Factors influencing the starch digestibility of starchy foods: A review.

Starchy foods are a major energy source of the human diet, their digestion is closely related to human health. Most foods require lots of processing before eating, therefore, many factors can influence starch digestibility. The factors that affect the digestibility of starches have been widely discussed previously, but the extracted starches in those studies were different from those present within the actual food matrix. This review summarizes the factors influencing the starch digestibility in starchy foods. Endogenous non-starch components hinder the starch digestive process. Food ingredients and additives decrease starch digestibility by inhibiting the activity of digestive enzymes or hindering the contact between starch and enzymes. Storage induce the retrogradation of starch, decreasing the digestibility of foods. Therefore, preparing starchy foods with whole grains, processing them as little as possible, using food additives reasonably, and storage conditions may all be beneficial measures for the production of low GI foods.

Effect of Cooking Method and Enzymatic Treatment on the in vitro Digestibility of Cooked and Instant Chestnut Flour.

Microwave treatment, roasting, boiling, and enzymatic treatment were used to prepare cooked and instant chestnut flour, and the in vitro digestibility were compared. Cooking gelatinized the starch and destroyed the granular and crystal structure, increasing starch digestibility. After enzymatic hydrolysis, starches were degraded by 20~24%, and the reducing sugar content of the instant flours increased by 79~94%. Starch digestibility was reduced after enzymatic hydrolysis, however, the estimated glycemic index (GI) increased to 65.1 ~ 77.7 due to the combined effect of increased reducing sugar and decreased starch hydrolysis in the instant flours. The chestnuts treated by 'boiling + enzymes' are still a medium GI food. These findings give guidance for the development of low GI cooked and instant chestnut flour.

Can platelet-rich plasma enhance the effect of meniscus repair? A meta-analysis of randomized controlled trials Platelet-rich plasma and meniscus repair.

BACKGROUND: Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, but some studies have suggested different views on the role of PRP. PURPOSE: To determine whether PRP can enhance the effect of meniscus repair with respect to pain reduction and improved functionality and cure rate in patients with meniscus injury. METHODS: By searching PubMed, EMBASE, Cochrane Library databases, clinicaltrials.gov, and the CNKI database from their inception till December 1, 2020, we performed a meta-analysis of RCTs reporting the results of the Pain Visual Analog Scale (VAS), the pain of Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, the International Knee Documentation Committee (IKDC), healing rate, and adverse events. The risk of bias is assessed using Cochrane's collaborative tools. The summary results are expressed with effect size and 95% confidence interval, and sensitivity were performed. RESULTS: The meta-analysis included 9 RCTs and 345 patients. In general, compared with the control group, used of PRP during meniscus surgery significantly improved the pain (SMD: -0.95, p < 0.00001,95% CI: -1.22 to -0.69, I2 = 42%) and knee joint function (SMD: 1.00, p = 0.01.95% CI: 0.22 to 1.79, I2 = 89%) of patients with meniscus injury at 6 months after treatment. However, both PRP and non-PRP showed improvements in the pain and knee joint function, with no significant difference between the groups at 1 months and beyond 12 months. The PRP enhancement technique showed benefit in improving the cure rate of meniscus repair (RR:1.44; p < 0.0001, 95% CI: 1.20-1.73). No serious adverse events were reported in any study. CONCLUSION: As an enhancement program for meniscus repair, PRP is worthy of further consideration in improving the function and pain of patients during the mid-term follow-up after surgery, and PRP can further improve the healing rate of meniscus repair. However, the evidence still needs to be interpreted carefully because of the quantity and quality of the included studies.

Preliminary Study of Vagus Nerve Magnetic Modulation in Patients with Prolonged Disorders of Consciousness.

Background: The number of patients with prolonged disorders of consciousness (pDOC) is increasing. However, its clinical treatment remains challenging. To date, no studies have reported the effect of vagus nerve modulation (VNM) using repetitive transcranial magnetic stimulation (rTMS) in patients with pDOC. We aimed to evaluate the effect of vagus nerve magnetic modulation (VNMM) on pDOC patients. Methods: We performed VNMM in 17 pDOC patients. The Revised Coma Recovery Scale (CRS-R), Glasgow scale (GCS), somatosensory evoked potentials (SEP) and brainstem auditory evoked potentials (BAEP) were assessed before and after treatment. Results: Both CRS-R and GCS results showed significant improvement in p DOC patients after VNMM treatment. The CRS-R improved from 7.88 ± 2.93 to 11.53 ± 4.94. The GCS score also improved from 7.65 ± 1.9 to 9.18 ± 2.65. The number of BAEP grades I increased from 3 to 5 after treatment. The number of BAEP grades I increased from 3 to 5, grade II increased by 1, and grade III decreased from 4 to 1. Conclusion: This study provides a preliminary indication of the potential of VNMM in the rehabilitation of pDOC patients. It provides the basis for a Phase 2 or Phase 3 study of VNMM in patients with pDOC.

Comparison of the effects of autologous and allogeneic purified platelet-rich plasma on cartilage damage in a rabbit model of knee osteoarthritis.

Background: Purified platelet-rich plasma (P-PRP) is gradually being used in the treatment of osteoarthritis (OA), and its sources are mainly divided into autologous and allogeneic blood. However, it is unclear whether autologous PRP is more effective or allogeneic PRP is superior. Objective: In this study, autologous and allogeneic P-PRP was injected at early stage of KOA in rabbits, and then the differences in the efficacy of the two P-PRPs against KOA were compared from several perspectives, including pathological histology and immunohistochemistry. Method: Experimental rabbits were divided into normal group (n = 8), model group (n = 8), autologous P-PRP group (n = 8), and allogeneic P-PRP group (n = 8) using a random number table method. The normal and model groups did not receive any treatment, and the autologous P-PRP and allogeneic P-PRP groups received intra-articular injections of autologous and allogeneic P-PRP, respectively, to observe the changes in the gross specimens of the knee joints of the experimental rabbits in each group. The histopathological changes of chondrocytes were also observed by HE-stained sections of articular cartilage, and the expression of chondrocytes Bone morphogenetic protein-2 (BMP-2) and Sox9 were detected by immunohistochemistry. Results: Compared with the allogeneic P-PRP group, the differences were statistically significant (P < 0.05) in the gross specimens and pathological histological findings in the autologous PRP group. Immunohistochemical results showed that the expression of BMP-2 and Sox9 was elevated in both the autologous P-PRP group and the allogeneic P-PRP group compared with the model group, and the expression of BMP-2 was higher in the autologous P-PRP group than in the allogeneic P-PRP group, with a statistically significant difference (P < 0.05), while there was no difference in the expression of Sox9 between the two groups (P > 0.05). Conclusion: Intra-articular injection of autologous P-PRP activated the expression of BMP-2 and Sox9 in chondrocytes and effectively improved KOA cartilage repair and reduced bone redundancy and joint fluid formation, and its efficacy was superior to that of intra-articular injection of allogeneic P-PRP.

Effect of platelet-rich plasma on meniscus repair surgery: A meta-analysis of randomized controlled trials.

BACKGROUND: Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, but some studies have suggested different views on the role of PRP. Therefore, a meta-analysis was conducted to determine whether PRP can enhance the effect of meniscus repair with respect to pain reduction and improved functionality and cure rate in patients with meniscus injury. METHODS: PubMed, EMBASE, Cochrane Library Databases, clinicaltrials.gov, and the CNKI Database were searched from their inception till December 1, 2020. The RCTs reporting the outcomes of the Pain Visual Analog Scale (VAS), Lysholm score, healing rate, and adverse events were included. The risk of bias was assessed using Cochrane collaborative tools. The simulated results were expressed with effect size and 95% confidence interval, and sensitivity and subgroup analysis were performed. RESULTS: The meta-analysis included 8 RCTs and 431 participants. Compared with the control group, use of PRP during meniscus surgery significantly improved the VAS (SMD: -0.40, P = .002, 95%CI: -0.66 to -0.15) and Lysholm score (MD: 3.06, P < .0001, 95%CI: 1.70-4.42) of meniscus injury, but the PRP showed no benefit in improving the healing rate of meniscus repair (RR: 1.22, P = .06, 95%CI: 0.99-1.51). No serious adverse events were reported in any study. CONCLUSIONS: PRP is safe and effective in improving the effect of meniscus repair as augment. High quality RCTs with long follow-up and definitive results are needed in the future to confirm the use and efficacy of PRP in meniscus tears.

Influence of moisture and amylose on the physicochemical properties of rice starch during heat treatment.

Moisture and amylose are important factors affecting the quality of heat-treated starches. The amylose content in heat-treated rice starch increased as moisture content (MC) increased from 8% to 30%, but decreased at MC of 70%. With the increase of MC, the paste transmittance, gelatinization temperature, and digestibility of starch increased, whereas the swelling power and enthalpy decreased. The long- and short-range molecular order and the digestive properties of starch with MC ≤ 30% changed moderately, but high MC (70%) gelatinized the starch and drastically changed the physicochemical properties. High amylose content in rice starch led to low long- and short-range molecular order, swelling power, and gelatinization temperature, but increased resistant starch. The results indicated that 30% of MC separates effects of heat treatment of starch, where low MC (≤30%) and high amylose lowers digestibility, which is beneficial for diabetics, while high MC (>30%) promotes solubility and transparency.

Inhibitory effect of chestnut (Castanea mollissima Blume) inner skin extract on the activity of α-amylase, α-glucosidase, dipeptidyl peptidase IV and in vitro digestibility of starches.

This study aimed to investigate the inhibitory effect of chestnut inner skin extract (CISE) on the activity of postprandial blood sugar-related enzymes. In total, 12 flavonoids were identified by HPLC-TOF-MS. CISE showed strong and weak inhibition on α-amylase and α-glucosidase, with the IC50 of 27.2 and 2.3 µg/mL, respectively. The inhibition modes of CISE against α-amylase and α-glucosidase were mixed-type and non-competitive type, respectively. Epicatechin gallate noncompetitively inhibited α-amylase, α-glucosidase and dipeptidyl peptidase IV (DPP-IV). Analysis by ultraviolet-visible spectroscopy, fluorescence spectroscopy and circular dichroism suggested that flavonoids altered the hydrophobicity and microenvironment of these enzymes. CISE decreased the starch bioavailability by reducing the enzymatic hydrolysis rate and increasing the fraction of undigested starch. The extract reduced the rapidly digestible starch and increased the resistant starch after incorporation into A-, B- or C- crystallinity starch. Thus, the chestnut inner skin is a useful resource for regulating postprandial blood sugar level.

Influence of amylose on the pasting and gel texture properties of chestnut starch during thermal processing.

The quality of starchy foods is highly correlated with their amylose content. After boiling or roasting, the amylose content in cooked chestnut starch decreased to 16.6-26.8%, which was significantly lower than that of raw chestnut starch (26.6-28.1%). After cooking, the pasting temperature and peak time increased, while the breakdown, peak viscosity, final viscosity and setback of starches decreased. The amylose content showed a negative correlation with the pasting characteristics of the starch gel of cooked chestnut. The amylose content negatively affected the springiness and chewiness of starch gel, and positively correlated with its cohesiveness and stringiness. The freeze-thaw stability of starch from cooked chestnut was lower than that of raw chestnut. The amylose content was negatively correlated with freeze-thaw stability and positively correlated with the solubility of starch. The results demonstrated that amylose plays an important role in the pasting and gel texture properties of starch during cooking.