Effects of Lianhuaqingwen Capsules in adults with mild-to-moderate coronavirus disease 2019: an international, multicenter, double-blind, randomized controlled trial.

BACKGROUND: In a randomized trial, Lianhuaqingwen (LHQW) capsule was effective for accelerating symptom recovery among patients with coronavirus disease 2019 (COVID-19). However, the lack of blinding and limited sample sizes decreased the level of clinical evidence. OBJECTIVES: To evaluate the efficacy and safety of LHQW capsule in adults with mild-to-moderate COVID-19. METHODS: We conducted a double-blind randomized controlled trial in adults with mild-to-moderate COVID-19 (17 sites from China, Thailand, Philippine and Vietnam). Patients received standard-of-care alone or plus LHQW capsules (4 capsules, thrice daily) for 14 days. The primary endpoint was the median time to sustained clinical improvement or resolution of nine major symptoms. RESULTS: The full-analysis set consisted of 410 patients in LHQW capsules and 405 in placebo group. LHQW significantly shortened the primary endpoint in the full-analysis set (4.0 vs. 6.7 days, hazards ratio: 1.63, 95% confidence interval: 1.39-1.90). LHQW capsules shortened the median time to sustained clinical improvement or resolution of stuffy or runny nose (2.8 vs. 3.7 days), sore throat (2.0 vs. 2.6 days), cough (3.2 vs. 4.9 days), feeling hot or feverish (1.0 vs. 1.3 days), low energy or tiredness (1.3 vs. 1.9 days), and myalgia (1.5 vs. 2.0 days). The duration to sustained clinical improvement or resolution of shortness of breath, headache, and chills or shivering did not differ significantly between the two groups. Safety was comparable between the two groups. No serious adverse events were reported. INTERPRETATION: LHQW capsules promote recovery of mild-to-moderate COVID-19 via accelerating symptom resolution and were well tolerated. Trial registration ChiCTR2200056727 .

Starch-enhanced degradation of HMW PAHs by Fusarium sp. in an aged polluted soil from a coal mining area.

The present study used strain ZH-H2 (Fusarium sp.) isolated by our group as the PAH-degrading strain and 5-6-rings PAHs as degradation objects. The soil incubation experiment was carried out to investigate the starch-enhanced degradation effects of HMW PAHs by Fusarium sp. in an Aged Polluted Soil from a Coal Mining Area. The results showed that the removal rates of BaP, InP and BghiP increased with increasing inoculation rate of ZH-H2 in the unsterile aged polluted soil of coal mining area, with the exception of BbF degradation which increased in the H2 treatment and then decreased. Different addition dosage of starch apparently resulted in degradation of 4 PAHs in soil, with removal rates of 14.47% for BaP, 23.83% for DbA, 30.77% for BghiP and 31.00% for InP obtained with treatment D2, respectively higher than in treatment D1. So starch addition apparently enhanced the degradation of the 4 PAHs, especially InP and BghiP, by native microbes in the aged HMW PAH-polluted soil. By adding starch to these aged polluted soils with inoculated strain ZH-H2, HMW-PAHs degradation was further improved and addition of 0.5 g kg-1 starch to soils with 1.0 g kg-1 Fusarium ZH-H2 (D2 + H2) performed best to the 4 HMW-PAHs in all of these combination treatments by a factor of up to 3.09, depending on the PAH. We found that the highest polyphenol oxidase activities under D2 + H2 treatments are consistent with the results of removal rates of 4 PAHs. Our findings suggest that the combination of Fusarium sp. ZH-H2 and starch offers a suitable alternative for bioremediation of aged PAH-contaminated soil in coal mining areas, with a recommended inoculation size of 0.5 g Fusarium sp. ZH-H2 and addition of 0.5 g kg-1 starch per kg soil.

A Meta-Analysis and Indirect Comparison of Endothelin A Receptor Antagonist for Castration-Resistant Prostate Cancer.

BACKGROUND: Endothelin A (ET-A) receptor antagonists including zibotentan and atrasentan, have been suggested as a treatment for castration-resistant prostate cancer (CRPC). Our aim was to conduct a meta-analysis and indirect comparison to assess the efficacy and safety of ET-A receptor antagonists for treatment of CRPC. METHODS: We systematically searched PubMed, EMBASE, the Cochrane Library, and Web of Science from inception to November 2014 to identify randomized controlled trials (RCTs) which assessed ET-A receptor antagonists for treatment of CRPC. Meta-analysis was conducted by STATA version 12.0 software. RESULTS: Eight RCTs were identified, involving 6,065 patients. The results of direct comparison showed that compared with placebo, there was no statistically significant difference in the improvement of progression-free survival (PFS), overall survival (OS), time to disease progression (TTP), and total adverse events (AEs) with ET-A receptor antagonist treatment for CRPC. The results of ET-A receptor antagonists plus docetaxel versus docetaxel alone were similar. The indirect comparisons showed that there were no significant differences between zibotentan plus docetaxel versus atrasentan plus docetaxel when compared with docetaxel alone or zibotentan versus atrasenta compared with placebo in the improvement of PFS, OS, TTP, and total adverse events. CONCLUSIONS: There were no significant benefits for ET-A receptor antagonists with or without docetaxel in the improvement of PFS, OS, TTP, and overall AEs. And there were no significant differences between zibotentan and atrasentan. Single-agent docetaxel should remain as one of the standard treatments.