mainly to friction rather than adhesion. The results suggest the function of closely packed keratin nanopillars on the toe pad of tree frogs and offer a guiding principle for the designing of new structured adhesives with strong attaching abilities.

Comparative effectiveness of Ginkgo injections for treating vertebrobasilar insufficiency: A systematic review and network meta-analysis.

WHAT IS KNOWN AND OBJECTIVE: This study sought to assess the clinical effectiveness of Ginkgo injections (GIs) combined with conventional drugs for vertebrobasilar insufficiency (VBI). METHODS: Randomized controlled trials (RCTs) that assessed the adjunctive effects of GIs for patients with VBI were retrieved from several English and Chinese databases from inception to December 2018. The Cochrane risk of bias method was used to evaluate the methodological quality of the eligible trials. The data were analysed by Stata 13.0 and WinBUGS 1.4.3 software. RESULTS: A total of 20 RCTs that included 1710 patients were included. All RCTs had an unclear risk of bias or a high risk of bias. The network meta-analysis (NMA) showed that the use of four kinds of GIs, especially Ginkgo leaf extract and dipyridamole injections (GDs), as adjunctive therapies with drugs for VBI increased the total effectiveness rate. Ginkgo biloba leaf extract injections (EGbs) combined with conventional drugs were more effective than only conventional drugs for improving the results of transcranial Doppler ultrasonography (TCD). Shuxuening injections (SXNs) seemed superior for improving blood viscosity-related indicators. Adverse events were mentioned in nine trials, and there was no difference between the GI group and the control group for the incidence rate of adverse events. WHAT IS NEW AND CONCLUSIONS: GIs showed significant benefits as an add-on therapy for VBI, as GIs increased the total effectiveness rate and improved the results of TCD examinations. Due to the limited sample size and quality of the included trials, the results of this review still need to be tested in larger, rigorous studies in the future.

Efficacy and safety of ginkgo injections in the treatment of angina pectoris caused by coronary heart disease in China: a network Meta-analysis and systematic review.

OBJECTIVE: To assess the clinical efficacy and safety of ginkgo injections (GIs) combined with conventional treatment (CT) against angina pectoris (AP) due to coronary heart disease (CHD). METHODS: Randomized controlled trials (RCTs) that used GIs to treat AP were searched in SinoMed, PubMed, China National Knowledge Infrastructure Database, Chinese Scientific Journals Database, Wanfang Database, Embase and Cochrane Library until March 2017. The Cochrane"risk of bias"method was used to evaluate the methodological quality of RCTs. Data were analyzed using Stata v13.1 and WinBUGS v1.4.3. RESULTS: A total of 73 RCTs involving 7621 patients were included. A Bayesian network Meta-analysis of RCTs was undertaken, and the advantages of four types of GI-supplemented CT in AP treatment were determined. CONCLUSION: GI-assisted CT was more effective against AP than CT alone. However, based on the limitations of the study, additional high-quality RCTs are required to confirm our findings.

Ginkgo Leaf Extract and Dipyridamole Injection as Adjuvant Treatment for Angina Pectoris: A Meta-Analysis of 41 Randomized Controlled Trials.

OBJECTIVE: To provide information about the effectiveness and safety of Ginkgo Leaf Extract and Dipyridamole Injection (GD) as one adjuvant therapy for treating angina pectoris (AP) and to evaluate the relevant randomized controlled trials (RCTs) with meta-analysis. METHODS: RCTs concerning AP treated by GD were searched in China Biology Medicine Disc (SinoMed), PubMed, the China National Knowledge Infrastructure Database (CNKI), the Chinese Scientifific Journals Database (VIP), Wanfang Database, Embase, and the Cochrane Library, from inception to February, 2017. The Cochrane Risk Assessment Tool was adopted to assess the methodological quality of the RCTs. The Review Manager 5.3 software was utilized to conduct the meta-analysis. RESULTS: A total of 41 RCTs involving 4,462 patients were included in the meta-analysis. The results indicated that the combined use of GD and Western medicine (WM) against AP was associated with a higher total effective rate [risk ratio (RR)=1.25, 95% confifidence interval (CI): 1.21-1.29, P<0.01], total effective rate of electrocardiogram (RR=1.29, 95% CI: 1.21-1.36, P<0.01). Additional, GD combined with WM could decrease the level of plasma viscosity [mean difference (MD)=-0.56, 95% CI:-0,81 to-0.30, P<0.01], fifibrinogen [MD=-1.02, 95% CI:-1.50 to-0.54, P<0.01], whole blood low shear viscosity [MD=-2.27, 95% CI:-3.04 to-1.49, P<0.01], and whole blood high shear viscosity (MD=-0.90, 95% CI: 1.37 to-0.44, P<0.01). CONCLUSIONS: Comparing with receiving WM only, the combine use of GD and WM was associated with a better curative effect for patients with AP. Nevertheless, limited by the methodological quality of included RCTs more large-sample, multi-center RCTs were needed to confifirm our fifindings and provide further evidence for the clinical utility of GD.

Comparative efficacy of Chinese herbal injections for treating acute cerebral infarction: a network meta-analysis of randomized controlled trials.

BACKGROUND: Chinese herbal injections (CHIs) are prepared by extracting and purifying effective substances from herbs (or decoction pieces) using modern scientific techniques and methods. CHIs combined with aspirin + anticoagulants + dehydrant + neuroprotectant (AADN) are believed to be effective for the treatment of acute cerebral infarction (ACI). However, no randomized controlled trial (RCT) has been performed to directly compare the efficacies of different regimens of CHIs. Therefore, we performed a systematic review and network meta-analysis (NMA) to compare the efficacies of different regimens of CHIs for ACI. METHODS: We conducted an overall and systematic retrieval from literature databases of RCTs focused on the use of CHIs to treat ACI up to June 2016. We used the Cochrane Handbook version 5.1.0 and CONSORT statement to assess the risk of bias. The data were analyzed using STATA 13.0 and WinBUGS 1.4.3 software. RESULTS: Overall, 64 studies with 6225 participants involving 15 CHIs were included in the NMA. In terms of the markedly effective rate, Danhong (DH) + AADN had the highest likelihood of being the best treatment. In terms of the improvement of neurological impairment, Shuxuening (SXN) + AADN had the highest likelihood of being the best treatment. Considering two outcomes, injections of SXN, Yinxingdamo (YXDM), DH, Shuxuetong (SXT), HongHuaHuangSeSu (HHHSS), DengZhanXiXin (DZXX) and Shenxiong glucose (SX) plus AADN were the optimum treatment regimens for ACI, especially SXN + AADN and YXDM + AADN. CONCLUSIONS: Based on the NMA, SXN, YXDM, DH, SXT, HHHSS, DZXX and SX plus AADN showed the highest probability of being the best treatment regimens. Due to the limitations of the present study, our findings should be verified by well-designed RCTs.

Sodium Tanshinone II A Sulfonate Injection as Adjuvant Treatment for Unstable Angina Pectoris: A Meta-Analysis of 17 Randomized Controlled Trials.

OBJECTIVE: To systematically evaluate the effectiveness and safety of Sodium Tanshinone II A Sulfonate Injection (STS) as one adjuvant therapy for treating unstable angina pectoris (UAP). METHODS: Randomized controlled trials (RCTs) of UAP treated by STS were searched in the China National Knowledge Infrastructure Database (CNKI), VIP Database for Chinese Technical Periodicals (VIP), Wanfang Database, the Chinese Biomedical Literature Database (CBM), Web of Science, the Cochrane Library, Embase, and PubMed, which from inception to January, 2016. The Cochrane Risk Assessment Tool was used to evaluate the methodological quality of the RCTs. The Review Manager 5.3 software was used to conduct the metaanalysis. RESULTS: The results showed that 17 RCTs involving 1,372 patients were included. The meta-analysis indicated that the combined use of STS and Western medicine (WM) in the treatment of UAP can obviously improve the total effective rate [risk ratio (RR)=1.31, 95% confidence interval (CI) (1.24,1.39), P<0.0001], and the total effective rate of electrocardiogram [RR=1.43, 95% CI (1.30,1.56), P<0.0001], decrease the level of CRP [mean difference (MD)=-3.06, 95%CI (-3.85,-2.27), P<0.00001], fibrinogen [MD=-1.03, 95% CI (-1.16,-0.89), P<0.00001], and whole blood high shear viscosity [MD=-0.70, 95% CI (-0.92,-0.49), P<0.00001]. Additionally, the occurrence of adverse drug reaction of the experimental group was significantly higher than that of the control group [RR=3.57, 95% CI (1.28, 9.94), P<0.05]. CONCLUSIONS: Compared with WM, the combined use of STS was more effective.

Injections of ginkgo in the treatment of cerebral infarction: a systematic review and network Meta-analysis.

OBJECTIVE: To assess the clinical effectiveness and safety of injections of ginkgo (GI) combined with Western Medicine (WM) for cerebral infarction (CI). METHODS: Randomized controlled trials (RCTs) of CI treated by GI were searched in China National Knowledge Infrastructure Database, Wanfang, China Science and Technology Journal Database, Web of Science, Cochrane library, Embase, PubMed and Chinese Biomedical Literature Database, with the publication data no later than April, 2016. The Cochrane risk of bias method was used to evaluate the methodological quality of the RCTs. The data were analyzed by Review Manager 5.3, Stata 13.0, and WinBUGS 14 software. RESULTS: Totally 37 RCTs involving 4330 patients were included. By direct comparison, the results of GI group were significantly superior to the routine WM group in the total effective rates [OR = 3.61, 95% CI (2.93, 4.44), P < 0.0001], the neural function defect score (NFDS) [MD = －4.39, 95% CI (－5.47, －3.32), P < 0.0001]. Network Meta-analysis (NMA) results showed that, between 5 GIs in efficacy, the difference comparing ginaton injections (GbE) to ginkgo-dipyidamolum injections (GD) [OR = 1.74, 95% CI (0.73, 3.65)], shuxuening injections (SXN) [OR = 1.06, 95% CI (0.609, 1.697)] or ginkgolides injections (GK) [OR = 4.711, 95% CI (1.178, 13.21)] reach statistical significance; the difference comparing GD to GK reach statistical significance [OR = 2.791, 95% CI (0.866, 6.908)]; the difference comparing SXN to GK reach statistical significance [OR = 4.537, 95% CI (1.203, 12.41)]. Besides, there was no difference between 4 GIs in NFDS. Probability ranking result showed a great possibility for GK [Surface under the Cumulative Ranking curve (SUCRA) = 80.3%] in improving the total effective rates, which were followed by GD (SUCRA = 73.34%), SXN (SUCRA = 46.59%), GbE (SUCRA = 45.46%), floium ginkgo extract and tertram ethypyrazine sodium chloride injections (FT) (SUCRA = 35.64%). However, GK (SUCRA = 80.3%) or GbE (SUCRA = 69.4%) was better than other GIs in reducing NFDS.GK + WM is the best treatment measures to reduce NFDS in cerebral infarction, which were followed by SXN + WM (SUCRA = 51.6%), GD + WM (SUCRA = 48.1%). CONCLUSION: GIs was more effectiveness on CI than the routine Western Medicine. But based on the limitations of the study, more high-quality randomized controlled trials will be necessary.

What are the best Salvia miltiorrhiza injection classes for treatment of unstable angina pectoris? A systematic review and network Meta-analysis.

OBJECTIVE: To undertake a systematic review and network meta-analysis (NMA) to compare the effectiveness among the different regimens of Salvia miltiorrhiza injection classes (SMICs) for unstable angina pectoris (UAP) treatment. METHODS: A systematic retrieval was conducted in several literature databases to identify randomized controlled trials focusing on the different regimens of SMICs for UAP treatment until January 2016. The quality assessment was accomplished according to the Cochrane risk of bias tool. Pair-wise meta-analyses were carried out by RevMan 5.3. A random-effects model of NMA was used to compare the different regimens of SMICs with regard to efficacy by STATA 13.0. RESULTS: A total of 111 studies involving 10 500 patients were included in the NMA. The methodological quality of included studies was not high. Current evidence shows that salvianolate (SI) is the optimal treatment for UAP in improving the total efficacy against UAP. Guanxingning (GXN) is the optimal treatment for UAP for improving the total effectiveness of electrocardiography. CONCLUSION: SMICs have advantages in preventing cardiovascular events. GXN, SI, and Danhong had the greatest probability of being the best treatment in the total efficacy against UAP and for improving the total effectiveness of electrocardiography.

Methylglyoxal: its presence and potential scavengers.

Hyperglycemia is the most important factor for the onset and progress of diabetic complications. A growing body of evidence indicates that the increase in reactive carbonyl intermediates such as methylglyoxal (MG) is a consequence of hyperglycemia in diabetes. Several studies have shown that higher levels of MG are present in diabetic patients' plasma compared to non-diabetics. Glyoxal (GO) and MG, the two major alpha-dicarbonyl compounds found in humans, are very reactive and lead to nonenzymatic glycation in vivo. Glycation is a complex series of reactions between reducing sugars and amino compounds, and it will lead to the formation of advanced glycation end products (AGEs). AGEs and dicarbonyl species are both linked to possible clinical significance in chronic and age-related diseases. It is well-known that tea is rich in polyphenolic compounds and that it has potential health benefits, including the prevention of diabetes. We have shown in a previous study that all tea polyphenols have very good MG trapping abilities. In this study, using time course, we have further indicated that one molecule form black tea, theaflavins-3,3'-digallate, can trap two molecules of MG under simulated physiological conditions. In addition, we have discovered that commercial carbonated beverages contain extremely high levels of MG. The potential hazardous effects of dietary MG on humans remain to be explored.

Trapping reactions of reactive carbonyl species with tea polyphenols in simulated physiological conditions.

The carbonyl stress that leads to the formation of advanced glycation end products (AGEs) in diabetes mellitus has drawn much attention recently. Reactive alpha-dicarbonyl compounds, such as glyoxal (GO) and methylglyoxal (MGO), have been shown to be a high potential glycation agent in vitro and in vivo. In this study, epicatechins in green tea and theaflavins in black tea were found to be able to reduce the concentration of MGO in physiological phosphate buffer conditions. Modified MGO derivatization for GC/flame ionization detector (FID) method in quantification was systematically conducted. In molar ratio of 3 (MGO/polyphenol), theaflavin-3,3'-digallate (TF3) in theaflavins and (-)-epigallocatechin (EGC) in epicatechins showed the highest MGO reduction at 66.65 and 45.74%, respectively, after 1 h of incubation. In kinetic study (molar ratio of MGO/polyphenol = 1:1), rapid MGO reduction occurred within 10 min. Identities of primary adducts between (-)-epigallocatechin gallate (EGCG) and MGO were determined. Newly generated stereoisomers at the C8 position of EGCG A-ring were isolated with a chiral column, and structurally confirmed by 2-D NMR analyses.