Network meta-analysis on efficacy and safety of different biologics for ulcerative colitis.

BACKGROUND: Therapeutic options for ulcerative colitis (UC) have increased since the introduction of biologics a few decades ago. Due to the wide range of biologics available, physicians have difficulty in selecting biologics and do not know how to balance the best drug between clinical efficacy and safety. This study aimed to compare the efficacy and safety of biologics in treating ulcerative colitis. METHODS: In this study, eight electronic databases (PubMed, Web of Science, Cochrane, Embase, Sinomed, China National Knowledge Infrastructure, Chongqing VIP Information, and WanFang Data) were searched to collect eligible studies without language restrictions. Retrieved 1 June 2023, from inception. All articles included in the mesh analysis are randomised controlled trials (RCTs). The inclusion of drugs for each outcome was ranked using a curved surface under cumulative ranking (SUCRA). Higher SUCRA scores were associated with better outcomes, whereas lower SUCRA scores were associated with better safety. This study has registered with PROSPERO, CRD42023389483. RESULTS: Induction Therapy: Among the biologic therapies evaluated for induction therapy, vedolizumab demonstrated the highest efficacy in achieving clinical remission (OR vs daclizumab, 9.09; 95% CI, 1.01-81.61; SUCRA 94.1) and clinical response. Guselkumab showed the lowest risk of recurrence of UC (SUCRA 94.9%), adverse events resulting in treatment discontinuation (SUCRA 94.8%), and serious infections (SUCRA 78.0%). Maintenance Therapy: For maintenance therapy, vedolizumab ranked highest in maintaining clinical remission (OR vs mesalazine 4.36; 95% CI, 1.65-11.49; SUCRA 89.7) and endoscopic improvement (SUCRA 92.6). Infliximab demonstrated the highest efficacy in endoscopic improvement (SUCRA 92.6%). Ustekinumab had the lowest risk of infections (SUCRA 92.9%), serious adverse events (SUCRA 91.3%), and serious infections (SUCRA 67.6%). CONCLUSION: Our network meta-analysis suggests that vedolizumab is the most effective biologic therapy for inducing and maintaining clinical remission in UC patients. Guselkumab shows promise in reducing the risk of recurrence and adverse events during induction therapy. Infliximab is effective in improving endoscopic outcomes during maintenance therapy. Ustekinumab appears to have a favorable safety profile. These findings provide valuable insights for clinicians in selecting the most appropriate biologic therapy for UC patients.

[Placebo control and its methodological issues on clinical trials of acupuncture therapy].

The paper introduces the placebo acupuncture simulation devices commonly used in clinical trial of acupuncture therapy. These devices are composed of Streitberger, Park, Takakura, Foam and Phantom acupuncture. Because acupuncture therapy is a kind of complex intervention, there are the controversies in methodology for the acupuncture placebo control of clinical trial. Placebo acupuncture may be an effective control, with a certain of specific therapeutic effect. The blinding effect of placebo acupuncture is highly questioned, specially, the sensation of deqi is hardly imitated during acupuncture. On these grounds, in this research, the suggestions has been proposed on the selection and the setting of placebo control in clinical trial of acupuncture therapy.

Fiber Nanoarchitectonics for Pre-Treatments in Facile Detection of Short-Chain Fatty Acids in Waste Water and Faecal Samples.

Short-chain fatty acids (SCFAs) are among the active metabolites in biological process both in the intestinal tract and the bioconversion of organic wastes, which has resulted in various human diseases and environmental problems. In order to accurately detect SCFAs, we introduced a novel extraction sorbent. Electrospun polyacrylonitrile (PAN) nanofiber membrane was synthesized, then poly (3, 4-Ethylenedioxythiophene) (PEDOT) was deposited onto the surface of electrospun PAN nanofibers by in situ polymerization. The morphology of the composite PAN/PEDOT nanofiber was characterized by scanning electronic microscopy (SEM) and FTIR spectrum. PAN/PEDOT was used to isolate and concentrate the SCFAs in waste water and fecal samples before gas chromatography mass spectrometry (GC-MS) analysis. The analytical method was evaluated systematically, and low limits of detection (LODs) of 0.34-0.87 µg/L and good linearity (R2 ≥ 0.9953) were obtained. The method was applied successfully for the determination of SCFAs in waste water and fecal samples, with good recovery (87.5-104.6%) and satisfactory reproducibility (relative standard deviation: 6.5-14.1%). The results indicated that the proposed method can be used as a potential approach for the determination of SCFAs with high sensitivity in waste water and biological samples.

Decreased inhibition of exosomal miRNAs on SARS-CoV-2 replication underlies poor outcomes in elderly people and diabetic patients.

Elderly people and patients with comorbidities are at higher risk of COVID-19 infection, resulting in severe complications and high mortality. However, the underlying mechanisms are unclear. In this study, we investigate whether miRNAs in serum exosomes can exert antiviral functions and affect the response to COVID-19 in the elderly and people with diabetes. First, we identified four miRNAs (miR-7-5p, miR-24-3p, miR-145-5p and miR-223-3p) through high-throughput sequencing and quantitative real-time PCR analysis, that are remarkably decreased in the elderly and diabetic groups. We further demonstrated that these miRNAs, either in the exosome or in the free form, can directly inhibit S protein expression and SARS-CoV-2 replication. Serum exosomes from young people can inhibit SARS-CoV-2 replication and S protein expression, while the inhibitory effect is markedly decreased in the elderly and diabetic patients. Moreover, three out of the four circulating miRNAs are significantly increased in the serum of healthy volunteers after 8-weeks' continuous physical exercise. Serum exosomes isolated from these volunteers also showed stronger inhibitory effects on S protein expression and SARS-CoV-2 replication. Our study demonstrates for the first time that circulating exosomal miRNAs can directly inhibit SARS-CoV-2 replication and may provide a possible explanation for the difference in response to COVID-19 between young people and the elderly or people with comorbidities.

Identifying the best regimen for primary eradication of Helicobacter pylori: analysis of 240 cases.

The treatment regimen for the eradication of Helicobacter pylori may be best when therapy is susceptibility guided. However, it is unrealistic to use a strategy based on susceptibility testing to prioritize therapy for every patient in China. Empirical therapy of H. pylori is still widely used. The study was designed to discuss the best first-line treatment regimen depending on empirical therapy. The focal point of the study was the optimal length of the therapy. Also, the selection of antibiotics was discussed in the article. This was a prospective, randomized, non-inferiority trial. H. pylori-infected patients who have no previous eradication therapy were randomly assigned to the following: 20 mg of rabeprazole, 1000 mg of amoxicillin, 500 mg of clarithromycin, and 220 mg of bismuth potassium citrate (BACPPI), administered twice a day for 10 or 14 days. The efficacy, side effects, and remission rate of clinical symptoms were determined. A total of 240 subjects were included in the study. The eradication rate with 14 and 10 days was essentially identical in both intention-to-treat (90.83% [95% CI, 86%-96%] vs. 87.50% [95% CI, 82%-93%]) and per-protocol (94.78% [95% CI, 91%-99%] vs. 92.11% [95% CI, 87%-97%]) analyses. Loss of appetite and belching symptoms were significantly better in the BACPPI-10 group than those in the control group after treatment. Side effects were generally mild and similar between groups. Our results showed that a 10-day amoxicillin-clarithromycin-containing bismuth quadruple therapy may be recommended for the primary empirical treatment of H. pylori infection in Beijing, China.

[Effects of sustained military physical related activity on balance ability].

OBJECTIVE: To evaluate the effects of sustained military physical related activity on balance abilities and the role of visual system in it, so as to provide the basis for precise training. METHODS: Fifty-four healthy males (age: 20.28±3.72 y, height: 173.21±5.67 cm; weight: 64.29±5.12 kg) were recruited in this experiment. Multiple military subjects were completed within 36 hours, and the workload was recorded (randomly select 11 people). After military activity, the balance abilities with opened eyes (54 people) and closed eyes (randomly selected 27 people) were evaluated. RESULTS: In terms of internal load, the heart rates (HR), excess post-exercise oxygen consumption (EPOC) and training impulse (TRIMP) for all exercises were increased significantly in military activity compared with rest (P＜0.05). Regard to balance abilities, compared to the rest with eyes-opened, the sway path-total (SPT), sway path-A-P ( SPAP ), sway path-M-L (SPML), sway V-total (SVT), sway V-A-P (SVAP), and sway V-M-L (SVML)after sustained military activity with eyes-opened were increased significantly (P＜0.05), while sway maximal amplitude-A-P (SMAAP), sway maximal amplitude-M-L (SMAML), and area of 100% ellipse (AE) had no significant changes; Compared to the rest, all indicators after the military activity with eyes-closed were significantly increased (P＜0.05). So vision could control the amplitude and area after the military activity. CONCLUSION: Sustained military related activity can damage the balance ability. After sustained military activity, the degree of damage of the balance ability in the closed-eyes is greater than that of the open-eyes, the amplitude and range of the center of gravity are increased, indicates that the visual system plays major role in controlling attitude stability.

[Effect of lower-limb dominance and non-dominance shuttle runs under load carriage on the balance responses in young cadets].

OBJECTIVE: This test was designed to evaluate the effect of lower-limb dominance and non-dominance shuttle runs under load carriage during different exercise load at the same exercise intensity on the balance responses. METHODS: Ten healthy young males were joined in this experiment, they were (20.80±2.04) years old and (173.99±2.87) cm tall. In a randomized cross-over design, they performed four times shuttle runs under unilateral load carriage:20 m×5 at dominant side, 20 m×5 at non-dominant side, 20 m×10 at dominant side, 20 m×10 at non-dominant side respectively. Balance abilities were evaluated immediately and 20 minute post-exercise respectively, and R-R interval was recorded. RESULTS: The HR, EPOC and TRIMP for all exercise load were increased significantly after shuttle runs compared to rest (P<0.01), the EPOC and TRIMP for 20 m×10 shuttle runs were significantly higher than those for 20 m×5 shuttle runs at the dominant and non-dominant side (P<0.01). Compared to the rest, the instability indices (general, anteroposterior and mediolateral movement) for 20 m×5 and 20 m×10 shuttle runs immediately post-exercise at the dominant and non-dominant side were increased significantly (P<0.05), and the magnitude of the mediolateral movement for 20 m×10 shuttle runs was higher than that of 20 m×5 shuttle runs (P<0.05). While there were no obvious difference between the dominant and the non-dominant side (P>0.05), which showed symmetrical change. In addition, during 20 minute recovery, the balance ability for all exercise load was returned to the rest value (P>0.05). CONCLUSIONS: The shuttle runs could impair the trunk control ability immediately post-exercise, the magnitude of mediolateral movement was increased as the exercise load increased. The changes of balance responses were similar between the dominant and the non-dominant side, the dominant and the non-dominant side might show cross-effects.

Time-course responses of circulating microRNAs to three resistance training protocols in healthy young men.

Circulating microRNAs (c-miRNAs) in human plasma have been described as a potential marker of exercise. The present study investigated the effects of three acute resistance training (RT) protocols on the time-course changes of the c-miRNAs profiles in young males. The subjects (n = 45) were randomly divided into three groups: muscular strength endurance (SE), muscular hypertrophy (MH) and maximum strength (MS). Venous blood samples were obtained before exercise and immediately, 1 h and 24 h after each RT protocol to assess the following biological parameters: c-miRNAs, anabolic and catabolic hormones, inflammatory cytokines and muscle damage markers. The results revealed that the levels of two c-miRNAs (miR-208b and miR-532), six c-miRNAs (miR-133a, miR-133b, miR-206, miR-181a, miR-21 and miR-221) and two c-miRNAs (miR-133a and miR-133b) changed significantly in response to the SE, MH and MS protocols (p < 0.05), respectively. The nature and dynamic processes of the c-miRNAs response were likely influenced by the RT modality and intensity. Moreover, miR-532 was negatively correlated with insulin-like growth factor-1 and positively correlated with interleukin-10, whereas miR-133a was negatively correlated with cortisol and positively correlated with testosterone/cortisol. These findings suggest that these c-miRNAs may serve as markers for monitoring the RT responses.

[Effect of jianpi tongluo jiedu recipe on expression levels of COX-2, NF-kappaBp65, and Bcl-2 in gastric mucosa of patients with precancerous lesions of gastric cancer].

OBJECTIVE: To explore the effect of Jianpi Tongluo Jiedu Recipe (JTJR) on protein expression levels of COX-2, NF-kappaBp65, Bcl-2, and Bax, mRNA expression levels of COX-2 and Bcl-2, and the apoptotic index (Al) in gastric mucosa of patients with precancerous lesions of gastric cancer (PL-GC). METHODS: Totally 65 PLGC patients were recruited and treated by JTJR (modified by syndrome typing), one dose per day for six successive months. Protein expression levels of COX-2, NF-KBp65, Bcl-2, and Bax were detected in 65 patients using immunohistochemical (IHC) assay before and after treatment. mRNA expression levels of COX-2 and Bcl-2 were detected in 54 patients using reverse transcription-polymerase chain reaction (RT-PCR). Meanwhile, changes of Al was detected in 65 patients using TdT-mediated dUTP-biotin nick end labeling (TUNEL) fluorescence method. RESULTS: After treatment with JTJR, positive protein expression levels of COX-2, NF-KBp65, and Bcl-2 were obviously decreased in the gastric mucosa of PLGC patients (P <0.01), but Bax positive protein expression was found to be higher (P < 0.05). At the same time mRNA expression levels of COX-2 and Bcl-2 were significantly lower after treatment than before treatment (P < 0.05, P < 0.01); Al also increased after treatment (P < 0.05). CONCLUSION: JTJR could promote apoptosis possibly via NF-kappaBp65/COX-2, COX-2/Bcl-2, and NF-kappaBp65/Bcl-2 signaling pathways, thereby affecting PLGC patients.

Zhen gan xi feng decoction, a traditional chinese herbal formula, for the treatment of essential hypertension: a systematic review of randomized controlled trials.

Objectives. To assess the clinical effectiveness and adverse effects of Zhen Gan Xi Feng Decoction (ZGXFD) for essential hypertension (EH). Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of ZGXFD for EH reported in any language, with main outcome measure as blood pressure (BP). Results. Six randomized trials were included. Methodological quality of the trials was evaluated as generally low. Four trials compared prescriptions based on ZGXFD with antihypertensive drugs. Meta-analysis showed that ZGXFD was more effective in BP control and TCM syndrome and symptom differentiation (TCM-SSD) scores than antihypertensive drugs. Two trials compared the combination of modified ZGXFD plus antihypertensive drugs with antihypertensive drugs. Meta-analysis showed that there is significant beneficial effect on TCM-SSD scores. However, no significant effect on BP was found. The safety of ZGXFD is still uncertain. Conclusions. ZGXFD appears to be effective in improving blood pressure and hypertension-related symptoms for EH. However, the evidence remains weak due to poor methodological quality of the included studies. More rigorous trials are warranted to support their clinical use.

Chinese patent medicine liu wei di huang wan combined with antihypertensive drugs, a new integrative medicine therapy, for the treatment of essential hypertension: a systematic review of randomized controlled trials.

Objectives. To assess the beneficial and adverse effects of Liu Wei Di Huang Wan (LWDHW), combined with antihypertensive drugs, for essential hypertension. Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of LWDHW combined with antihypertensive drugs for essential hypertension reported in any language, with main outcome measures as blood pressure. The quality of the included studies was assessed with the Jadad scale and a customized standard quality assessment scale. Results. 6 randomized trials were included. The methodological quality of the trials was evaluated as generally low. The pooled results showed that LWDHW combined with antihypertensive drugs was more effective in blood pressure and the scale for TCM syndrome and symptom differentiation scores compared with antihypertensive drugs alone. Most of the trials did not report adverse events, and the safety is still uncertain. Conclusions. LWDHW combined with antihypertensive drugs appears to be effective in improving blood pressure and symptoms in patients with essential hypertension. However, the evidence remains weak due to the poor methodological quality of the included studies.

Banxia baizhu tianma decoction for essential hypertension: a systematic review of randomized controlled trials.

Objectives. To assess the current clinical evidence of Banxia Baizhu Tianma Decoction (BBTD) for essential hypertension (EH). Search Strategy. Electronic databases were searched until July 2012. Inclusion Criteria. We included randomized clinical trials testing BBTD against placebo, antihypertensive drugs, or combined with antihypertensive drugs against antihypertensive drugs. Data Extraction and Analyses. Study selection, data extraction, quality assessment, and data analyses were conducted according to Cochrane standards. Results. 16 randomized trials were included. Methodological quality of the included trials was evaluated as generally low. 2 trials compared prescriptions based on BBTD using alone with antihypertensive drugs. Meta-analysis showed no significant effect of modified BBTD compared with captopril in systolic blood pressure (MD: -0.75 (-5.77, 4.27); P = 0.77) and diastolic blood pressure (MD: -0.75 (-2.89, 1.39); P = 0.49). 14 trials compared the combination of BBTD or modified BBTD plus antihypertensive drugs with antihypertensive drugs. Meta-analysis showed there are significant beneficial effect on systolic blood pressure in the combination group compare to the antihypertensive drugs (MD: -4.33 (-8.44, -0.22); P = 0.04). The safety of BBTD is uncertain. Conclusions. There is encouraging evidence of BBTD for lowering SBP, but evidence remains weak. Rigorously designed trials are warranted to confirm these results.

[Proteomic analysis of myocardial hypertrophy induced by left kidney artery coarctation in rats].

AIM: To identify the expression of proteins in cardiomyocytes in rats with left kidney artery coarctation. METHODS: 16 male SD rats were separated into 2 groups (n=8): 2 kidney 1 Clip group (2K1C) and sham operation group (SO). The postoperational 8th week, after examination by normal doppler and tissue doppler echocardiography, the extracted proteins from cardiomyocytes were isolated by two-dimensional gel electrophoresis with staining. The gel images were acquired by scanner and 2-DE analysis software. Different spots observed on two 2D gels were selected and identified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS). RESULTS: Overall, 21 protein spots showed significant difference, and 14 out of which were identified. CONCLUSION: Kidney artery coactation-induced cardiac hypertrophy displays different expression of proteins in cardiomyocytes.

[Assessment of cardiac structure and function by echocardiographic values for male Balb/c mice].

AIM: To assess the parameters of cardiac structure and function of male Balb/c mice by the echocardiography. METHODS: A total of 27 male Balb/c mice (from five to seven week old) were examined with a 13-MHz transthoracic linear-array transducer, hearts were removed from mice anesthetized with Nembutal, and the left ventricular (LV) mass were weighed. RESULTS: Complete 2-dimensional echocardiography for cardiac structure and function were obtained. Hemodynamic parameters were recorded. A correlation existed between LV weight (x) and echocardiographic LV mass (y) with the 2D) guided M-mode method: y = 1.15x + 3.26, (r = 0.80). CONCLUSION: Echocardiography appears to be a promising approach for noninvasively assessing LV mass and function in mice.

[Alpha-galactosidase A gene mutation in a Chinese family with Fabry disease mimicking clinical features of hypertrophic cardiomyopathy].

OBJECTIVE: To screen gene mutation in alpha-galactosidase A (alpha-Gal A) in a nonconsanguineous Chinese family with Fabry disease (FD) with clinical manifestations similar to hypertrophic cardiomyopathy (HCM). METHODS: Mutation analysis was performed by using purified PCR products to direct sequence analysis on an ABI-377XL automated DNA sequencer. DNA analysis of alpha-Gal A gene and physical and clinical examinations were performed in a female proband and in her relatives (15 subjects in total). RESULTS: Three hemizygotes and 6 heterozygotes were diagnosed for FD by the alpha-Gal A gene analysis with a missense mutation in exon 5 of the alpha-Gal A sequence, leading to a TGG32TGA substitution, which may induce the absent of tryptophan's translation (corresponded to TGG) by the terminator codon TGA. Six patients in the family were revealed as HCM by echocardiography. CONCLUSIONS: Present results show that it is important to differentiate FD from other causes of hypertrophy in patients with cardiac hypertrophy. Screening for alpha-Gal A gene mutations in patients with FD and in their relatives could help to identify all suspected cases within the families.