Objective
To evaluate the efficacy and safety of Jianpi Jieyu Decoction (JJD) for treating patients with mild-to-moderate depression of Xin (Heart)-Pi (Spleen) deficiency (XPD) syndrome.
Methods
In ...this multi-center, randomized, controlled study, 140 patients with mild-to-moderate depression of XPD syndrome were included from Xiyuan Hospital of China Academy of Chinese Medical Sciences and Botou Hospital of Traditional Chinese Medicine from December 2017 to December 2019. They were randomly divided into JJD group and paroxetine group by using a random number table, with 70 cases in each group. The patients in the JJD group were given JJD one dose per day (twice daily at morning and evening, 100 mL each time), and the patients in the paroxetine group were given paroxetine (10 mg/d in week 1; 20 mg/d in weeks 2–6), both orally administration for a total of 6 weeks. The primary outcome was the change of 17-item Hamilton Depression Rating Scale (HAMD-17) score at week 6 from baseline. The secondary outcomes included the Hamilton Anxiety Scale (HAMA) score, Traditional Chinese Medicine Symptom Scale (TCMSS), and Clinlcal Global Impression (CGI) scores at the 2nd, 4th, and 6th weekends of treatment, HAMD-17 response (defined as a reduction in score of >50%) and HAMD-17 remission (defined as a score of ⩽7) at the end of the 6th week of treatment. Adverse events (AEs) were also recorded.
Results
From baseline to week 6, the HAMD-17 scores decreased 10.2 ± 4.0 and 9.1 ± 4.9 points in the JJD and paroxetine groups, respectively (
P
=0.689). The HAMD-17 response occurred in 60% of patients in the JJD group and in 50% of those in the paroxetine group (
P
=0.292); HAMD-17 remission occurred in 45.7% and 30% of patients, respectively (
P
=0.128). The differences of CGI scores at the 6th week were not statistically significant (
P
>0.05). There were significant differences in HAMD-17 scores between the two groups at 2nd and 4th week (
P
=0.001 and
P
=0.014). The HAMA scores declined 8.1 ± 3.0 and 6.9 ± 4.3 points from baseline to week 6 in the JJD and paroxetine groups, respectively (
P
=0.905 between groups). At 4th week of treatment, there was a significant difference in HAMA between the two groups (
P
=0.037). TCMSS decreased 11.4 ± 5.1, and 10.1 ± 6.8 points in the JJD and paroxetine groups, respectively (
P
=0.080 between groups). At the 6th week, the incidence of AEs in the JJD group was significantly lower than that in the paroxetine group (7.14% vs. 22.86%,
P
<0.05).
Conclusion
Compared with paroxetine, JJD was associated with a significantly lower incidence of AEs in patients with mild-to-moderate depression of XPD syndrome, with no difference in efficacy at 6 weeks. (Trial registration No. ChiCTR2000040922)
Cyanobacteria are of special concern because they proliferate in eutrophic water bodies worldwide and affect water quality. As an ancient photosynthetic microorganism, cyanobacteria can survive in ...ecologically diverse habitats because of their capacity to rapidly respond to environmental changes through a web of complex signaling networks, including using second messengers to regulate physiology or metabolism. A ubiquitous second messenger, bis-(3',5')-cyclic-dimeric-guanosine monophosphate (c-di-GMP), has been found to regulate essential behaviors in a few cyanobacteria but not Microcystis, which are the most dominant species in cyanobacterial blooms. In this study, comparative genomics analysis was performed to explore the genomic basis of c-di-GMP signaling in Microcystis aeruginosa.
Proteins involved in c-di-GMP metabolism and regulation, such as diguanylate cyclases, phosphodiesterases, and PilZ-containing proteins, were encoded in M. aeruginosa genomes. However, the number of identified protein domains involved in c-di-GMP signaling was not proportional to the size of M. aeruginosa genomes (4.97 Mb in average). Pan-genome analysis showed that genes involved in c-di-GMP metabolism and regulation are conservative in M. aeruginosa strains. Phylogenetic analysis showed good congruence between the two types of phylogenetic trees based on 31 highly conserved protein-coding genes and sensor domain-coding genes. Propensity for gene loss analysis revealed that most of genes involved in c-di-GMP signaling are stable in M. aeruginosa strains. Moreover, bioinformatics and structure analysis of c-di-GMP signal-related GGDEF and EAL domains revealed that they all possess essential conserved amino acid residues that bind the substrate. In addition, it was also found that all selected M. aeruginosa genomes encode PilZ domain containing proteins.
Comparative genomics analysis of c-di-GMP metabolism and regulation in M. aeruginosa strains helped elucidating the genetic basis of c-di-GMP signaling pathways in M. aeruginosa. Knowledge of c-di-GMP metabolism and relevant signal regulatory processes in cyanobacteria can enhance our understanding of their adaptability to various environments and bloom-forming mechanism.
The crystal structure of Cd-MOF-74 was obtained for the first time that possesses high sensitivity for the detection of copper ions from water and simulated biological fluids based on changes in ...luminescent intensity. Furthermore, Cd-MOF-74 could selectively remove Cu
from simulated biological fluids that contain Mg
, Co
, Zn
, Fe
, Ni
, Na
, and K
. The adsorption capacity of this adsorbent for copper ions reached 189.5 mg g
and it quickly adsorbed copper ions within 10 minutes under 10 ppm Cu
in the simulated biological system. XPS, PXRD, and gas adsorption measurements revealed that this high sensitivity and selectivity of Cd-MOF-74 resulted from the partial substitution of Cd
by Cu
in the framework. Although many MOF materials have been employed for sensor or selective adsorption of Cu
, Cd-MOF-74 is the first example of MOFs showing both capabilities in simulated biological fluids, which represents a pioneering work that extends the applications of MOF materials in the biological field.
Preclinical and clinical studies have suggested a neuroprotective effect of remote ischemic conditioning (RIC), which involves repeated occlusion/release cycles on bilateral upper limb arteries; ...however, robust evidence in patients with ischemic stroke is lacking.
To assess the efficacy of RIC for acute moderate ischemic stroke.
This multicenter, open-label, blinded-end point, randomized clinical trial including 1893 patients with acute moderate ischemic stroke was conducted at 55 hospitals in China from December 26, 2018, through January 19, 2021, and the date of final follow-up was April 19, 2021.
Eligible patients were randomly assigned within 48 hours after symptom onset to receive treatment with RIC (using a pneumatic electronic device and consisting of 5 cycles of cuff inflation for 5 minutes and deflation for 5 minutes to the bilateral upper limbs to 200 mm Hg) for 10 to 14 days as an adjunct to guideline-based treatment (n = 922) or guideline-based treatment alone (n = 971).
The primary end point was excellent functional outcome at 90 days, defined as a modified Rankin Scale score of 0 to 1. All end points had blinded assessment and were analyzed on a full analysis set.
Among 1893 eligible patients with acute moderate ischemic stroke who were randomized (mean SD age, 65 10.3 years; 606 women 34.1%), 1776 (93.8%) completed the trial. The number with excellent functional outcome at 90 days was 582 (67.4%) in the RIC group and 566 (62.0%) in the control group (risk difference, 5.4% 95% CI, 1.0%-9.9%; odds ratio, 1.27 95% CI, 1.05-1.54; P = .02). The proportion of patients with any adverse events was 6.8% (59/863) in the RIC group and 5.6% (51/913) in the control group.
Among adults with acute moderate ischemic stroke, treatment with remote ischemic conditioning compared with usual care significantly increased the likelihood of excellent neurologic function at 90 days. However, these findings require replication in another trial before concluding efficacy for this intervention.
ClinicalTrials.gov Identifier: NCT03740971.
Background: Cervical cancer is the fourth most common cancer in women, with an estimated 600,000 new cases and 340,000 deaths worldwide in 2020. However, there remains limited understanding of the ...association between individual socioeconomic status, clinical characteristics, and health-related quality of life (HRQoL) of women with cervical precancerous lesions. This study investigates socioeconomic and clinical variations in HRQoL of women with cervical precancerous lesions and cervical cancer in Yunnan Province, China. Methods: The present study employed a cross-sectional survey design. An EuroQol Five Dimensions Five Level (EQ-5D-5L) questionnaire was used to assess HRQoL of 400 patients with cervical precancerous lesions and cervical cancer in Yunnan Province, China, from 2019 to 2020. Analysis of variance (ANOVA) and independent samples t-tests were performed to identify the independent variables associated with EQ-5D-5L utility scores and visual analogue scale (VAS) scores. Predictors of utility scores were confirmed using a Tobit regression model. Results: The mean EQ-5D-5L utility scores of cervical precancerous lesions and cervical cancer patients was 0.939 (standard deviation (SD), 0.104), and the mean VAS score was 80.84 (SD, 16.551). Patients aged 40–59 years (β = –0.037, p = 0.005), patients who were not aware of the human papillomavirus (HPV) vaccine (β = –0.032, p = 0.004), and patients who underwent radical hysterectomy (β = –0.036, p = 0.006) had significantly lower utility scores, whereas having high monthly household income (β = 0.023, p = 0.033) was significantly associated with higher EQ-5D-5L utility scores. Age (p = 0.023) was statistically significant in differences in patients’ VAS scores. Anxiety/depression was the most frequently reported issue (35.75%) among participants. Conclusions: Future cervical cancer prevention and treatment guidelines should focus on low-income women, women aged 40–59 years, and those lacking knowledge about cervical cancer prevention.
The distribution and chemical speciation of arsenic (As) in different sized atmospheric particulate matters (PMs), including total suspended particles (TSP), PM10, and PM2.5, collected from Baoding, ...China were analyzed. The average total mass concentrations of As in TSP, PM10, and PM2.5 were 31.5, 35.3, and 54.1 µg/g, respectively, with an order of PM2.5 >PM 10 > TSP, revealing that As is prone to accumulate on fine particles. Due to the divergent toxicities of different As species, speciation analysis of As in PMs is further conducted. Most of previous studies mainly focused on inorganic arsenite (iAsIII), inorganic arsenate (iAsV), monomethylarsonate (MMA), and dimethylarsinate (DMA) in PMs, while the identification and sensitive quantification of trimethylarsine oxide (TMAO) were rarely reported. In this study, a high-performance liquid chromatography coupled to inductively coupled plasma mass spectrometry system was optimized for As speciation including TMAO in PMs. An anion exchange column was used to separate MMA, DMA and iAsV, while a cation exchange column to separate TMAO and iAsIII. Results showed that iAsV was the dominate component in all the samples, corresponding to a portion of 79.2% ± 9.3% of the total extractable species, while iAsIII, TMAO and DMA made up the remaining 21%. Our study demonstrated that iAsIII accounted for about 14.4% ± 11.4% of the total extracted species, with an average concentration of 1.7 ± 1.6 ng/m3. It is worth noting that TMAO was widely present in the samples (84 out of 97 samples), which supported the assumption that TMAO was ubiquitous in atmospheric particles.
Display omitted
Display omitted
•The modified O/O emulsion solvent evaporation method produces high-yield florfenicol instant microparticles.•Improving the oral bioavailability of florfenicol by developing ...florfenicol instant microparticles.•Polymer poloxamer 188 covers the surface of the microparticles to improve the solubility of the poorly soluble drug florfenicol.
Surfactants can improve the hydrophobicity of poorly water-soluble drugs and increase the stability of microparticles by reducing surface tension. This study describes that surfactant-engineered florfenicol instant microparticles (FIMs) increase bioavailability through a micellar solubilization mechanism. The FIMs were prepared by a modified emulsification method, and the optimal prescription was obtained by a combination of single factor investigation and response surface methodology. The microparticles prepared in this study reduce the polymer materials while increasing the drug content. FIM has a smaller particle size and modification of poloxamer, resulting in better solubility and higher bioavailability. The in vitro solubility of FIM is 1.43 times higher than that of the bulk drug, and the dissolution equilibrium can be achieved in 10 minutes. Compared with florfenicol, FIM showed a decrease in Tmax in the plasma concentration curve, with a peak concentration of 1.43 times and an area of 1.41 times. Considering the advantages of in vitro/in vivo performance and ease of preparation, FIMs may have great application prospects in pharmacy research.
The rapid development of intelligent technology puts forward higher requirements for portable and flexible energy storage devices. In this paper, nitrogen and oxygen co-doped graphene quantum dots ...were used as electrode material of flexible planar micro-supercapacitors (PMSCs) and the electrode/gap width was 6 μm/2 μm. Electrochemical performance of the flexible devices was investigated at different bending angles with scan rates of 0.01 V/s to 10000 V/s. When bending 75°, the area capacitance and the energy density were 2.61 μF cm
−2
and 0.36 nWh cm
−2
at the scan rate of 0.01 V/s, and the power density was 173.66 μW cm
−2
at the scan rate of 10000 V/s. When bending 0°, the area capacitance and energy density were the same as that when bending 75°, and the power density was 198.36 μw cm
−2
. The output current of the two flexible devices was 200 μA when bending 75° and 250 μA when bending 0°. The capacitance retention was 87.5% when bending 75° and 90.4% when bending 0° at the scan rate of 500 V/s after 10000 cycles. The results indicated that the bending has little effect on the electrochemical performance of the flexible PMSCs.
Patients with coronary chronic total occlusion (CTO) require effective antiplatelet therapy after percutaneous coronary intervention (PCI). Ticagrelor has more pronounced platelet inhibition than ...clopidogrel. However, the most appropriate dose of ticagrelor in East Asian populations remains unclear.
We compared ticagrelor (180 mg loading dose, 90 mg twice daily thereafter and 120 mg loading dose, 60 mg twice daily thereafter) and clopidogrel (300 mg loading dose, 75 mg daily thereafter) for prevention of cardiovascular events in 525patients with CTO undergoing PCI.
The rate of in-hospital major adverse cardiac and cerebral events (MACCE) was not different between the groups. At 1-year follow-up, target vessel revascularization (TVR) in both ticagrelor groups were significantly lower than that in the clopidogrel group (p = 0.047); TVR was significantly decreased in 60 mg ticagrelor compared to standard dose clopidogrel (p = 0.046). At 1-year follow-up, overall MACCE in both ticagrelor groups were significantly lower than that in the clopidogrel group (p = 0.023). Kaplan-Meier analysis showed MACCE-free survival was significantly higher in both ticagrelor groups than in the clopidogrel group (p = 0.024). During hospitalization, minor bleeding was significant increased in the 90 mg ticagrelor group (p = 0.021). At 1-year follow-up, risk of major and minor bleeding were significantly increased in the 90 mg ticagrelor group.
In East Asian patients with CTO undergoing PCI, 60 mg ticagrelor was as effective as 90 mg, at the same time significantly reduced risk of bleeding.
Anaplasma capra is an emerging tickborne human pathogen initially recognized in China in 2015; it has been reported in ticks and in a wide range of domestic and wild animals worldwide. We describe ...whole-genome sequences of 2 A. capra strains from metagenomic sequencing of purified erythrocytes from infected goats in China. The genome of A. capra was the smallest among members of the genus Anaplasma. The genomes of the 2 A. capra strains contained comparable G+C content and numbers of pseudogenes with intraerythrocytic Anaplasma species. The 2 A. capra strains had 54 unique genes. The prevalence of A. capra was high among goats in the 2 endemic areas. Phylogenetic analyses revealed that the A. capra strains detected in this study were basically classified into 2 subclusters with those previously detected in Asia. Our findings clarify details of the genomic characteristics of A. capra and shed light on its genetic diversity.
PDF
