Background and Purpose As of 5 March 2021, coronavirus disease 2019 (COVID-19) has infected more than 116 million people worldwide, with over 91 million convalescent patients. A decrease in function of multiple organs has been reported in recovering patients. In China, traditional Chinese medicine (TCM) is recommended to treat patients in the rehabilitation period; however, its efficacy and safety still need to be confirmed. Experimental Approach We conducted a multicentre, double-blind, randomised controlled trial that recruited patients with COVID-19 during the rehabilitation period. In total, 131 patients were randomly divided into two groups: 66 in the Bufei Huoxue capsules (BFHX)-treated group and 65 in the control group. BFHX was administered orally three times a day (1.4g/dose) for 90 days, and the control group was administered placebo for 90 days. The primary endpoint was to evaluate improvements in fatigue symptoms and exercise tolerance. Key Results After three months of treatment, the six-minute walk distance (6MWD) of the BFHX-treated group was significantly longer than that of the control group, compared to baseline. The Fatigue Assessment Inventory (FAI) was lower in the BFHX-treated group than in the control group. Adverse event rates were higher in the BFHX-treated group, but there was no statistical difference between groups. Conclusions and Implications BFHX may have strong rehabilitative effects on patients recovering from COVID-19 in terms of improvements in physiological activities, such as fatigue symptoms and exercise tolerance. The drug has proven to have favourable safety and effectiveness profiles.
Abstract Background Patients with pulmonary hypertension (PH) and chronic obstructive pulmonary disease (COPD) have an increased risk of disease exacerbation and decreased survival. We aimed to develop and validate a non‐invasive nomogram for predicting COPD associated with severe PH and a prognostic nomogram for patients with COPD and concurrent PH (COPD–PH). Methods This study included 535 patients with COPD–PH from six hospitals. A multivariate logistic regression analysis was used to analyse the risk factors for severe PH in patients with COPD and a multivariate Cox regression was used for the prognostic factors of COPD–PH. Performance was assessed using calibration, the area under the receiver operating characteristic curve and decision analysis curves. Kaplan–Meier curves were used for a survival analysis. The nomograms were developed as online network software. Results Tricuspid regurgitation velocity, right ventricular diameter, N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), the red blood cell count, New York Heart Association functional class and sex were non‐invasive independent variables of severe PH in patients with COPD. These variables were used to construct a risk assessment nomogram with good discrimination. NT‐proBNP, mean pulmonary arterial pressure, partial pressure of arterial oxygen, the platelet count and albumin were independent prognostic factors for COPD–PH and were used to create a predictive nomogram of overall survival rates. Conclusions The proposed nomograms based on a large sample size of patients with COPD–PH could be used as non‐invasive clinical tools to enhance the risk assessment of severe PH in patients with COPD and for the prognosis of COPD–PH. Additionally, the online network has the potential to provide artificial intelligence‐assisted diagnosis and treatment. Highlights A multicentre study with a large sample of chronic obstructive pulmonary disease (COPD) patients diagnosed with PH through right heart catheterisation. A non‐invasive online clinical tool for assessing severe pulmonary hypertension (PH) in COPD. The first risk assessment tool was established for Chinese patients with COPD–PH.
Abstract Background Cancer chemoprevention is a new approach in cancer prevention, in which chemical agents are used to prevent cancer in normal and/or high-risk populations. Although chemoprevention has shown promise in some epithelial cancers, currently available preventive agents are limited and the agents are costly, generally with side effects. Natural products, such as grape seed, green tea, and certain herbs have demonstrated anti-cancer effects. To find a natural product that can be used in chemoprevention of cancer, we tested Arizona cactus fruit solution, the aqueous extracts of cactus pear, for its anti-cancer effects in cultured cells and in an animal model. Method Aqueous extracts of cactus pear were used to treat immortalized ovarian and cervical epithelial cells, as well as ovarian, cervical, and bladder cancer cells. Aqueous extracts of cactus pear were used at six concentrations (0, 0.5, 1, 5, 10 or 25%) to treat cells for 1, 3, or 5 days. Growth inhibition, apoptosis induction, and cell cycle changes were analyzed in the cultured cells; the suppression of tumor growth in nude mice was evaluated and compared with the effect of a synthetic retinoid N-(4-hydroxyphernyl) retinamide (4-HPR), which is currently used as a chemoprevention agent. Immunohistochemistry staining of tissue samples from animal tumors was performed to examine the gene expression. Results Cells exposed to cactus pear extracts had a significant increase in apoptosis and growth inhibition in both immortalized epithelial cells and cancer cells in a dose- and time-dependent manner. It also affected cell cycle of cancer cells by increasing G1 and decreasing G2 and S phases. Both 4-HPR and cactus pear extracts significantly suppressed tumor growth in nude mice, increased annexin IV expression, and decreased VEGF expression. Conclusion Arizona cactus pear extracts effectively inhibited cell growth in several different immortalized and cancer cell cultures, suppressed tumor growth in nude mice, and modulated expression of tumor-related genes. These effects were comparable with those caused by a synthetic retinoid currently used in chemoprevention trials. The mechanism of the anti-cancer effects of cactus pear extracts needs to be further studied.
Multiple abnormalities of bone morphogenetic protein (BMPs) signaling are implicated in the process of pulmonary arterial hypertension (PAH). BMP4 plays an important role during the process of pulmonary arterial remodeling and mutant of the principle BMP4 receptor, BMP receptors II (BMPRII), is found to associate with the development of PAH. However, the likely mechanism defining the contribution of BMPRII to BMP4 mediated signaling in pulmonary arterial smooth muscle cells (PASMCs) remains comprehensively unclear. We previously found that enhanced store operated calcium entry (SOCE) and basal intracellular calcium concentration [Ca2+]i were induced by BMP4 via upregulation of TRPC1, 4 and 6 expression in PASMCs, and that BMP4 modulated TRPC channel expression through activating p38MAPK and ERK1/2 signaling pathways. In this study, BMPRII siRNA was used to knockdown BMPRII expression to investigate whether BMP4 upregulates the expression of TRPC and activating Smad1/5/8, ERK1/2 and p38MAPK pathway via BMPRII in distal PASMCs. Our results showed that knockdown of BMPRII: 1) attenuated BMP4 induced activation of P-Smad1/5/8, without altering BMP4 induced P-p38MAPK and P-ERK1/2 activation in PASMCs; 2) did not attenuate the BMP4-induced TRPC1, 4 and 6 expression; 3) did not affect BMP4-enhanced SOCE and basal [Ca2+]i. Thus, we concluded that BMP4 activated Smad1/5/8 pathway is BMPRII-dependent, while the BMP4 - ERK/p-P38 - TRPC - SOCE signaling axis are likely mediated through other receptor rather than BMPRII.
Summary Context Graves’ orbitopathy ( GO ) is a potentially sight‐threatening disease for which currently available medical therapy is not reliably successful. Mycophenolate mofetil ( MMF ) is a selective immunosuppressant used widely in many autoimmune diseases. Preliminary studies have shown that MMF is effective in the treatment of active GO . Objective To evaluate the efficacy and safety of MMF in patients with active moderate‐to‐severe GO . Patients One hundred and 74 patients with active moderate‐to‐severe GO were randomized to receive either MMF or glucocorticoids ( GC ). Main Outcome Measures The primary outcome was overall response at the 12th and 24th weeks; the outcome assessments included clinical activity score ( CAS ), soft tissue involvement, pain, visual acuity, proptosis, diplopia and reduction in eye movements. The secondary outcome was changes in those individual parameters. Adverse effects were recorded at each visit. Results A greater overall response rate was found in the MMF group compared with the GC group at the 24th week (91·3% vs 67·9%, P = 0·000). MMF therapy showed a better CAS response than GC (92·5% vs 70·5% improved, P < 0·05). Patients treated with MMF showed a significantly improved rate of diplopia and proptosis than patients treated with GC at the 24th week (90·4% and 68·8% improved, respectively). Disease reactivation was not observed in the patients treated with MMF but was observed in five patients after GC therapy. Adverse events occurred in 4 of 80 patients treated with MMF (5%), all of which were mild to moderate. A severe adverse event was only observed in one patient treated with GC but not at all in patients treated with MMF . Conclusion Compared with GC treatment, MMF therapy is more effective and safer for patients with active moderate‐to‐severe GO .
Objective To investigate the effect of renal artery revascularization through renal artery stenting(PTRAS)on blood pressure in patients with renal artery stenosis. Methods During April 2000 through May 2005 110 cases of renal artery stenosis received PTRAS and followed up for at least 1 year with blood pressure measurements pre-and 1 year post-PTRAS. Results The technical success rate was 100% for all 110 cases. The renal artery stenosis were decreased from 60% ～ 100% before PTRAS to 0% ～ 15% after the stent placement. There was significant difference between blood pressure pre-and 1 year post PTRAS. Systolic pressures decreased from(153 ± 32) mmHg to(131 ± 27) mmHg and diastolic pressures from(87 ± 19) mmHg to(75 ± 19) mmHg. The administration of antihypertensive diugs reduced from(2.6 ± 0.9 ) sorts to(1.9 ± 0.9) sorts. Conclusions PTRAS revascularization is an effective procedure for blood pressure control in renal vascular hypertension during one year follow up.
Objective: To clarify Radix et Caulis Acanthopanacis Senticosi decoction (DAS) via Chitosan Flocculation. Methods: The operating conditions were optimized and the results were compared with that of ethanol subsiding. Economic budget was carried out. Results: The optimized conditions were: 28.6mL/L Chitosan flocculating agent was added at 30 °C and pH 5.36. Conclusion: Chitosan coagulating method was economic and efficient on the clarification of DAS and can replace ethanol subsiding method.
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