SBC (Sanhuang Xiexin Tang combined with Baihu Tang plus Cangzhu) alleviates NAFLD by enhancing mitochondrial biogenesis and ameliorating inflammation in obese patients and mice / 中国天然药物

In the context of non-alcoholic fatty liver disease (NAFLD), characterized by dysregulated lipid metabolism in hepatocytes, the quest for safe and effective therapeutics targeting lipid metabolism has gained paramount importance. Sanhuang Xiexin Tang (SXT) and Baihu Tang (BHT) have emerged as prominent candidates for treating metabolic disorders. SXT combined with BHT plus Cangzhu (SBC) has been used clinically for Weihuochisheng obese patients. This retrospective analysis focused on assessing the anti-obesity effects of SBC in Weihuochisheng obese patients. We observed significant reductions in body weight and hepatic lipid content among obese patients following SBC treatment. To gain further insights, we investigated the effects and underlying mechanisms of SBC in HFD-fed mice. The results demonstrated that SBC treatment mitigated body weight gain and hepatic lipid accumulation in HFD-fed mice. Pharmacological network analysis suggested that SBC may affect lipid metabolism, mitochondria, inflammation, and apoptosis-a hypothesis supported by the hepatic transcriptomic analysis in HFD-fed mice treated with SBC. Notably, SBC treatment was associated with enhanced hepatic mitochondrial biogenesis and the inhibition of the c-Jun N-terminal kinase (JNK)/nuclear factor-kappa B (NF-κB) and extracellular signal-regulated kinase (ERK)/NF-κB pathways. In conclusion, SBC treatment alleviates NAFLD in both obese patients and mouse models by improving lipid metabolism, potentially through enhancing mitochondrial biogenesis. These effects, in turn, ameliorate inflammation in hepatocytes.

Clinical features of patients with severe dengue in Guangdong Province from 2013 to 2019 / 中华传染病杂志

Objective:To analyze the clinical features of patients with severe dengue (SD) in Guangdong Province, and to improve the understanding of the diagnosis and treatment of SD in China.Methods:The clinical data, laboratory examination and etiological test results of 257 SD cases from 29 dengue fever designated hospitals in Guangdong Province from January 1, 2013 to December 31, 2019 were respectively collected. The relevant indicators of the criteria for severe organ involvement were quantified. Logistic regression analysis was performed to analyze the risk factors for the development of multiple organ failure in SD patients.Results:Among the 257 SD patients, age was (64.1±20.1) years old, with 65.4%(168/257) of them ≥60 years old, 142 were male and 115 were female. One hundred and fifty-two (59.1%) patients had underlying conditions, including 115(44.7%) patients with hypertension. The clinical manifestations were mainly fever (98.4%(253/257)), fatigue (70.0%(180/257)), cough or expectoration (44.4%(114/257)), lethargy or irritability (39.3%(101/257)), vomiting (30.4%(78/257)), abdominal pain or tenderness (20.6%(53/257)), hepatomegaly (2.3%(6/257)), bleeding tendency (59.5%(153/257)), and pleural effusion or ascites (43.6%(112/257)). Platelet count levels were decreased in 90.9%(231/254) of the cases, and 97.1%(234/241) of patients had normal or decreased hematocrit. The most common of severe manifestations were severe organ involvement (61.1%(157/257)), followed by severe bleeding (37.0%(95/257)) and severe plasma leakage (30.0%(77/257)). Severe organ involvements were more common in the kidney (27.6%(71/257)) and heart (26.8%(69/257)). Multivariate logistic regression analysis showed that age (odds ratio ( OR)=1.051, 95% confidence interval ( CI) 1.004 to 1.100, P=0.035), hypertension ( OR=5.224, 95% CI 1.272 to 21.462, P=0.022), elevated aspartate aminotransferase (AST) level ( OR=1.002, 95% CI 1.001 to 1.003, P=0.001), blood urea nitrogen (BUN) ( OR=1.050, 95% CI 1.005 to 1.098, P=0.030), and international normalized ratio (INR) ( OR=4.604, 95% CI 1.601 to 13.238, P=0.005) were risk factors for the development of multiple organ failure in SD patients. The detection results of serum samples form 113 SD patients in acute phase showed that dengue virus (DENV)-1 accounted for 89.4%(101/113), DENV-2 accounted for 9.7%(11/113), and DENV-3 accounted for 0.9% (1/113). Conclusions:Elderly and those with co-existing conditions such as hypertension in SD patients in Guangdong Province are more common. Severe organ involvement such as kidney and heart is the main cause of SD. DENV-1 infection is predominant. Significant elevated levels of AST, BUN and INR may be related to a poor prognosis.

Preliminary evidence from a multicenter prospective observational study of the safety and efficacy of chloroquine for the treatment of COVID-19

BackgroundEffective therapies are urgently needed for the SARS-CoV-2 pandemic. Chloroquine has been proved to have antiviral effect against coronavirus in vitro. In this study, we aimed to assess the efficacy and safety of chloroquine with different doses in COVID-19. MethodIn this multicenter prospective observational study, we enrolled patients older than 18 years old with confirmed SARS-CoV-2 infection excluding critical cases from 12 hospitals in Guangdong and Hubei Provinces. Eligible patients received chloroquine phosphate 500mg, orally, once (half dose) or twice (full dose) daily. Patients treated with non-chloroquine therapy were included as historical controls. The primary endpoint is the time to undetectable viral RNA. Secondary outcomes include the proportion of patients with undetectable viral RNA by day 10 and 14, hospitalization time, duration of fever, and adverse events. ResultsA total of 197 patients completed chloroquine treatment, and 176 patients were included as historical controls. The median time to achieve an undetectable viral RNA was shorter in chloroquine than in non-chloroquine (absolute difference in medians -6.0 days; 95% CI -6.0 to -4.0). The duration of fever is shorter in chloroquine (geometric mean ratio 0.6; 95% CI 0.5 to 0.8). No serious adverse events were observed in the chloroquine group. Patients treated with half dose experienced lower rate of adverse events than with full dose. ConclusionsAlthough randomised trials are needed for further evaluation, this study provides evidence for safety and efficacy of chloroquine in COVID-19 and suggests that chloroquine can be a cost-effective therapy for combating 102 the COVID-19 pandemic.

Clinical features of 41 cases of brucellosis from a hospital in Foshan of Guangdong Province from 2013 to 2016 / 中华地方病学杂志

Objective To investigate the epidemiological and clinical features of brucellosis in Foshan.Methods The epidemiological history,clinical manifestations,laboratory tests,treatment and outcomes of 41 patients with brucellosis from 2013 to 2016 in the First People's Hospital of Foshan were retrospectively analyzed.Results Brucellosis onsets occurred mainly from February to June [85.4％ (35/41)],and 58.5％ (24/41) of them had positive epidemic history.Irregular fever,rachialgia/arthralgia,fatigue and hepatosplenomegaly occurred in 29 (70.7％),20 (48.8％),19 (46.3％) and 16 (39.0％) of the patients,respectively.The C-reactive protein (hs-CRP) of patients infected with Brucella only was lower than that in patients infected also with other bacteria (26.72 vs 50.87 mg/L,Z =-2.300,P ＜ 0.05),but no significant difference of white blood cell counts (5.77 × 109/L vs 5.83 × 109/L),neutrophil (3.50 × 109/L vs 3.84 × 109/L) and procalcitonin (PCT,0.10 vs 0.14 μg/L) between the two groups were observed.The patients with positive epidemic history had lower white blood cell,neutrophil and monocyte counts than those who did not had epidemic history (4.73 × 109/Lvs 7.28 × 109/L,2.73 × 109/L vs 4.79 × 109/L,and 0.36 × 109/L vs 0.64 × 109/L;F =9.486,10.130,9.785,P ＜ 0.05).And no significant difference of lymphocyte counts,hs-CRP and PCT between the two groups were observed (1.57 × 109/L vs 1.73 × 109/L,29.30 vs 35.76 mg/L,and 0.15 vs 0.09 μg/L;P ＞ 0.05).All the cases were infected by Brucella melitensis,and 33 of them were sensitive to general antibiotics in vitro.There were 40 cases discharged after treatment,and 34 cases still needed to increase antibiotic treatment courses.Most patients had good outcomes.Conclusions In Foshan,patients with irregular fever and rachialgia or arthralgia,and no significantly increased inflammation index,should be aware of brucellosis.We should strengthen the screening of brucellosis in Foshan.

Molecular adsorbent recirculating system in treatment of severe pneumonia complicated with multipie organ dysfunction syndrome / 中华临床感染病杂志

Objective To evaluate the effect of molecular adsorbent recirculating system(MARS)in treatment of severe pneumonia complicated with multiple organ dysfunction syndrome(MODS).MethodsSeventy-five patients who were diagnosed as severe pneumonia complicated with MODS were randomly divided into MARS group,continuous renal replacement therapy(CRRT)group and routine comprehensive therapy group.Flow dynamics,respiration function,liver function and renal function,coagulation function,inflammatory mediators,and Marshall scores were measured and compared before and after the treatment. The survival curves in 60 days were also compared among three groups.Results With MARS therapy,mean heart rates,peak inspiratory airway pressure,serum TBil,plasma D-dimmer levels and Marshall score were decreased;mean artery pressure,PaO2,oxygenation index,urine output,and platelet counts were increased;the levels of proinflammatory(NO,IL-6,IL-8,TNF-α and LBP)and anti-inflammatory(IL-10 and IL-13)mediator were decreased remarkably.The differences of these indicators between MARS group and other two groups were statistically significant(P＜0.05).And after MARS therapy,respiratory rate and Cr level were decreased,while SaO2 and WBC were increased significantly(P＜0.05).The 60 day-survival rate in MARS group was 80%(20/25),36%(9/25)in routine comprehensive therapy,and 52%(13/ 25)in CRRT group(P＜0.05).Conclusion MARS therapy has better effect on severe pneumonia conplicated with MODS than routine comprehensive therapy and CRRT.