Short-term and long-term effectiveness of acupuncture and Tuina on knee osteoarthritis: study protocol for a randomized controlled trial.

Background: The effectiveness of acupuncture and tuina in treating knee osteoarthritis (KOA) is still controversial, which limits their clinical application in practice. This study aims to evaluate the short-term and long-term effectiveness of acupuncture and tuina on KOA. Methods/design: This parallel-group, multicenter randomized clinical trial (RCT) will be conducted at the outpatient clinic of five traditional Chinese medicine hospitals in China. Three hundred and thirty participants with KOA will be randomly assigned to acupuncture, tuina, or home-based exercise group with a ratio of 1:1:1. The primary outcome is the proportion of participants achieving a minimal clinically important improvement defined as a ≥ 12% reduction on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain dimension on short term (week 8) and long term (week 26) compared with baseline. Secondary outcomes are knee joint conditions (pain, function, and stiffness), self-efficacy of arthritis, quality of life, and psychological conditions, which will be evaluated by the WOMAC score and the Patient Global Assessment (PGA), and in addition, the respondents index of OMERACT-OARSI, Short Form 12 Health Survey (SF-12), arthritis self-efficacy scale, and European five-dimensional health scale (EQ-5D). Adverse events will be collected by self-reported questionnaires predefined. Clinical trial registration: https://www.chictr.org.cn.

How different nitrogen fertilizers affect arsenic mobility in paddy soil after straw incorporation?

In straw return fields, nitrogen-fertilizers are added to mitigate microbial competition for nitrogen with plants. However, in arsenic (As)-contaminated paddy fields, the specific effects of different nitrogen fertilizers on As mobility after straw incorporation and the interactions among iron(Fe)/carbon(C)/nitrogen(N)/As are not well understood. In the reported microcosm experiment we monitored As-mobility as a function of different dosages of KNO3, NH4Cl and rice straw incorporation. Addition of both KNO3 and NH4Cl significantly inhibited the As mobilization induced by straw incorporation. Following the KNO3 addition, the As concentration in porewater dropped by 51-66% after 2 days of the incubation by restraining Fe reduction and enhancing Fe oxidation. High-dose NH4Cl addition reduced As in porewater by 22-43% throughout the incubation by decreasing porewater pH. High-throughput sequencing results demonstrated that KNO3 addition enriches both the denitrifying and Fe-oxidizing bacteria, while diminishing Fe-reducing bacteria; NH4Cl addition has the opposite effect on Fe-reducing bacteria. Network analysis revealed that As and Fe concentrations in porewater were positively correlated with the abundance of denitrifying and Fe-reducing bacteria. This study broadens our insight into the As biogeochemistry associated with the N/C/Fe balance in soil, which are of great significance for agronomic management and mitigation the risk of As-contaminated paddy fields.

Floralozone Ameliorated Atherosclerosis in Experimental Atherosclerotic Rats Involved with Sphingosine 1-Phosphate 1 Enhancement.

Atherosclerosis (AS) is a chronical pathological process of the arterial narrows due to the AS plaque formation. The aim of this study was to explore the therapeutic effect and the underlying mechanism of Floralozone on experimental atherosclerotic model rats. Experimental atherosclerotic model rats were induced by the right carotid artery balloon injury and intraperitoneal injection of vitamin D3 in rats after 4 weeks high-fat diet. The results exhibited that Floralozone could ameliorate vascular injury and vasorelaxation of descending aortas and increase the superoxide dismutase activity and the expression of sphingosine 1-phosphate (S1P) 1 and reduce the intercellular cell adhesion molecule-1, vascular cell adhesion molecule-1, interleukin (IL)-1, IL-6 level, and the malondialdehyde activity in experimental atherosclerotic rats. However, Fingolimod, an S1P1 inhibitor, could reverse these Floralozone effects in experimental atherosclerotic rats. Our results indicated that Floralozone could inhibit the atherosclerotic plaque formation and improves arterial stenosis and reduces endothelial dysfunction in experimental atherosclerotic rats, which might be involved with S1P1 enhancement.

NH4H2PO4-extractable arsenic provides a reliable predictor for arsenic accumulation and speciation in pepper fruits (Capsicum annum L.).

Dietary arsenic (As) intake from food is of great concern, and developing a reliable model capable of predicting As concentrations in plant edible parts is desirable. In this study, pot experiments were performed with 16 Chinese upland soils spiked with arsenate [As(V)] to develop a predictive model for As concentrations in pepper fruits (Capsicum annum L.). Our results showed that after three months' aging, concentrations of bioavailable As (extracted by 0.05 M NH4H2PO4) in various soils varied widely, depending on soil total As concentrations and soil properties such as soil pH and amorphous iron (Fe) contents. Furthermore, both the bioconcentration factor (BCF, denoted as the ratio of fruit As to soil As) and total As concentrations in pepper fruits were largely determined by concentrations of bioavailable As, which explained 27% and 69% variations in the BCF and fruit As concentrations, respectively. Apart from bioavailable As, soil pH and Fe contents were another two important factors influencing As accumulation in pepper fruits. Taking the three factors into account, concentrations of fruit As can be well predicted using a stepwise multiple linear regression (SMLR) analysis (R2 = 0.80, RMSE = 0.17). Arsenic species in soils and edible parts were also analyzed. Although As(V) predominated in soils (>96%), As in pepper fruits presented as As(V) (46%) and arsenite [As(III)] (39%) with small amount of methylated As (<15%). Aggregated boosted tree (ABT) analysis revealed that inorganic As concentrations in pepper fruits were determined by concentrations of bioavailable As, phosphorus (P) and Fe in soils. In contrast to inorganic As, methylated As concentrations were not correlated with those factors in soils. Taken together, this study established an empirical model for predicting As concentrations in pepper fruits. The predictive model can be used for establishing the As threshold in fruit vegetable farming soils.

[Chemical constituents in chloroform fraction of Houttuynia cordata].

Nine compounds were isolated from chloroform fraction of Houttuynia cordata,and the isolates were identified as follows:( S)-5,6,6 a,7-tetrahydro-2,10-dimethoxy-4 H-dibenzo [DE,G] quinoline-1,9-diol( 1),( +)-isoboldine ß-N-oxide( 2),liriotulipiferine( 3),telitoxinone( 4),isoboldine( 5),(-)-clovane-2ß,9α-diol( 6),benzoic acid( 7),acantrifoside E( 8),and dibutyl phthalate( 9). Among them,compound 1 was new,and compounds 2-9 were reported from this species for the first time.

Fractionation and Biological Activities of Water-Soluble Polysaccharides from Sclerotium of Tiger Milk Medicinal Mushroom, Lignosus rhinocerotis (Agaricomycetes).

This study investigated antioxidant and anti-inflammatory properties, and the direct cytotoxic effect of Lignosus rhinocerotis fractions, especially the polysaccharide fraction, on nasopharyngeal carcinoma cells. L. rhinocerotis crude extract was obtained through hot water extraction. The precipitate saturated with 30% ammonium sulfate was purified with ion-exchanged chromatography. Gel permeation chromatography multiangle laser light scattering analysis equipped with light scattering and UV signals revealed two district groups of polymers. A total of four peaks were observed in the total carbohydrate test. Fraction C, which was the second region of the second peak eluted with 0.3 M NaOH, showed the highest integrated molecular weight, whereas fraction E had the lowest integrated molecular weight of 19,790 Da. Fraction A contained the highest ß-D-glucan content. Enzymatic analysis showed that most of the polysaccharide fractions contained ß-1-3 and ß-1-6 skeletal backbones. The peak eluted with 0.6 M NaOH was separated in fraction D (flask 89-92) and fraction E (93-96). The results showed that fraction E expressed higher antioxidant activities than fraction D whereas fraction D expressed higher chelating activity than fraction E. The extract saturated with 30% ammonium sulfate exhibited higher reducing power than the extract saturated with 100% ammonium sulfate. Fractions D and E significantly inhibited the secretion of tumor necrosis factor-α in lipopolysaccharide-stimulated RAW 264.7 macrophages in a dose-dependent manner. There was no apparent difference in the viability of cells exposed or unexposed to L. rhinocerotis fractions.

Differential identification of mushrooms sclerotia by IR macro-fingerprint method.

Many macrofungus sclerotia are well-known medicinal herbs, health food and nutritional supplements. However, the prevalent adulterant commercial products are major hindrances to their incorporation into mainstream medical use in many countries. The mushroom sclerotia of Lignosus rhinocerotis, Poria cocos, Polyporus umbellatus, Pleurotus tuber-regium and Omphalia lapidescens are commonly used in traditional Chinese medicine. In this study, IR macro-fingerprint method was used in the identification of these sclerotia. The results showed that the spectrum of L. rhinocerotis (LR) was comparable with P. cocos with 94.4% correlation, except that the peak at 1543cm(-1) of LR appeared in lower intensity. The spectrum of P. umbellatus and P. tuber-regium was also correlated (91.5%), as both spectra could be clearly discriminated in that P. umbellatus spectrum has small base peaks located at the range of 1680-1500cm(-1). O. lapidescens was not comparable with all the other sclerotia as its spectrum was totally different. Its base peak was broad and derivated equally along the range. The first IR has revealed the dissimilarity among five mushrooms sclerotia. The second derivative and 2DIR further enhanced the identification in detail.

[Puerarin attenuates PM2.5-induced vascular endothelial cells injury via ERK1/2 signaling pathway].

To investigate the effect and the mechanism of puerarin in attenuating PM2.5-induced human umbilical vein endothelial cells (EA.hy926) injury, the samples of fine particulate matter (PM2.5) were collected and made into suspension. Different concentrations of PM2.5 (0,20, 200, 400 mg•L⁻¹) were used to contaminate EA.hy926 cells for 24 h. The cells survival rate was detected by MTT assay; cells apoptosis of EA.hy926cells was detected by flow cytometry; the protein levels of p-ERK1/2, Bax and Bcl-2 were detected by Western blot; the contents of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), malonaldehyde (MDA), and the activities of superoxide dismutase (SOD) and lactic dehydrogenase (LDH) were measured by ELISA. Puerarin at different concentrations (10, 50, 100 µmol•L⁻¹) or a specific inhibitor of ERK1/2 pathway PD98059 (20 µmol•L-1) was added into the EA.hy926 cells to observe the intervention effect and mechanism of puerarin. Compared with the control group, PM2.5 reduced the cells survival rate, up-regulatedp-ERK1/2 protein level and Bax/Bcl-2 ratio in a dose dependent manner to promote apoptosis; increased the contents of TNF-α, IL-6 and MDA, the activity of LDH, but decreased SOD activity in the EA.hy926 cells (P<0.05). Compared with PM2.5 group, puerarin increased the cells survival rate, down-regulated p-ERK1/2 protein level and Bax/Bcl-2 ratio in a dose dependent manner to inhibit the apoptosis; decreased the contents of TNF-α, IL-6 and MDA, the activity of LDH, but increased SOD activity in the EA.hy926 cells (P<0.05). The results indicated that puerarin could attenuate PM2.5-induced EA.hy926 cells injury via the inhibition of ERK1/2 pathway.

Protective effect of oxymatrine on myocardial fibrosis induced by acute myocardial infarction in rats involved in TGF-ß1-Smads signal pathway.

Oxymatrine (1), a component extracted from a traditional Chinese herb Sophora japonica (Sophora flavescens Ait.), has been demonstrated to have a variety of pharmacological actions. Abundant experimental evidence indicates that 1 may exert a protective effect on the cardiovascular system. This study was designed to explore the possible role of 1 against myocardial fibrosis induced by acute myocardial infarction (AMI) and its modulation on transforming growth factor beta 1 (TGF-ß(1))-Smads signaling pathways. Rats with AMI induced by ligation of left anterior descending branch were randomly assigned to receive 1 50 and 25 mg/kg intragastrically, and model group which were further compared with sham-operated group, and positive group treated with captopril. The effects of 4-week therapy with 1 starting 24 h after infarction had been investigated based on (1) hemodynamics, (2) tissue weights, (3) biochemical indicator (hydroxyproline contents in left ventricle), and (4) TGF-ß(1), TGF-ß(1) receptor (TßR(1)), Smad3, Smad4, Smad7, Col1, and Col3 expression by semi-quantitative reverse transcription PCR. Treatment with 1 significantly ameliorated hemodynamics, inhibited the expression of TßR(1) mRNA and Smad3 mRNA, and reduced the left ventricle weight/body weight. The results of this research indicated that 1 might protect against myocardial fibrosis and the mechanism may be involved in modulating TGF-ß(1)-Smads signal pathway.

[Andrographolide drop-pill in treatment of acute upper respiratory tract infection with external wind-heat syndrome: a multicenter and randomized controlled trial].

OBJECTIVE: To evaluate the safety and efficacy of andrographolide drop-pill in treatment of acute upper respiratory tract infection with external wind-heat syndrome. METHODS: A multicenter, randomized controlled trial was conducted. In phase I, 202 patients with acute upper respiratory tract infection were randomly divided into two groups: trial group (n=101) and control group (n=101). In phase II, 276 patients with acute upper respiratory tract infection were randomly divided into two groups: trial group (n=138) and control group (n=138). The patients in the trial group received andrographolide drop-pill, at a dose of 1.5 g, three times a day; the patients in the control group received andrographolide tablet, at a dose of 1.5 g, three times a day. The therapeutic courses in both groups were 3 days. Clinical symptoms, physical signs, adverse effects, blood, urine and stool tests, hepatorenal function and electrocardiogram were examined before and after the treatment. RESULTS: After treatment in the phase I, the cure rates in the trial group and the control group were 44.55%, 42.57% (full analysis set, FAS) and 45.00%, 43.00% (per protocol set, PPS), and the total obvious rates were 94.06%, 94.06% (FAS) and 95.00%, 95.00% (PPS), respectively. There were no significant differences between the two groups (P>0.05). In the phase II, the cure rates in the trial group and the control group were 39.13%, 33.82% (FAS) and 38.69%, 33.58% (PPS), and the total obvious rates were 96.38%, 96.32% (FAS) and 96.36%, 96.27% (PPS), respectively. There were no significant differences between the two groups (P>0.05) too. No adverse effects were found in the trial. CONCLUSION: Andrographolide drop-pill is effective and safe in the treatment of acute upper respiratory tract infection with external wind-heat syndrome.