A review on the Role of Oral Nutritional Supplements in Chronic Obstructive Pulmonary Disease.

Due to the high smoking rate in developing countries and the rising aging population in high-income countries, the global prevalence of chronic obstructive pulmonary disease (COPD), estimated to be 11.7%, is increasing and is the third-leading cause of mortality. COPD is likely to be present in elderly individuals with impaired gastro-enteric functions. Gastrointestinal congestion, dyspnea, and anxiety are pathophysiological characteristics of COPD, contributing to poor appetite, reduced dietary intake, and high-energy expenditure. These factors are implicated in the progression of malnutrition in COPD patients. Malnutrition is detrimental to lung functions and is associated with an increased risk of infection, exacerbation and mortality, and a longer duration of hospitalization. Therefore, nutritional support to treat malnutrition in COPD patients is very vital. Oral nutritional supplements (ONS) may hold the key to COPD treatment. To clarify this statement, we review current evidence for ONS in COPD patients to benefit from clinical outcomes.

[The vitamin D nutritional status in Chinese urban women of child-bearing age from 2010 to 2012].

Objective: To evaluate the vitamin D nutritional status in Chinese women of child-bearing age by analyzing serum 25-hydroxyvitamin D level in 2010-2012. Methods: Data were obtained from the China Nutrition and Health Survey in 2010-2012. Using cluster sampling and proportional stratified random sampling, 1 514 women of child-bearing age (18-44 years old) from 34 metropolis and 41 small and medium-sized cities were included in this study. Demographic information was collected by questionnaire and serum 25-hydroxyvitamin D concentration was determined by radioimmunoassay, in accordance with the 2010 Institute of Medicine of the National Academies standards. We compared differences in vitamin D levels, specifically serious deficiency, lack of deficiency, insufficiency, and excess. Results: The overall serum 25-hydroxyvitamin D level of Chinese urban women of child-bearing age (P(50) (P(25)-P(75))) was 20.1 (15.1-26.3) ng/ml; minorities had a significantly higher serum 25-hydroxyvitamin D level of 22.0 (15.9-27.5) ng/ml compared with women of Han nationality (19.8 (14.9-26.2) ng/ml) (χ(2)=7.02, P=0.008). The proportions of women with serious deficiency, lack of deficiency, insufficiency, and excess vitamin D were 11.6% (n=175), 37.9% (n=574), 35.1% (n=531), and 0.3% (n=5), respectively. Only 15.1% (n=229) of women of child-bearing age had normal vitamin D nutritional status. No significant differences in vitamin D nutritional status were observed according to age, body mass index, city, nationality, educational level, marital status, or household income per capita (P>0.05). Conclusion: Most Chinese urban women of child-bearing age have poor vitamin D levels and require vitamin D supplementation.

[Post-marketing surveillance of Tanreqing injection in children: a real world study].

Objective: To evaluate the safety of Tanreqing injection among children in the real world. Methods: A multicenter, large sample, ambispective cohort study, with registration-type clinical safety monitoring. A total of 6 188 inpatients and patients from the emergency units, aged ≤ 14 years who all had been using Tanreqing injection in 59 secondary and tertiary hospitals in China, were recruited between January, 2014 and May, 2015. The main outcomes would include incidence and severity of adverse drug reaction (ADR)/adverse drug event (ADE) of Tanreqing injection. Univariate analysis was used to explain the risk factors of ADR. Results: The overall incidence of ADE was 4.20‰ (26 cases), including 4 serious ones. The incidence of ADR was 3.07‰ (19 cases), including 17 cases of general ADR and 2 cases of new ADR. All the ADR cases were mild or moderate, mostly showing damages in skin and appendages. The onset of disease happened in 24 hours after the Tanreqing injection but all the ADR cases got improved or cured. Having histories of allergies to drugs or foods would increase the incidence of ADR. Conclusion:Tanreqing injection caused low incidence of ADR in children. Progams as stratifying high-risk patients and improving administrative management could further increase the safety level of Tanreqing injection.

Neuroprotective effects of Hu-Yi-Neng, a diet supplement, on SH-SY5Y human neuroblastoma cells.

OBJECTIVES: Oxidative stress is considered the potential risk to the development of dementia. Some medicines, vitamins, and diet supplements have been suggested to have possible benefits via the antioxidative effects to slow the decline of cognitive function in demented and non-demented individuals. However, few studies were conducted to examine their functions, especially in composite diet supplements. Hu-Yi-Neng is a composite diet supplement, including ginkgo biloba, extract of pine bark, phosphatidyl serine, docosahexaenoic acid, and folic acid, used extensively in Taiwan. Therefore, our aim is to investigate the potential protective effects of Hu-Yi-Neng on human neuron cells. MATERALS AND METHODS: H2O2-induced neuronal toxicity was characterized in SH-SY5Y human neuroblastoma cells by the decrease of cell viability using PrestoBlue™ assay and by the increase of intracellular reactive oxygen species (ROS) level using DCFH-DA (2', 7'-dichlorodihydrofluorescin diacetate) assays. HO-1 mRNA expression was detected by real-time PCR. Akt and Erk 1/2 proteins were detected by western blotting. RESULTS: Pretreatment with Hu-Yi-Neng significantly reversed the decrease in cell viability induced by H2O2 in SH-SY5Y cells. Furthermore, Hu-Yi-Neng dose-dependently suppressed the elevation of intracellular reactive oxygen species (ROS) level. Hu-Yi-Neng protected SH-SY5Y cells from oxidative stress may via the increase in mRNA expression of heme oxygenase-1 (HO-1), an antioxidant enzyme. In addition, Hu-Yi-Neng inhibited H2O2-induced phosphorylation of Akt kinase but further increased the phosphorylation of Erk 1/2. CONCLUSION: Our results suggest that Hu-Yi-Neng has protective effect against oxidative stress-induced neuron cell loss and it could be an ideal composite diet supplement for preventing neurodegenerative diseases.

Ipriflavone reverses the adverse effects of a low-calcium diet on the histology of the tibia in caged layers.

1. Ipriflavone (IP) has been widely studied in humans and is effective for inhibiting osteoclastic bone resorption and enhancing osteoblastic bone formation. The aim of this study was to investigate the effects of IP on the structural histology and histomorphometric parameters of tibia in laying hens fed on a low-calcium diet. 2. A total of 200 Hy-Line Brown laying hens, 24 weeks of age, were divided randomly into 4 groups which were fed on one of 4 diets (CaN, standard diet; CaL, low-calcium diet; IP1, low-calcium diet + 8 mg/kg of IP; IP2, low-calcium diet + 20 mg/kg of IP) for 60 d after which 10 hens of each group, chosen at random, were killed and the tibiae were processed and assessed under a fluorescent microscope 3. The cortical bone showing resorption cavities had become porous, and medullary bone did not completely fill the marrow cavity in the CaL group compared with the CaN group. However, in the IP2 group, the cortical bone showed a structure comparable to the CaN group with an absence of resorption cavities, and more medullary bone filled the marrow cavity compared with the CaL group. 4. The CaL hens had significantly lower trabecular bone area, trabecular perimeter, per cent trabecular area, trabecular number and trabecular thickness and significantly wider trabecular separation compared with CaN. These results indicated that the low-calcium diet led to increased loss of tibial bone, eventually causing osteoporosis. However, compared with the CaL group, the IP2 group caused a significant increase in trabecular bone area and bone quality. 5. It is concluded that even in hens fed on a low-calcium diet, the addition of 20 mg/kg IP exerted beneficial effects on histological structure and structural histomorphometric parameters of tibia, indicating an alleviation of caged layer osteoporosis (CLO).

Prescription pattern of traditional Chinese medicine for climacteric women in Taiwan.

BACKGROUND: Traditional Chinese medicine (TCM) has become more popular as a therapy for symptom relief among menopause-aged women. The aim of this study was to analyze the utilization of TCM for climacteric women in Taiwan. METHODS: The study analyzed frequency distributions among 19 379 women aged 45-55 years, recruited from a random-sampled cohort of 200 000 people from the National Health Insurance database. Data mining was conducted to explore the co-prescription patterns for finished herbal products (FHP). RESULT: There were 19 379 women aged 45-55 years in the sample; of these, 12 572 (64.9%) utilized TCM services at least once. A total of 4078 (21.0%) of the 19 379 climacteric women utilized 145 200 (79.2%) TCM visits. Of these, 39 802 (21.7%) visits were because of diseases of the musculoskeletal system and connective tissue, of which more than half were treated with acupuncture and traumatology manipulative therapies. There were 28 154 visits with FHP prescriptions because of non-specific symptoms and ill-defined conditions, and Jia-wei-xiao-yao-san was the most frequent formula. Nearly two-thirds of FHP contained more than two herbal formulae. CONCLUSIONS: Women of climacteric age in Taiwan utilized TCM more often than other age groups. To deal with multiple symptoms and/or diseases among climacteric women, new prescription patterns of combining two or more herbal formulae have evolved. Studies on safety issues and drug-herb interactions are warranted for future research.

Berberine inhibits the expression of TNFalpha, MCP-1, and IL-6 in AcLDL-stimulated macrophages through PPARgamma pathway.

Macrophages are the main source of cytokines in atherosclerotic plaques. Modified low-density lipoproteins may stimulate macrophages to produce large quantities of proinflammatory cytokines that promote atherosclerosis. Berberine is the main component of the traditional Chinese medicine umbellatine, which has a widespread effect and was used to treat many diseases clinically. Our previous study found that berberine could increase adipophilin expression in macrophages, which is a target gene of PPARgamma. PPARgamma agonist could decrease proinflammatory cytokines in macrophage. In this study, we investigated the effects and the mechanism of action of berberine on the expression and secretion of TNFalpha, MCP-1, and IL-6 in vitro to identify new pharmacological actions of berberine. The results of RT-PCR and ELISA shows that berberine may inhibit the expression and secretion of the tumor necrosis factor alpha (TNFalpha), monocyte chemoattractant protein 1 (MCP-1), and interleukin-6 (IL-6) in macrophages stimulated by acetylated low-density lipoprotein (AcLDL), whereas the peroxisome proliferator-activated receptor gamma (PPARgamma) inhibitor GW9662 could attenuate this effect of berberine. This study demonstrates that berberine may inhibit the expression and production of TNF-alpha, MCP-1, and IL-6 in AcLDL-stimulated macrophages. This effect might be partially mediated through PPARgamma activity.

Upper extremities flexibility comparisons of collegiate "soft" martial art practitioners with other athletes.

The aim of this study was to compare the flexibility of the upper extremities in collegiate students involved in Aikido (a kind of soft martial art attracting youth) training with those involved in other sports. Fifty freshmen with a similar frequency of exercise were divided into the Aikido group (n = 18), the upper-body sports group (n = 17), and the lower-body sports group (n = 15) according to the sports that they participated in. Eight classes of range of motion in upper extremities were taken for all subjects by the same clinicians. The Aikido group had significantly better flexibility than the upper-body sports group except for range of motion in shoulder flexion (p = 0.22), shoulder lateral rotation (p > 0.99), and wrist extension (p > 0.99). The Aikido group also had significantly better flexibility than the lower-body sports group (p < 0.01) and the sedentary group (p < 0.01) in all classes of range of motion. The upper-body sports group was significantly more flexible in five classes of range of motion and significantly tighter in range of motion of wrist flexion (p < 0.01) compared to the lower-body sports group. It was concluded that the youths participating in soft martial arts had good upper extremities flexibility that might not result from regular exercise alone.

Risk of extrapyramidal syndrome in schizophrenic patients treated with antipsychotics: a population-based study.

To compare the prevalence of extrapyramidal syndrome (EPS) between the first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs), the co-prescribing rate of anti-Parkinson drugs (APDs) of each antipsychotic drug was analyzed using population database. Fourteen antipsychotics had been prescribed during the 5-year study period. Among the SGAs, quetiapine had the lowest crude co-prescribing rate of APDs (27.09%), whereas risperidone had the highest rate (66.50%). Among the FGAs, thioridazine and loxapine had the lowest (60.99%) and highest rates (96.35%), respectively. The rankings of the co-prescribing rate of APDs among antipsychotics, in increasing order, were quetiapine, clozapine, olanzapine, thioridazine, zotepine, chlorpromazine, risperidone, sulpiride, clotiapine, flupentixol, haloperidol, zuclopentixol, trifluoperazine, and loxapine. The results indicate that the risk of EPS appears to be lower in SGAs than in FGAs; however, the considerably high rate of EPS in some of the newer generation of antipsychotics warrants clinical attention.

A nationwide survey on epidemiological characteristics of childhood Henoch-Schönlein purpura in Taiwan.

OBJECTIVE: To evaluate the annual incidence and other epidemiological characteristics of Henoch-Schönlein purpura (HSP) among children in Taiwan. METHODS: The records of patients were derived from the research database of the Bureau of National Health Insurance, Taiwan, Republic of China, from January 1999 to December 2002. Children younger than 17 yr of age with the diagnosis of HSP were included into this study. Data for each patient including sex, age, date of onset and length of hospitalization were recorded and analysed. RESULTS: A total of 2759 cases were included with an annual incidence of 12.9 (11.8-13.4) per 100 000 children <17 yr of age. The occurrence of HSP had a peak at the age of 5 to 6 yr. In this study, 1118 (40.5%) patients had been hospitalized at some stage. There were 1454 males and 1305 females, for a male to female ratio of 1.11. Males had a higher annual incidence before the age of 10 yr (P = 0.04), and had a lower incidence than females at older ages (P = 0.02). Disease onset was more common in autumn and winter, and no apparent change in seasonal pattern was noted over 4 yr. CONCLUSIONS: Insurance claim data provide useful information on the epidemiology of HSP in Taiwan. Childhood HSP in Taiwan, with an incidence of 12.9 per 100 000 children, occurs commonly in autumn and winter; and at the age of 5 to 6 yr. The characteristics presented in this study may provide valuable data for understanding and further studies of HSP.

Physician control of pediatric antimicrobial use in Beijing, China, and its rural environs.

BACKGROUND: Antibiotic resistance is recognized as an increasing problem in China. It is widely believed that because antibiotics are available without a prescription, changing physician prescribing behaviors will not decrease inappropriate usage. This study identified the sources of antibiotics and the important influence that physicians have on antibiotic use by children in one region of China. METHODS: Trained medical professionals surveyed parents of children attending several kindergartens in urban Beijing and rural Gu'An, Hebei County. Parents completed a questionnaire concerning the children's recent illnesses, care-seeking patterns and antibiotic use. The team also observed hospital- and non-hospital-based pharmacy purchases of antibiotics for children, assessed the proportion accompanied by a prescription and then interviewed parents about factors influencing those purchases. RESULTS: Of 241 urban and 143 rural kindergarten parents, 76 to 82% usually obtained children's antibiotics from a hospital pharmacy (with a prescription). For 84% the first source of care was usually a physician (primarily western medicine, sometimes traditional Chinese medicine). Only 5% of antibiotics were obtained from independent vendors without prior physician consultation. Among 229 observed antibiotic purchases 72% occurred at hospital-based facilities, even after longer observation times at nonhospital pharmacies. Prescriptions accompanied all hospital-based antibiotic purchases, contrasting with 18% of nonhospital transactions (P < 0.001). Together 86% of parents self-reported that the observed purchase stemmed from a doctor's recommendation. CONCLUSIONS: Doctors directly and indirectly controlled the majority of antibiotic usage for childhood illnesses in Beijing and Gu'An (Hebei County). Physician education and implementation of treatment guidelines might substantially reduce inappropriate antimicrobial usage and help prevent antimicrobial resistance in this region.

Epidemiological survey of oral submucous fibrosis and leukoplakia in aborigines of Taiwan.

A population-based survey was designed to investigate the prevalence of areca/betel quid chewing, oral submucous fibrosis and leukoplakia in a typical aboriginal community of southern Taiwan. Three hundred and twelve people 20 years of age or older were collected in the study. The prevalence of chewing areca/betel quid was 69.5%, with an average of 17.3 portions a day for an average 24.4 years. More women (78.7%) than men (60.6%) chewed areca/betel quid. The prevalences of oral submucous fibrosis and leukoplakia were 17.6% and 24.4%, respectively. It was found that the odds ratio for chewing areca/betel quid and having at least one of the above oral mucosal lesions was 8.21. Any additional smoking or drinking habits were not significant for having oral mucosal lesions. Although the areca/betel quid in Taiwan does not contain any tobacco, a significant association was still identified between areca/betel quid chewing and oral mucosal lesions.

Cloning and characterization of two mouse genes with homology to the yeast Sir2 gene.

The yeast Sir2 gene encodes a protein (Sir2p) that plays an essential role in silencing regulation at mating-type loci, rDNA, and telomeres. Recent studies have also shown that the protein participates in cell cycle regulation, DNA double-strand break repair, meiotic checkpoint control, and histone deacetylation. Overexpression of wildtype Sir2p in yeast resulted in an extended life span but mutant Sir2p shortened the life span, suggesting its function in aging processes. Sir2p is evolutionarily conserved from prokaryotes to higher eukaryotes. However, its function(s) in mammals remains unknown. To investigate Sir2p function(s) in mice, we cloned and characterized two mouse Sir2-like genes. Our results revealed that the two mouse Sir2-like proteins (mSIR2L2 and mSIR2L3) are most similar to the human Sir2-like proteins SIR2L2 and SIR2L3, respectively. Sir2 core domains are highly conserved in the two proteins and yeast Sir2p; however, the intracellular localizations of both mSIR2L2 and mSIR2L3 differ from that of yeast Sir2p and from one another. The two mouse genes have completely different genomic structures but were mapped on the same chromosome. It seems that the two mouse proteins, though they have Sir2 conserved domains, may function differently than yeast Sir2p.

[Studies on quality standards for Pollen Typhae(puhuang)].

OBJECTIVE: To work out quality standards for Pollen Typhae(Puhuang). METHOD: Isorhamnetin-3-O-neohesperidoside, typhaneoside, isorhamnetin and beta-sitosterol in Pollen Typhae marketed in ten cities of China were identified by TLC. The contents of isorhamnetin-3-O-neohesperidoside and typhaneoside were determined by HPLC. RESULT: The method is sensitive and specific for identifying isorhamnetin-3-O-neohesperidoside, typhaneoside, isorhamnetin and beta-sitosterol. The linear ranges of isorhamnetin-3-O-neohesperidoside and typhaneoside were 0.188-0.940 microgram with and average recovery of 97.77%; and 0.164-0.820 microgram with an average recovery of 98.42% respectively. CONCLUSION: The method can be used both qualitatively and quantitatively as standards for the quality control of Pollen Typhae.

[Exploration on baking conditions for Atractylodes macrocephala Kloidz in qiweibaizhusan bags].

This paper is concerned with a comprehensive study on the conditions required for baking pieces and grains of Atractylodes macrocephala Kloidz. through the determination of the relative content of atractylone and moisture content in the rhizome. Optimum roasting temperature and time before pulverizing have been determined, thus providing reliable basis for devising the suitable technological process.

[Study on decocting conditions for Pueraria lobata Ohui in qiweibaizhu bage].

Taking the puerarin content---the chief constituent of Pueraria lobata---as the index in the mixed decoction of Pueraria lobata etc, we have adopted the method of orthogon al experiment to explore the best decocting conditions for Pueraria lobata. The results show that a better way to decoct Pueraria lobata is to cut the root into slices of 0.4-0.7 cm, and water 12-15 times the weight of the root and decoct for 30 minutes. It makes no big difference whether the root is soaked or not.