Efficacy of the combination of Chinese herbal medicine and negative pressure wound therapy in the treatment of patients with diabetic foot ulcer: A meta-analysis.

This study aimed to systematically evaluate the clinical efficacy of Chinese herbal medicine combined with negative pressure wound therapy (NPWT) in the treatment of diabetic foot ulcers (DFU). Computerised searches of the China National Knowledge Infrastructure, Wanfang, Chinese BioMedical Literature Database, PubMed, Cochrane Library and Embase databases were conducted for randomised controlled trials on the use of Chinese herbal medicines combined with NPWT for the treatment of DFU. The search period ranged from the time of establishment of each database to July 2023. Literature screening and data extraction were performed independently by two investigators, and the quality of the included studies was assessed. The meta-analysis was performed using Review Manager 5.4 software. A total of 25 studies were analysed, including 1777 DFUs, with 890 and 887 patients in the experimental and control groups, respectively. The results showed that the treatment of DFUs with a Chinese herbal medicine in combination with NPWT increased the overall effectiveness (odds ratio [OR] = 4.32, 95% confidence interval [CI]: 2.96-6.30, p < 0.001), wound healing rate (mean difference [MD] = 18.35, 95% CI: 13.07-23.64, p < 0.001) and ankle brachial index (MD = 0.10, 95% CI: 0.06-0.14, p < 0.001); reduced the wound healing time (MD = -11.01, 95% CI: -13.25 to -8.78, p < 0.001) and post-treatment wound area (MD = -1.73, 95% CI: -2.46 to -1.01, p < 0.001); decreased the C-reactive protein level (MD = -3.57, 95% CI: -5.13 to -2.00, p < 0.001); and increased vascular endothelial growth factor level (MD = 19.20, 95% CI: 8.36-30.05, p < 0.001). Thus, Chinese herbal medicines combined with NPWT can effectively promote wound healing, reduce inflammation and shorten the disease course in patients with DFU, while demonstrating precise clinical efficacy.

Efficacy and safety of the integration of traditional Chinese medicine and western medicine in the treatment of diabetes-associated cognitive decline: a systematic review and meta-analysis.

Objective: In order to offer possible therapeutic treatment evidence for diabetes-associated cognitive decline (DACD), we thoroughly evaluated the effectiveness and safety of combining Traditional Chinese Medicine (TCM) and Western Medicine (WM) in the current study. Methods: The present study employed a comprehensive search strategy across multiple databases, namely, PubMed, EMBASE, Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Scientific Journals Database (VIP), and Chinese Biomedical Literature Database (CBM), to identify relevant articles published until July 2023. Subsequently, a systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to assess the efficacy and safety of integrating TCM with WM for the treatment of DACD. The literature included in this study was assessed using the GRADE criteria and the Cochrane Handbook for Systematic Reviews of Interventions. Statistical analysis was conducted using RevMan 5.4 software. Results: A total of 20 RCTs involving 1,570 patients were ultimately included in this meta-analysis. The pooled results demonstrated that the integration of TCM and WM therapy significantly enhanced the overall effectiveness rate compared to WM therapy alone [OR = 4.94, 95% CI (3.56, 6.85), p < 0.00001]. Additionally, the combination therapy resulted in reductions in fasting blood glucose [MD = -0.30, 95% CI (-0.49, -0.10), p = 0.003], HbA1c [MD = -0.71, 95%CI (-1.03, -0.40), p < 0.00001], TNF-α levels [MD = -8.28, 95%CI (-13.12, -3.44), p = 0.0008], and TCM Syndrome Score [MD = -5.97, 95%CI (-9.06, -2.88), p = 0.0002]. Meanwhile, the combination therapy had a positive effect on MoCA Score [MD = 2.52, 95% CI (1.75, 3.30), p < 0.00001], and MMSE Score [MD = 2.31, 95% CI (1.33, 3.29), p < 0.00001]. In addition, the safety of the combination therapy was comparable to that of the WM alone [OR = 0.40, 95% CI (0.12, 1.31), p = 0.13]. Conclusion: The integration of TCM and WM therapy outperformed WM alone in DACD treatment. Simultaneously, the combination therapy could improve the therapeutic effect on blood glucose, cognitive function, and inflammation to a certain extent with few adverse effects. However, given the constraints imposed by the quality limitations of the incorporated studies, as well as the potential presence of reporting bias, it is imperative that our findings be substantiated through rigorous, large-scale, randomized controlled trials of superior quality in the future.

Effect of bacterial community succession on environmental factors during litter decomposition of the seaweed Gracilaria lemaneiformis.

In large-scale seaweed farming, an understanding of the decomposition process plays a pivotal role in optimizing cultivation practices by considering the influence of the bacterial community. Therefore, we assessed the bacterial community structure and its influence on environmental factors during Gracilaria lemaneiformis decomposition, utilizing both microcosms and in-situ simulations. The decomposition rates in the microcosms and in situ simulations reached 79 % within 180 days and 81 % within 50 days, respectively In the microcosms, the dissolved oxygen content decreased from 5.3 to 0.4 mg/L, while the concentrations of total organic carbon, nitrogen, and phosphorus in the water increased by 165 %, 1636 %, and 2360 %, respectively. The common dominant bacteria included Proteobacteria, Planctomycetes, Firmicutes, Bacteroidetes, and Spirochaetae. Planctomycetes and Firmicutes were positively correlated with the total organic carbon, nitrogen, and phosphorus concentrations. Planctomycetes species played significant roles during the decomposition process. The overall findings of this study could inform more sustainable seaweed cultivation practices.

Antitumor Effect of Si-Jun-Zi Decoction on SGC7901 Gastric Cancer Cells by CMTM2 Activation.

The Si-Jun-Zi decoction (SJZ), a traditional Chinese medicine (TCM) formula, is used clinically against multiple malignancies, including gastric cancer (GC). In previous study, we have shown that SJZ plays an anticancer role in SGC7901 cell xenograft mice models. However, the underlying mechanisms are unclear. The objective of this study was to evaluate the effect and mechanism of SJZ on the proliferation, migration, invasion, and cancer stem cell-like properties of GC cells. High-throughput mRNA sequencing analysis was performed to investigate the global alterations in gene expression in xenograft tumors, and 56 significantly differentially expressed genes (43 upregulated and 13 downregulated genes) were identified between the SJZ group and the Model group totally. We focused on CMTM2, which was significantly increased after SJZ intervention, as a candidate target gene of SJZ. The results indicated that CMTM2 expression was elevated in SJZ-treated SGC7901 cells and knocking-down CMTM2 expression partially hampered the inhibitory effects of SJZ on the proliferation, migration, and invasion of GC cells. Moreover, SJZ treatment repressed the spheroid and colony-forming capacity in GC cells, accompanied by downregulation of stem cell markers including SOX2, NANOG, and CD44. CMTM2 knockdown antagonized the effects of SJZ on the cancer stem cell-like properties of SGC7901 cells. Thus, SJZ effectively suppressed the proliferation, migration, invasion, and cancer stem cell-like properties of GC cells in vitro by upregulating CMTM2 expression.

Nursing students' willingness to work in geriatric care: An integrative review.

AIMS: This integrative review aims to explore the willingness of nursing students to work in geriatric care over the past 10 years and to explore the factors influencing nursing students to work in geriatric care. DESIGN: An integrative review. METHODS: Studies investigating nursing students' willingness in gerontological nursing work and related influencing factors published in English in Cochrane Library, MEDLINE, Embase, PsycINFO and CINAHL between 2010-2020 were included. Data collected in April 2020. RESULTS: Twenty-four studies were analysed. Most studies presented a contradictory or negative attitude about the willingness of nursing students to engage in gerontological nursing work. In most studies that rank the intention to work in nursing fields, gerontological care received the lowest or a relatively low ranking. The main factors affecting work related to gerontological nursing include prior experience caring for older adults, attitudes towards geriatrics, anxiety about ageing, clinical practice environment and living experience with older family members.

Protective role of vitamin B6 against mitochondria damage in Drosophila models of SCA3.

Polyglutamine (polyQ)-mediated mitochondria damage is one of the prime causes of polyQ toxicity, which leads to the loss of neurons and the injury of non-neuronal cells. With the discovery of the crucial role of the gut-brain axis and gut microbes in neurological diseases, the relationship between visceral damage and neurological disorders has also received extensive attention. This study successfully simulated the polyQ mitochondrial damage model by expressing 78 or 84 polyglutamine-containing Ataxin3 proteins in Drosophila intestinal enterocytes. In vivo, polyQ expression can reduce mitochondrial membrane potential, mitochondrial DNA damage, abnormal mitochondrial morphology, and loose mitochondrial cristae. Expression profiles evaluated by RNA-seq showed that mitochondrial structural genes and functional genes (oxidative phosphorylation and tricarboxylic acid cycle-related) were significantly down-regulated. More importantly, Bioinformatic analyses demonstrated that pathological polyQ expression induced vitamin B6 metabolic pathways abnormality. Active vitamin B6 participates in hundreds of enzymatic reactions and is very important for maintaining mitochondria's activities. In the SCA3 Drosophila model, Vitamin B6 supplementation significantly suppressed ECs mitochondria damage in guts and inhibited cellular polyQ aggregates in fat bodies, indicating a promising therapeutic strategy for the treatment of polyQ. Taken together, our results reveal a crucial role for the Vitamin B6-mediated mitochondrial protection in polyQ-induced cellular toxicity, which provides strong evidence for this process as a drug target in polyQ diseases treatment.

Protection of Siganus oramin, rabbitfish, from heavy metal toxicity by the selenium-enriched seaweed Gracilaria lemaneiformis.

Seaweed is an inherently important entity in marine ecosystems. It is not only consumed by aquatic animals but also improves environmental quality in the mariculture. Seaweed is also part of the diet of human beings. The purpose of the present study was to evaluate the antagonism of selenium (Se)-enriched Gracilaria lemaneiformis against heavy metals, specifically, the potential of dietary Se-enriched Gracilaria to protect against heavy metal toxicity in rabbitfish (Siganus oramin). Growth rate, heavy metal (Se, Cd, Pb, Cu, Zn and Cr) concentrations, malondialdehyde (MDA), metallothionein (MT), and the activity of the antioxidants, glutathione peroxidase (GPX), catalase (CAT) and superoxide dismutase (SOD) were all assessed. The results showed that the total organic and inorganic Se concentration for the 250 mg L-1 Se-enriched Gracilaria was significantly higher than those of the 50 and 10 mg L-1 treatments after 3 days of enrichment. The mean total Se concentrations in Gracilaria were 42.5 µg g-1 in the 250 mg L-1 treatment, 13.5 µg g-1 in the 50 mg L-1 treatment and 2.5 µg g-1 in the 10 mg L-1 treatment, respectively. Organic Se accounts for 80-82% of total Se in Se-enriched Gracilaria. The Se concentration of rabbitfish fed Se-enriched Gracilaria was significantly higher than control. Furthermore, Se increased Cu and Zn absorption, and enhanced MT generation, and improved GPX, CAT, and SOD antioxidant activity, and decreased MDA concentrations and lipid peroxidation levels, all antagonistic to Cd, Pb and Cr. The effects of Se-enriched Gracilaria on waterborne Cd, Pb and Cr-induced toxicity occurred via both enzymatic and non-enzymatic antioxidative mechanisms in rabbitfish. Selenium had synergistic effects on Zn and Cu in rabbitfish. For the 50 mg L-1 Se-enriched Gracilaria treatment, the Se, Cu, Zn, and antagonistic Cd, Pb, Cr, and the antioxidant enzymes CAT, SOD, GPX activities, and MT concentrations in rabbitfish were higher than that with the 250 mg L-1 and 10 mg L-1 Se-enriched Gracilaria treatments. The 50 mg L-1 Se treatment of Gracilaria was deemed to be the optimum concentration to promote growth of rabbitfish. Therefore, the obtained results suggest Se-enriched Gracilaria can antagonize heavy metal toxicity, and is an advisable Se supplement to improve the edible safety of cultured animals.

Generalized additive models for biomass simulation of submerged macrophytes in a shallow lake.

Submerged macrophytes are widely distributed primary producer that play important roles in maintaining healthy aquatic ecosystems. Generally, the relationships between macrophytes and environmental factors are complicated, so nonlinear nonparametric models with relatively flexible structures are optimal for macrophyte habitat simulation. In this study, generalized additive model (GAM) was used to evaluate the response of the submerged macrophytes biomass to water environmental factors in the Baiyangdian Lake. Forward stepwise method was used to implement model optimization. Likelihood ratio test was used to determine whether adding a variable enhances the model performance. Four individual variables (water depth, transparency, total nitrogen, and total phosphorus) and two interaction terms (water depth × transparency and water depth × total phosphorus) were included in the optimal GAM. The optimal model explained 70.5% of the biomass variation with a relatively low residual deviance value (22.40). There was a significant correlation between the measured and predicted data (R2 = 0.716, p = 0.0004). The response lines generated by the model indicated that macrophyte biomass had a positive correlation with transparency but negative correlations with total nitrogen and nitrite nitrogen in water. The response patterns of macrophyte biomass to water depth and total phosphorus were unimodal. The biomass reached the maximum value when the water depth was about 2.1 m and the total phosphorus concentration was 0.07 mg/L. Water depth and transparency, which affect light availability, are critical physical variables affecting the conditions associated with the submerged macrophytes, and excess nitrite and phosphorus limiting macrophyte biomass.

The Chinese herbal formulae (Yitangkang) exerts an antidiabetic effect through the regulation of substance metabolism and energy metabolism in type 2 diabetic rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Type 2 diabetes mellitus (T2DM) regarded as a "hot" disease in traditional Chinese medicine (TCM). Accordingly, TCM uses a cold drug or formula such as the Chinese herbal formulae "Yitangkang" (YTK) as a treatment. YTK exhibited a good clinical antidiabetic effect in several experiments. The correlation between the properties of a TCM drug or formula and its ability to regulate the substance metabolism, the energy metabolism and the endocrine system has been proven. AIM OF THE STUDY: The present study aiming to evaluate the mechanism of antidiabetic action of YTK from the above perspective. MATERIALS AND METHODS: Three groups of streptozotocin (STZ)-diabetic rats have been treated with YTK at oral doses of 56 g/kg/d, 28 g/kg/d and 14 g/kg/d for 28 days using metformin as a reference drug. After treatment, several indices correlated with energy metabolism (superoxide dismutase, glutathione peroxidase, lactic dehydrogenase, adenotriphos, creatine phosphate kinase, AMPK, Na+-K+-ATPase and Respiratory Chain Complex I, II, III, IV), substance metabolism (hepatic glycogen, acetyl-coenzyme A, pyruvic acid, adipose triglyceride lipase, triglycerides, high-density lipoproteins, low-density lipoproteins, malonyldialdehyde), endocrine system (triiodothyronine, thyroxine, 17-hydroxycorticosteroid) and cyclic nucleotide system (cyclic adenosine monophosphate, cyclic guanosine monophosphate) have been determined. The specialty and tendency of YTK's effects were analyzed to elucidate its property and mechanism of action according to the theory of TCM. RESULTS: Our findings showed that the formulae YTK could effectively regulate the levels of blood glucose, HbA1c, glucagon-like peptide-1, and significantly down-regulate the substance metabolism, energy metabolism and endocrine system indices of the diabetic rats. CONCLUSION: These results were consistent with the TCM description of YTK as a "cold" treatment. It could provide an effective way to interpret the scientific connotation and comprehensive system of the Chinese herbal formulae.

Protection of dietary selenium-enriched seaweed Gracilaria lemaneiformis against cadmium toxicity to abalone Haliotis discus hannai.

Seaweed Gracilaria lemaneiformis is the main dietary source of the abalone mariculture industry in China. In this study, we examined the protection of selenium (Se)-enriched G. lemaneiformis against cadmium (Cd) toxicity in the abalone, Haliotis discus hannai, using various indices including metal concentration (Se and Cd), growth rate, GPx enzymatic antioxidants, and metallothionein (MT) concentration over a period of 28 days of exposure. The growth rates and Se contents increased significantly in abalones fed with Se-enriched G. lemaneiformis, while the toxicity of Cd was reduced. Seven to 12 days Cd exposure to the Se-enriched G. lemaneiformis not only affected GPx activity but the MT levels fluctuated irregularly. MT concentrations increased after 3 days exposure and then gradually decreased to the control level after Day 7. There were statistically significant positive correlations between MT levels, GPx activity and Se concentrations, and negative relationships between MT levels, GPx activity and Cd levels in abalones. These findings suggest that Se-enriched Gracilaria protects abalone against Cd toxicity. The possible mechanism is the induction of MT with a concomitant increased capacity of GPx enzymatic antioxidants.

Proteogenomic Analyses Revealed Favorable Metabolism Pattern Alterations in Rotifer Brachionus plicatilis Fed with Selenium-rich Chlorella.

Organoselenium have garnered attention because of their potential to be used as ingredients in new anti-aging and antioxidation medicines and food. Rotifers are frequently used as a model organism for aging research. In this study, we used Se-enriched Chlorella (Se- Chlorella), a novel organoselenium compound, to feed Brachionus plicatilis to establish a rotifer model with a prolonged lifespan. The results showed that the antioxidative effect in Se-enriched rotifer was associated with an increase in guaiacol peroxidase (GPX) and catalase (CAT). The authors then performed the first proteogenomic analysis of rotifers to understand their possible metabolic mechanisms. With the de novo assembly of RNA-Seq reads as the reference, we mapped the proteomic output generated by iTRAQ-based mass spectrometry. We found that the differentially expressed proteins were primarily involved in antireactive oxygen species (ROS) and antilipid peroxidation (LPO), selenocompound metabolism, glycolysis, and amino acid metabolisms. Furthermore, the ROS level of rotifers was diminished after Se- Chlorella feeding, indicating that Se- Chlorella could help rotifers to enhance their amino acid metabolism and shift the energy generating metabolism from tricarboxylic acid cycle to glycolysis, which leads to reduced ROS production. This is the first report to demonstrate the anti-aging effect of Se- Chlorella on rotifers and to provide a possible mechanism for this activity. Thus, Se- Chlorella is a promising novel organoselenium compound with the potential to prolong human lifespans.

Selenium-Containing Polysaccharide-Protein Complex in Se-Enriched Ulva fasciata Induces Mitochondria-Mediated Apoptosis in A549 Human Lung Cancer Cells.

The role of selenium (Se) and Ulva fasciata as potent cancer chemopreventive and chemotherapeutic agents has been supported by epidemiological, preclinical, and clinical studies. In this study, Se-containing polysaccharide-protein complex (Se-PPC), a novel organoselenium compound, a Se-containing polysaccharide-protein complex in Se-enriched Ulva fasciata, is a potent anti-proliferative agent against human lung cancer A549 cells. Se-PPC markedly inhibited the growth of cancer cells via induction of apoptosis which was accompanied by the formation of apoptotic bodies, an increase in the population of apoptotic sub-G1 phase cells, upregulation of p53, and activation of caspase-3 in A549 cells. Further investigation on intracellular mechanisms indicated that cytochrome C was released from mitochondria into cytosol in A549 cells after Se-PPC treatment. Se-PPC induced depletion of mitochondrial membrane potential (ΔΨm) in A549 cells through regulating the expression of anti-apoptotic (Bcl-2, Bcl-XL) and pro-apoptotic (Bax, Bid) proteins, resulting in disruption of the activation of caspase-9. This is the first report to demonstrate the cytotoxic effect of Se-PPC on human cancer cells and to provide a possible mechanism for this activity. Thus, Se-PPC is a promising novel organoselenium compound with potential to treat human cancers.

Selenium accumulation in unicellular green alga Chlorella vulgaris and its effects on antioxidant enzymes and content of photosynthetic pigments.

The aim of the present study was to investigate selenite effects in the unicellular green algae Chlorella vulgaris as a primary producer and the relationship with intracellular bioaccumulation. The effects of selenite were evaluated by measuring the effect of different selenite concentrations on algal growth during a 144 h exposure period. It was found that lower Se concentrations (≤ 75 mg L(-1)) positively promoted C. vulgaris growth and acted as antioxidant by inhibiting lipid peroxidation (LPO) and intracellular reactive oxygen species (ROS). The antioxidative effect was associated with an increase in guaiacol peroxidase (GPX), catalase (CAT), superoxide dismutase (SOD) and photosynthetic pigments. Meanwhile, significant increase in the cell growth rate and organic Se content was also detected in the algae. In contrast, these changes were opposite in C. vulgaris exposed to Se higher than 100 mg L-1. The antioxidation and toxicity appeared to be correlated to Se bioaccumulation, which suggests the appropriate concentration of Se in the media accumulation of C. vulgaris should be 75 mg L-1. Taken together, C. vulgaris possesses tolerance to Se, and Se-Chlorella could be developed as antioxidative food for aquaculture and human health.

Gracilaria lemaneiformis polysaccharide as integrin-targeting surface decorator of selenium nanoparticles to achieve enhanced anticancer efficacy.

The poor permeability of glioma parenchyma represents a major limit for antiglioblastoma drug delivery. Gracilaria lemaneiformis polysaccharide (GLP), which has a high binding affinity to αvß3 integrin overexpressed in glioma cells, was employed in the present study to functionalize selenium nanoparticles (SeNPs) to achieve antiglioblastoma efficacy. GLP-SeNPs showed satisfactory size distribution, high stability, and selectivity between cancer and normal cells. In U87 glioma cell membrane, which has a high integrin expression level, GLP-SeNPs exhibited significantly higher cellular uptake than unmodified SeNPs. As expected, U87 cells exhibited a greater uptake of GLP-SeNPs than C6 cells with low integrin expression level. Furthermore, the internalization of GLP-SeNPs was inhibited by cyclo-(Arg-Gly-Asp-Phe-Lys) peptides, suggesting that cellular uptake into U87 cells and C6 cells occurred via αvß3 integrin-mediated endocytosis. For U87 cells, the cytotoxicity of SeNPs decorated by GLP was enhanced significantly because of the induction of various apoptosis signaling pathways. Internalized GLP-SeNPs triggered intracellular reactive oxygen species downregulation. Therefore, p53, MAPKs, and AKT pathways were activated to advance cell apoptosis. These findings suggest that surface decoration of nanomaterials with GLP could be an efficient strategy for design and preparation of glioblastoma targeting nanodrugs.

Neuroprotective effects of compounds with antioxidant and anti-inflammatory properties in a Drosophila model of Parkinson's disease.

BACKGROUND: Parkinson's disease (PD) is the most common movement disorder. Extrapyramidal motor symptoms stem from the degeneration of the dopaminergic pathways in patient brain. Current treatments for PD are symptomatic, alleviating disease symptoms without reversing or retarding disease progression. Although the cause of PD remains unknown, several pathogenic factors have been identified, which cause dopaminergic neuron (DN) death in the substantia nigra (SN). These include oxidative stress, mitochondrial dysfunction, inflammation and excitotoxicity. Manipulation of these factors may allow the development of disease-modifying treatment strategies to slow neuronal death. Inhibition of DJ-1A, the Drosophila homologue of the familial PD gene DJ-1, leads to oxidative stress, mitochondrial dysfunction, and DN loss, making fly DJ-1A model an excellent in vivo system to test for compounds with therapeutic potential. RESULTS: In the present study, a Drosophila DJ-1A model of PD was used to test potential neuroprotective drugs. The drugs applied are the Chinese herb celastrol, the antibiotic minocycline, the bioenergetic amine coenzyme Q10 (coQ10), and the glutamate antagonist 2,3-dihydroxy-6-nitro-7-sulphamoylbenzo[f]-quinoxaline (NBQX). All of these drugs target pathogenic processes implicated in PD, thus constitute mechanism-based treatment strategies. We show that celastrol and minocycline, both having antioxidant and anti-inflammatory properties, confer potent dopaminergic neuroprotection in Drosophila DJ-1A model, while coQ10 shows no protective effect. NBQX exerts differential effects on cell survival and brain dopamine content: it protects against DN loss but fails to restore brain dopamine level. CONCLUSION: The present study further validates Drosophila as a valuable model for preclinical testing of drugs with therapeutic potential for neurodegenerative diseases. The lower cost and amenability to high throughput testing make Drosophila PD models effective in vivo tools for screening novel therapeutic compounds. If our findings can be further validated in mammalian PD models, they would implicate drugs combining antioxidant and anti-inflammatory properties as strong therapeutic candidates for mechanism-based PD treatment.