Combining Ozonated Autohemotherapy with Pharmacological Therapy for Comorbid Insomnia and Myofascial Pain Syndrome: A Prospective Randomized Controlled Study.

Objective: To examine the efficacy and safety of ozonated autohemotherapy (O3-AHT) combined with pharmacological therapy for comorbid insomnia and myofascial pain syndrome (MPS). Materials and Methods: One hundred and eighteen patients were randomly divided into two groups: the control group (N = 50) and the O3-AHT group (N = 53). Patients in both groups were given the same pharmacological management for three weeks. Patients in the O3-AHT group were treated with ozonated autohemotherapy (the concentration of ozone was 20 µg/ml in the first week, 30 µg/ml in the second week, and 40 µg/ml in the third week) combined with pharmacological therapy. Primary (the insomnia severity index (ISI) and visual analogue scale (VAS)) and secondary outcomes (the Epworth sleepiness scale (ESS), polysomnography data, the anxiety and preoccupation about sleep questionnaire (APSQ), the beck depression index (BDI), and the multidimensional fatigue inventory (MFI)) were examined at pretreatment, posttreatment, 1 month, and 6 months. Results: Fifty patients in the control group and fifty-three patients in the O3-AHT group completed the study. In both groups, insomnia and pain symptoms were relieved significantly compared with pretreatment. Compared with the control group, the O3-AHT group had significantly improved sleep quality, pain, and negative mood at different time points. No adverse complications were observed in either group. Conclusion: Compared with pharmacological therapy alone, ozonated autohemotherapy combined with pharmacological therapy can ameliorate insomnia, reduce pain intensity, improve negative mood, and alleviate fatigue more effectively without serious adverse complications.

Acupoint Catgut Embedding as Adjunctive Therapy for Patients With Gallstones.

AIMS OF THIS STUDY: A randomized clinical trial was undertaken to investigate the efficacy of acupoint catgut embedding (ACE) as adjunctive therapy to tauroursodeoxycholic acid (TUDCA) therapy on gallbladder emptying and clinical symptoms in patients with gallstone disease. MATERIALS AND METHODS: Between August 2018 and January 2019, 70 patients with gallstones in our hospital were enrolled in this prospective clinical trial. All the patients were randomly divided into the ACE group (ACE+TUDCA treatment for 8 wk) and the Sham group (Sham ACE+TUDCA treatment for 8 wk). In the ACE group, all the patients were nightly given ACE every 2 weeks, and in 2 groups, every patient took TUDCA 500 mg at bedtime. The parameters about gallbladder emptying were detected by ultrasound before and after the treatment, and the clinical symptom scores were recorded at the same time points. RESULTS: A total of 63 patients with gallstone disease were included in our study, with 33 patients in the ACE group and 30 patients in the Sham group. In the ACE group, the empty volume (EV) and gallbladder ejection fraction (GBEF) were improved after treatment (P<0.05). Almost every symptom score (except symptom 7, P=0.15) and total score were decreased (P<0.05). In the Sham group, the symptom 1, 2, 4, 5 scores, and total score were significantly decreased (P<0.05). Moreover, the residual volume in the ACE group was significantly lower than in the Sham group (P=0.008). The EV and GBEF in the ACE group were higher than that in the Sham group (P<0.05). The score of symptom 6 in the ACE group was lower than that in the Sham group (P=0.008). CONCLUSION: ACE therapy could more effectively improve the gallbladder emptying with a shorter treatment course. Therefore, ACE+TUDCA therapy might be a time-saving treatment for gallstones.

Fruit, vegetables, and mushrooms for the preparation of extracts with α-amylase and α-glucosidase inhibition properties: A review.

The inhibition of the α-amylase and α-glucosidase activity facilitates the maintenance of circulating glucose levels by decreasing the rate of blood sugar absorption. Existing enzyme inhibitors such as acarbose, miglitol, and voglibose are used for inhibiting the activity of these enzymes, however, alternative solutions are required to avoid the side-effects of using these drugs. The current study aims to review recent evidence regarding the in vitro α-amylase and α-glucosidase inhibition activities of extracts derived from selected fruit, vegetables, and mushrooms. The mechanisms of action of the extracts involved in the inhibition of both enzymes are also presented and discussed. Compounds including flavonoids, phenolic acids, anthocyanins, saponins, carotenoids, terpenes, sugars, proteins, capsaicinoids, fatty acids, alkaloids have been shown to have α-amylase and α-glucosidase inhibition activities. Harvesting period, maturity stage, sample preparation, extraction technique, and solvent type are parameters that affect the α-amylase and α-glucosidase inhibition activities of the extracts.

Responses of Labile Organic Nitrogen Fractions and Enzyme Activities in eroded Mollisols After 8-year Manure Amendment.

Soil erosion will cause a degradation in soil nitrogen supplying capacity (SNSC) and manure amendment is an effective way to restored eroded soils. Both labile fractions of soil organic N (SON) and N transformation enzymes are indicators for SNSC, but the effect of manure amendments on labile SON fractions and the relationship between labile SON fractions and enzyme activities remains unclear. In this study, five degrees of erosion were simulated in Mollisols (removal of 0, 5, 10, 20 and 30 cm of topsoil) to analyse the changes in labile SON fractions and nitrogen transformation enzyme activities after 8-year manure amendment. We found that soil total N (TN), labile SON fractions and enzyme activities all increased after manure amendments. The largest labile SON fraction was particle organic nitrogen (POM-N) and the second was light fraction organic nitrogen (LFOM-N), which accounted >60% for TN in total. Correlation analysis showed that both urease and protease activities were significantly correlated with POM-N, LFOM-N, microbial biomass N and dissolvable organic N, indicating that both urease and protease activities can be used to predict labile SON pools and enzyme activities worked similarly in indicating SNSC with labile SON fractions. Altogether, 8-year manure amendment could recover SNSC of lightly eroded Mollisols to natural levels, i.e. erosion depths at 5 cm and 10 cm; however, it is not able to recover SNSC in Mollisols suffering severe erosion.

Prevalence, awareness, and treatment of anemia in Chinese patients with nondialysis chronic kidney disease: First multicenter, cross-sectional study.

This was the first multicenter, cross-sectional survey to assess the prevalence of anemia, patient awareness, and treatment status in China. Data of patients with chronic kidney disease (CKD; age, 18-75 years; both out- and inpatients) from 25 hospitals in Shanghai, seeking medical treatment at the nephrology department, were collected between July 1, 2012 and August 31, 2012. The prevalence, awareness, and treatment of anemia in patients with nondialysis CKD (ND-CKD) were assessed. Anemia was defined as serum hemoglobin (Hb) levels ≤12 g/dL in women and ≤13 g/dL in men. A total of 2420 patients with ND-CKD were included. Anemia was established in 1246 (51.5%) patients: 639 (51.3%) men and 607 (48.7%) women. The prevalence of anemia increased with advancing CKD stage (χtrend = 675.14, P < 0.001). Anemia was more prevalent in patients with diabetic nephropathy (68.0%) than in patients with hypertensive renal damage (56.6%) or chronic glomerulonephritis (46.1%, both P < 0.001). Only 39.8% of the anemic patients received treatment with erythropoietin and 27.1% patients received iron products; furthermore, 22.7% of the patients started receiving treatment when their Hb level reached 7 g/dL. The target-achieving rate (Hb at 11-12 g/dL) was only 8.2%. Of the 1246 anemia patients, only 7.5% received more effective and recommended intravenous supplementation. Anemia is highly prevalent in patients with ND-CKD in China, with a low target-achieving rate and poor treatment patterns. The study highlights the need to improve multiple aspects of CKD management to delay the progression of renal failure.

Effect of erythropoietin on the migration of bone marrow-derived mesenchymal stem cells to the acute kidney injury microenvironment.

Bone marrow-derived mesenchymal stem cells (BMSCs) preferentially migrate to the injured tissue but with limited efficiency. Here we investigated the effect of erythropoietin (EPO) treatment on the BMSC migration to the acute kidney injury (AKI) microenvironment. The possible mechanisms were also discussed. A hypoxia/re-oxygenation (HR) model of renal tubular epithelial cells (RTECs) was established to generate AKI in vitro, and a chemotaxis experiment was conducted using the transwell chamber. EPO treatment enhanced the BMSC migration to the HR-RTEC culturing chamber in a SDF-1 level-dependent manner, which was fully inhibited by the treatment of anti-SDF-1 antibody. The BMSC migration could also be partly blocked by LY294002 (phosphoinositide 3-kinase (PI3K) inhibitor) and PD98059 (MAPK inhibitor). Western blot analysis showed that phosphorylated Akt and phosphorylated MAPK in BMSCs were enhanced by EPO treatment. In the in vivo experiment, BMSCs were transplanted into the AKI mice and EPO was subcutaneously injected. The results showed that EPO injection increased the SDF-1 protein expression and BMSC accumulation in the renal tissue, which was consistent with a decent improvement of renal function. In addition, the BMSC accumulation in the renal tissue was blocked by anti-SDF-1 antibody, LY294002 or PD98059. Our data suggest that AKI microenvironment had a directional chemotactic effect on BMSCs, which could be further enhanced by the EPO treatment. The increased SDF-1 level in the AKI microenvironment and the activations of PI3K/AKT and MAPK in BMSCs were the possible mechanisms for the effect of EPO. Therefore, BMSC transplantation combined with EPO injection can be a novel and effective approach for AKI repair.

Mineral and bone disorder in Chinese dialysis patients: a multicenter study.

BACKGROUND: Mineral and bone disorder (MBD) in patients with chronic kidney disease is associated with increased morbidity and mortality. Studies regarding the status of MBD treatment in developing countries, especially in Chinese dialysis patients are extremely limited. METHODS: A cross-sectional study of 1711 haemodialysis (HD) patients and 363 peritoneal dialysis (PD) patients were enrolled. Parameters related to MBD, including serum phosphorus (P), calcium (Ca), intact parathyroid hormone (iPTH) were analyzed. The achievement of MBD targets was compared with the results from the Dialysis Outcomes and Practice Study (DOPPS) 3 and DOPPS 4. Factors associated with hyperphosphatemia were examined. RESULTS: Total 2074 dialysis patients from 28 hospitals were involved in this study. Only 38.5%, 39.6% and 26.6% of them met the Kidney Disease Outcomes Quality Initiative (K/DOQI) defined targets for serum P, Ca and iPTH levels. Serum P and Ca levels were statistically higher (P < 0.05) in the HD patients compared with those of PD patients, which was (6.3 ± 2.1) mg/dL vs (5.7 ± 2.0) mg/dL and (9.3 ± 1.1) mg/dL vs (9.2 ± 1.1) mg/dL, respectively. Serum iPTH level were statistically higher in the PD patients compared with those of HD patients (P = 0.03). The percentage of patients reached the K/DOQI targets for P (37.6% vs 49.8% vs 54.5%, P < 0.01), Ca (38.6% vs 50.4% vs 56.0%, P < 0.01) and iPTH (26.5% vs 31.4% vs 32.1%, P < 0.01) were lower among HD patients, compared with the data from DOPPS 3 and DOPPS 4. The percentage of patients with serum phosphorus level above 5.5 mg/dL was 57.4% in HD patients and 47.4% in PD patients. Age, dialysis patterns and region of residency were independently associated with hyperphosphatemia. CONCLUSIONS: Status of MBD is sub-optimal among Chinese patients receiving dialysis. The issue of hyperphosphatemia is prominent and needs further attention.

[Effects of glycyrrihizic acid and prednisone on pathological and ultrastructural changes of kidney in rats with chronic aristolochic acid nephropathy].

OBJECTIVE: To investigate the effects of glycyrrihizic acid (GA) and prednisone on renal injury in chronic aristolochic acid nephropathy (AAN) rat model. METHODS: Ninety-eight male Wistar rats of SPF grade were randomly divided into 4 groups, the normal control group (n = 20), the GA group, the model group, and the prednisone group, 26 rats in each group. Rats in the latter 3 groups were made into AAN model by administration of aristolochic acid (AA, contained in extract of Caulis Aristolochiae Manshuriensis) 20 mg/(kg x d) by gastric gavage, and equal volume of drinking water was given to rats in the control group. Medication was started 2 h later, the GA group was treated with GA 25 mg/(kg x d), the prednisone group with prednisone 3.15 mg/(kg x d), and to the other two groups equal volume of drinking water was given. Body weight was measured weekly, renal function related indices and morphology of the renal tissue were examined at the 4th, 8th and 12th weekend. RESULTS: Along with the feeding time, body weight in the control group increased steadily, while that in the treated groups increased slowly. The ratio of serum creatinine/body weight increased markedly in the model group, while it significantly lowered in the treated groups. Morphological examination showed that the structural injury in the treated groups was milder than that in the model group, and its degree of fibrosis was milder also (15% - 20% vs 30%). Electronmicroscopy showed that AA induced, injury degeneration and necrosis of renal tubular epithelial cells, and markedly injured the cell organs, such as mitochondria, and induced nuclear variation, while in the treated groups, it was mainly limited in renal tubule, with normal cell organs, few nucleolus variation and less interstitial collagen fibers. CONCLUSION: GA and prednisone could reduce the serum creatinine level, improve renal function, relieve the renal morphological changes, and decrease the inter stitial fibrosis, showing a definite preventing effect on chronic AAN in rats.