Exploring the Safety, Effectiveness, and Cost-Effectiveness of a Chinese Patent Medicine (Fufang E'jiao Syrup) for Alleviating Cancer-Related Fatigue: A Protocol for a Randomized, Double-Blinded, Placebo-Controlled, Multicenter Trial.

OBJECTIVE: To provide higher level evidence on the benefits of a Chinese patent medicine (CPM) (Fufang E'jiao Syrup, FFEJS) for alleviating cancer-related fatigue (CRF), this article describes a protocol for a randomized controlled trial. METHODS/DESIGN: We designed a double-blind, placebo-controlled stratified permuted block randomization clinical trial on CRF among 3 types of cancer in China. Participants will be equally allocated to FFEJS group or placebo group according to the randomization sequence and the hospitals they were enrolled at. Each patient will receive 20 ml of either the study formula FFEJS or a placebo formula, 3 times a day for 6 weeks. The follow-up period will be another 4 weeks for safety evaluation. The primary outcome is the difference in improvement of fatigue as measured with the Revised Piper Fatigue Scale-Chinese Version (RPFS-CV). Secondary outcomes include change in fatigue (measured by routine blood panel and hormones in peripheral blood) and QoL (measured by Edmonton symptom assessment scale and Functional Assessment of Cancer Therapy). Patient safety will be measured by liver, renal or cardiac damage, and the risk of FFEJS having a tumor promotion and progression effect will be monitored throughout this study. Cost-effectiveness will also be evaluated mainly by incremental cost per each quality-adjusted life year gained. DISCUSSION: This article describes the study design of a CPM for CRF in patients with advanced cancer through exploring the effectiveness, safety, and cost-effectiveness of FFEJS. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04147312. Registered on 1 Sep 2019.

A comparative study on the effects of resveratrol and oxyresveratrol against tyrosinase activity and their inhibitory mechanism.

Resveratrol and oxyresveratrol are two natural polyhydroxy trans-stilbene products. Previous studies have shown that both of them can effectively inhibit the activity of tyrosinase. However, little attention has been paid to study the difference of their inhibitory mechanism. To reveal this difference, in this work a comparative study on the inhibitory effects of resveratrol and oxyresveratrol against cellular tyrosinase activity and melanin content were investigated by B16F0 cells, and the inhibitory mechanism of them on tyrosinase was revealed by cell-free tyrosinase inhibition, intrinsic fluorescence spectrum, circular dichroism and molecular docking. The results showed that the inhibitory capacity of oxyresveratrol toward tyrosinase activity and melanin formation was better than that of resveratrol. The difference of their inhibitory mechanism may be closely related to the different types of inhibition, the different strength of their interaction with tyrosinase and the different number of hydrogen bonds between them. The data in this study provide a scientific basis for revealing the inhibitory mechanisms of resveratrol and oxyresveratrol toward tyrosinase, and lay an experimental foundation for further development and utilization of them.