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BACKGROUND@#Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.@*OBJECTIVE@#This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m@*MAIN OUTCOME MEASURES@#The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment.@*RESULTS@#A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group.@*CONCLUSION@#SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.@*TRIAL REGISTRATION NUMBER@#NCT02063100 on ClinicalTrials.gov.
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<p><b>OBJECTIVE</b>To explore the osteogenic activity of a micro-arc oxidation (MAO)-treated strontium (Sr)-substituted hydroxyapatite (Sr-HA) coating developed to enhance the osseointegration of titanium dental implants, and to investigate the strengthening mechanisms of bone bonding of crystalline hydroxyapatite (HA) with incorporation of strontium in vivo.</p><p><b>METHODS</b>The morphology and phase component of the oxidized film of Sr-HA and HA coated implants were examined by SEM and X-ray diffraction (XRD). Then, twenty-four implants were inserted into the metaphysis of rabbits tibias and femurs using polyfluorochrome sequential labeling. Four and 12 weeks following the surgery, the morphology and chemical composition of the bone-implant interfaces were evaluated by histological examination and energy-dispersive X-ray.</p><p><b>RESULTS</b>The XRD patterns showed that diffraction peaks of HA shift to lower 2θ values with Sr-addition, which resulted in decreases in lattice energy and then crystallinity. Sr-HA coating presented a microporous structure in the SEM observation. Meanwhile, Sr-HA coating exhibited osteogenic activity at the early stage of bone healing period and new bone mineral apposition ratio [(4.75 ± 0.46) microm/d] was significantly higher than that of the control group [(3.21 ± 0.44) microm/d]. An apatite layer was observed at the interface of bone-Sr-HA coating in light microscopy observation and energy-dispersive X-ray analysis. Then the apatite layer was precipitated and formed new bone which became mature bone and bonded tightly to the Sr-HA.</p><p><b>CONCLUSIONS</b>Strontium-substituted hydroxyapatite coating shows high biological activity, which can accelerate the formation of apatite layer, hence the osteogenic ability.</p>