The Chinese patent medicine Tongfengding capsule for gout in adults: a systematic review of safety and effectiveness

Abstract Background Gout is a common inflammatory arthritis caused by increased serum uric acid levels. Untreated or insufficiently treated gout can lead to deposition of monosodium urate crystals in joints, cartilage, and kidneys. Although Tongfengding capsules, a Chinese patent medicine, have long been used to treat gout, their effects and safety have not been reviewed systematically. This study evaluated its efficacy and safety for gout in adults. Methods Randomized controlled trials involving Tongfengding capsule for gout in adults were searched from PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CBM, CNKI, and VIP databases, and analyzed using the Cochrane Handbook criteria. The primary outcome measures were the total effective rate. The secondary outcome measures including the blood uric acid (BUA), 24-h urinary total protein (24-h UTP), blood urea nitrogen (BUN), interleukin (IL)-6, IL-8, tumor necrosis factor-alpha (TNF-α) and adverse effects. The risk of bias was evaluated in all included studies. RevMan ver. 5.3.5 and GRADE profiler was used for data analysis and assessing the quality of evidence, respectively. Results Six studies (n = 607 Chinese participants) were included. Tongfengding capsules plus conventional treatment significantly increased the total effective rate (RR 1.21, 95% CI 1.11-1.33), while reducing the BUA (MD − 66.05 μmol/L, 95% CI − 81.26 to − 50.84), 24-h UTP (MD − 0.83 g/24 h, 95% CI − 0.96 to − 0.70), BUN (MD − 0.90 mmol/L, 95% CI − 1.60 to − 0.20), IL-6 (MD − 6.99 ng/L, 95% CI − 13.22 to − 0.75), IL-8 (MD − 12.17 ng/L, 95% CI − 18.07 to − 6.27), TNF-α (MD − 8.50 ng/L, 95% CI − 15.50 to − 1.51), and adverse effects (RR 0.21, 95% CI 0.04-0.95). Conclusion Tongfengding capsules plus conventional treatment is safe and beneficial for adults with gout compared with conventional treatment.

circ_0001821 regulates the proliferation, apoptosis, migration and invasion of cutaneous squamous cell carcinoma A431 cells by targeting miR-203 / 中国肿瘤生物治疗杂志

@#[摘 要] 目的： 探讨circ_0001821通过靶向miR-203调控皮肤鳞状细胞癌（cutaneous squamous cell carcinoma，CSCC）A431细胞增殖、凋亡、迁移及侵袭的分子机制。方法：选取2018年2月至2019年8月海南医学院第二附属医院收治的39例CSCC患者的癌及配对癌旁组织，以及人CSCC细胞系A431，用qPCR法检测CSCC癌和癌旁组织中circ_0001821的表达水平。利用脂质体转染技术，分别将si-circ_0001821、si-NC、miR-203 mimic、miR-NC、si-circ_0001821与anti-miR-NC、si-circ_0001821与anti-miR-203转染至A431细胞，用qPCR法检测转染细胞中circ_0001821和miR-203的表达水平，MTT法、流式细胞术和Transwell实验分别检测A431细胞的增殖、凋亡、迁移及侵袭能力，WB法检测细胞中增殖、凋亡、迁移及侵袭相关蛋白的表达水平。通过Circinteractome数据库预测circ_0001821与miR-203存在结合位点，双荧光素酶报告基因实验验证circ_0001821与miR-203的靶向关系。结果：CSCC组织中circ_0001821的表达水平显著高于癌旁组织（P<0.01）。转染si-circ_0001821可显著降低细胞中circ_0001821的表达水平（P<0.01），降低细胞增殖、迁移和侵袭能力（均P<0.01），提高细胞凋亡率（P<0.01）。双荧光素酶报告基因实验证实，circ_0001821可靶向结合miR-203。转染miR-203 mimic可显著降低A431细胞的增殖、迁移和侵袭能力（均P<0.01），提高细胞凋亡率（P<0.01）。共转染si-circ_0001821与anti-miR-203可明显逆转下调circ_0001821表达对A431细胞增殖、迁移、侵袭及凋亡的调控作用。结论：circ_0001821通过靶向miR-203调控CSCC细胞A431的增殖、迁移、侵袭能力及细胞凋亡。

Study on continuous improvement of clinical application of evidence-based practice program of physical restraint in ICU patients / 中国实用护理杂志

Objective:To understand the current status of the evidence-based practice program of physical restraint in ICU patients and analyze its influencing factors, formulate and implement an action plan for continuous application of the program, so as to improve the knowledge level and evidence-based nursing ability of nurses, promote the improvement of patient outcomes, and strengthen the organization′s evidence-based cultural atmosphere.Methods:This study selected the program application departments of China Japan Friendship Hospital Surgical ICU as the research object, including all nurses, patients, nursing process, department standard system, etc. To understand the status and influencing factors of the project through observation and interview methods. The "Optimized Version of Evidence-based Practice Program of Physical Restraint in ICU Patients" was formulated and implemented, and a before-and-after comparative study method was used to comprehensively evaluate the implementation effect from the level of patients, nurses and organization.Results:The implementation rate of the 7 review standards of the program application department showed a downward trend; the patient restraint rate and restraint duration increased compared with the previous period; after the implementation of the optimized version program, the implementation of each item had been improved; the physical restraint rate decreased from 34.91% (37/106) before optimization to 28.57% (8/28) ( χ 2 value was 0.40, P>0.05), and the time of physical restraint decreased from 60.93 hours before optimization to 48.09 hours after optimization ( Z value was -0.19, P>0.05). Conclusions:The continuous application of the evidence-based practice project of physical restraint in ICU patients was not very optimistic. The continuity of implementation was affected by many factors. The continuous quality improvement of this evidence-based practice project can promote the improvement of the standard of physical restraint of patients, improve the quality of life of patients, promote the improvement of nurses' knowledge level and the improvement of evidence-based nursing ability; at the same time, it created a better organization′s evidence-based cultural atmosphere.

Application study of the best evidence for physical restraint in ICU patients based on guidelines / 中国实用护理杂志

Objective:To explore the effect of evidence-based physical restraint practice in ICU patients based on the best evidence.Methods:Based on the previous studies of evidence- based nursing program of physical restraint in ICU patients, the nurses were trained, and the evidences were introduced into clinical application and the effect of program application on nurse level, patient level and organization system were evaluated. Results:The body restraint duration of ICU patients in the contrd group was 41 (14.25, 166.50) h, and the body restraint duration of intervention group was 37(16.75,107.50) h, the difference was statistically significant ( Z value was 1.71, P<0.05). The level of physical restraint knowledge, attitude, behavior and total scores of ICU nurses increased from (12.30±1.73), (33.69±3.80), (45.19±10.56), (91.17±13.38) before implementation to (13.37±2.07), (36.81 ±3.61), (49.17±4.98), (98.08±6.11) after implementation. The differences in attitude, behavior and total scores were statistically significant ( t values were 4.05, 0.96, 2.44, P<0.05).At the organizational system level, after the application of the program, the related procedures, norms, assessment tools, nursing record sheets, restraint tools, training materials courses and so on were improved in the department. Conclusions:By introducing the best evidence of physical restraint into clinical application, it can guide nurses to use physical restraint more scientifically and standardize physical restraint behavior.At the same time, it can reduce the use of physical constraints to a certain extent, reduce the rate of physical restraints, shorten the average length of restraint, and improve the flow system related to physical restraints, so as to provide reference for the implementation of physical restraints.

Construction of evidence-based practical nursing scheme for ICU patients with physical constraints based on guidelines / 中国实用护理杂志

Objective:To standard the behavior of clinical physical restraint and reduce the rate of physical restraint.Methods:Evidence-based method was used to screen the clinical practice guide of physical restraint, and the recommendations were integrated and the clinical applicability was evaluated. The nursing scheme of physical restraint evidence-based practice for ICU patients was constructed through group discussion, and 12 experts were consulted by Delphi method for 2 rounds of correspondence.Results:Included 2 high quality guidelines, integrated the recommendations and evaluated the clinical applicability, and then summarized them into 11 recommendations on three major topics: practical recommendation, educational recommendation and organizational recommendation. Constructed nursing programs including physical restraint implementation process, treatment relationship, physical restraint evaluation, physical restraint dynamic monitoring, restraint substitution method and so on. The enthusiasm of experts was 100%, the authority coefficient was 0.87. The expert acceptance rate was 0.75-1, and the coefficient of variation of expert letter was 0.14-0.26.Conclusions:The construction process of evidence-based nursing scheme for ICU patients with physical restraint is rigorous and the results are reliable, which can be used to guide and standardize the implementation and nursing of physical restraint for ICU patients in clinic.

Analysis on the prevalence of drinking-tea type endemic fluorosis among children in Lhasa, Tibet / 中国学校卫生

Objective@#To investigate the prevalence of drinking-tea type endemic fluorosis among children in Lhasa, Tibet, and to provide basic data for the early prevention of dental fluorosis and skeletal fluorosis among children.@*Methods@#Stratified cluster random sampling method was used to select primary school 1 991 students in 6 counties.@*Results@#The detection rate of dental fluorosis was 27.2%, the index of dental fluorosis was 0.44, and the total severity of fluorosis prevalence was identified as very mild among 6 counties. The detection rate of dental fluorosis increased with the age of the children：male and female increased by 36.2 and 28.5 percentage points,respectively. There was no significant difference between male and female students(χ2=0.08, P> 0.05). The urine fluoride test results suggested that urine fluoride concentration among participate children was below the standard limits value(geometric mean of urinary fluorine <1.4 mg/L).@*Conclusion@#The prevalence of tea-drinking type endemic fluorosis among children in Lhasa is more serious compared with that from other regions of China. The cumulative effect of fluorine in human body makes older students more prone to dental fluorosis. It is suggested that more school-based health education programs should be carried out to prevent tea drinking type endemic fluorosis.

Diagnosis and treatment of idiopathic hypogonadotropic hypogonadism in males / 中华男科学杂志

Idiopathic hypogonadotropic hypogonadism (IHH) is often caused by hyposecretion of gonadotropin and consequently affects male fertility. The patient with IHH has a smaller penis and testes with spermatogenic dysfunction. At present, IHH is treated mainly with hCG, hMG, GnRH, and their different combinations. However, due to the lack of large-sample evidence, it is not yet clear which therapy is the best option. This article presents an overview of our experience in the treatment of IHH in the last decade and a review of relevant literature, aiming at a deeper insight into this male disease.

A modified method by differential adhesion for enrichment of bladder cancer stem cells

ABSTRACT Purpose: In a previous study the vaccine was effective against bladder cancer in a mouse model. However, a small portion of tumors regrew because the vaccine could not eliminate bladder cancer stem cells (CSCs). In this study, we showed a modified method for the isolation of bladder CSCs using a combination of differential adhesion method and serum-free culture medium (SFM) method. Materials and Methods: Trypsin-resistant cells and trypsin-sensitive cells were isolated from MB49, EJ and 5637 cells by a combination of differential adhesion method and SFM method. The CSCs characterizations of trypsin-resistant cells were verified by the flow cytometry, the western blotting, the quantitative polymerase chain reaction, the resistance to chemotherapy assay, the transwell assay, and the tumor xenograft formation assay. Results: Trypsin-resistant cells were isolated and identified in CSCs characters, with high expression of CSCs markers, higher resistance to chemotherapy, greater migration in vitro, and stronger tumorigenicity in vivo. Conclusion: Trypsin-resistant cells displayed specific CSCs properties. Our study showed trypsin-resistant cells were isolated successfully with a modified method using a combination of differential adhesion method and SFM method.

Gene expressions of LTC4 synthase homologs in Con A-induced mouse hepatitis and regulative effect of cyclosporine A / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To explore the gene expressions of LTC4 synthase homologs in concanavalin A (Con A)-induced mouse hepatitis and regulation role of cyclosporine A (Cs A) treatment.</p><p><b>METHODS</b>Male Balb/c mouse liver injury model was developed by iv injection of Con A (20 mg/kg) and protected by Cs A pretreatment (150 mg/kg) before Con A administration. Blood samples were collected at indicated times after Con A treatment with or without Cs A pretreatment. Liver damage was assessed by serum transaminase ALT and AST measurement and histological evaluation. Meantime, three LTC4 synthase homolog gene expressions were determined by RT-PCR.</p><p><b>RESULTS</b>Serum ALT and AST upregulation were accompanied with histological damage at 2 h after Con A administration, and further aggravated at 8 h. mGST2 gene expression increased 1.7 fold at 2 h and 1.9 fold at 8 h, while the expression of LTC4 S and mGST3 changed little. Pretreatment with Cs A prevented mouse liver from injury by Con A and partly inhibited the mGST2 gene expression upregulation.</p><p><b>CONCLUSIONS</b>Administration of Con A in mouse lead to a significant increase of mGST2 gene expression without any significant effect on LTC4 S and mGST3 mRNA levels. Cs A pretreatment results in protection of liver damage, whereas fails to fully inhibit the increase of mGST2 gene expression.</p>

Protective effects of triterpenoids on primarily cultured rat hepatocytes injured by D-galactosamine and carbon tetrachloride / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the protective effects and mechanism of triterpenoids on primarily cultured rat hepatocytes injured by D-galactosamine (D-GalN) or carbon tetrachloride (CCl4).</p><p><b>METHODS</b>Rat hepatocytes were isolated by two-step collagenase perfusion and cultured in RPMI 1640 medium. Protective effects of asiatic acid (AA) and beta-glycyrrhetinic acid (GA) were evaluated on hepatocytes injured by D-GalN (2 mmol/L) or CCl4 (10 mmol/L). Cell morphology was observed by light microscope, cell viability was measured by MTT assay, AST and LDH were determined by an automatic analyzer. Fluorescence assay was applied to test reactive oxygen species (ROS), nitric oxide end products (NOx) and reduced glutathione (GSH), and JC-1 staining was used to determine mitochondria membrane potential (DeltaPsim).</p><p><b>RESULTS</b>AST and LDH in medium were decreased when treated with AA and GA after D-GalN injury (P<0.05), furthermore AA enhanced the hepatocyte viability (P<0.05). Moreover, AA and GA significantly reduced ROS and NOx generation, and ameliorated DeltaPsim lost induced by D-GalN. AA also inhibited GSH decrease due to D-GalN and CCl4 treatment.</p><p><b>CONCLUSION</b>Both AA and GA could protect hepatocytes from D-GalN and CCl4 injuries, which is associated with reducing intracellular ROS and NOx, reversing GSH depression and ameliorating DeltaPsim lost.</p>

Protective effects of lidocaine against lung injury after hemorrhagic shock in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the protective effect of lidocaine against lung injury after hemorrhagic shock in rabbits.</p><p><b>METHODS</b>Eighteen healthy rabbits were randomly divided into 3 groups (n=6), namely lidocaine group (group L), hemorrhagic shock group (group H) and control group (group C). Hemorrhagic shock model was established in rabbits in groups L and H, and the venous blood samples were collected for measurement of plasma malondialdehyde (MDA) and superoxidedismutase (SOD) before phlebotomy (T0), 2 h after hemorrhagic shock (T1) and 2 h after resuscitation (T2). Blood samples were also taken for measurement of MDA and SOD at the same time points in group C. The wet to dry weight ratio of the lung (W/D) was measured at T2.</p><p><b>RESULTS</b>MDA level was significantly lower while SOD level significantly higher in group L than in group H (P<0.05). The W/D ratio in group L was reduced significantly as compared with that in group H (P<0.05).</p><p><b>CONCLUSION</b>Lidocaine can remarkably alleviate lung injury after hemorrhagic shock by inhibiting MDA production and increasing SOD content.</p>

Patient-controlled intravenous analgesia with sufentanil and fentanyl after thoracotomy: a comparative study / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of sufentanil and fentanyl at equivalent dose for patient-controlled intravenous analgesia (PCIA) after thoracotomy.</p><p><b>METHODS</b>Sixty ASA I-II patients (20-60 years of age) undergoing radical operation for lung or esophageal cancer were randomly divided into sufentanil intravenous analgesia group (group S, with sufentanil 1 microg/ml) and fentanyl intravenous analgesia group (group F, fentanyl 10 microg/ml). PCIA was administered with background infusion of 2.5 ml/h, bolus injection of 2.5 ml and lockout time of 15 min. The pain intensity according to visual analogue scale (VAS), cumulative analgesic consumption (CAC), sedative scores and side effects at 24 and 48 h after administration were recorded. SpO(2), respiratory rate (RR), blood pressure (BP) and ECG were continuously monitored.</p><p><b>RESULTS</b>There were no significant differences in CAC between the two groups, but he VAS was lower in group S than in group F (P<0.05) and the sedative efficacy was superior in group S (P<0.05). The incidence of nausea and vomiting in group S was lower than that in group F (P<0.05). No significant differences were observed in SpO(2), RR, heart rate and mean arterial pressure between the two groups.</p><p><b>CONCLUSION</b>PCIA with sufentanil provides better efficacy of analgesia and sedation with lower incidence of nausea and vomiting than with fentanyl in postoperative patients with thoracotomy.</p>