ABSTRACT
Traditional Chinese herbal medicine has provided clinical benefits to patients infected with coronavirus 2019 (COVID-19) in China. Jinhua Qinggan granule (JHQGG) is a Chinese multi-herbal formula previously developed for the treatment of H1N1 influenza and has been encouraged for use in patients with clinically suspected COVID-19 infection. However, the immunopharmacological mechanism for the efficacy of JHQGG has not yet been confirmed. To obtain insight into this issue, the present study examined the acute effects of JHQGG ingestion on hematological and immunological parameters using uninfected individuals as subjects. For this purpose, 18 healthy volunteers were enrolled, all of whom tested negative for prior and current severe acute respiratory syndrome coronavirus 2 infection. Peripheral blood samples were collected 1 h after a single oral JHQGG administration and subjected to hematological, biochemical and cytokine tests. JHQGG rapidly induced a significant decrease in the plasma level of interleukin (IL)-6 (P=0.00309) and an increase in the plasma level of interferon (IFN)-γ (P=0.0268). A decrease in IL-6 and an increase in IFN-γ levels were observed in 14 (77.8%) and 13 (72.2%) subjects, respectively. Notably, JHQGG significantly decreased the proportion of neutrophils (P=0.00561) and increased that of lymphocytes (P=0.00485);accordingly, the neutrophil/lymphocyte ratio (NLR) was significantly reduced by JHQGG (P=0.00649). These findings suggest that the clinical benefits of the use of JHQGG against COVID-19 are, at least in part, associated with its rapid modulatory effects on IL-6, IFN-γ and NLR. Considering that IL-6 and NLR are critical biomarkers for severe COVID-19 infection, JHQGG may thus be suitable not only for suppressing disease onset in suspected and asymptomatic cases, but also for preventing disease progression in patients with mild to severe infection. The present open-label, single-arm study has been prospectively registered on the University Hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) under the trial no. UMIN000040407 on May 15, 2020. Copyright: © 2021 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
ABSTRACT
Gamification of virtual rehabilitation devices gained rapid interest in the last two decades. Its popularity and use in remote telehealth and rehabilitation have gained more importance and application with the current COVID-19 pandemic situation. The benefits of gamification and the use of virtual reality (VR) games in rehabilitation therapy and telerehabilitation have been particularly well demonstrated in post-stroke patients. In this study, we present our pilot study using a game-based therapy approaches for the upper limb (UL) rehabilitation in elderly post-stroke patients in Singapore. The aim of the study is to develop a smart multi-sensory musical assistive system, called SilverTune, to promote the rehabilitation outcomes of elderly post-stroke patients. The SilverTune is like a musical instrument which is highly adaptable to provide six types of music audios and play interactions to cater for various elderly's preferences and therapeutic movement requirements. SilverTune can also quantitatively record therapeutic data, analyze performance in real time, and give multi-modal feedback to both elderly and therapist. It is designed to produce a variety of digital audios like drum, saxophone, bell, harp, etc. via changing the shape and the interaction behaviours of the users. A SilverTune mobile app was developed as a companion mobile app for SilverTune music therapy. The app can play the digital contents, which is activated by SilverTune. Furthermore, the app can record user's profile and the data input from SilverTune for future analysis by the therapist. Two games were developed to play using SilverTune device. The first is a horse racing game where the horse moves around a racetrack. The second is a table tennis game whereby the table tennis ball is required to be served across the net to gain points. The horse racing game facilitated shoulder flexion and extension, whereas the table tennis game facilitated shoulder horizontal abduction and adduction. If the movement of the SilverTunes device is detected by the accelerometer, the horse or bat will run or swing forward. If no movement is detected, then the horse or bat will be stationary. Participants' self-perceived level of performance and satisfaction were shown to have significant improvements after the intervention phase. Particpants were also assessed before and after interventions using Fugl Meyer Assessment-Upper Extremity (FMA-UE), Canadian Occupational Performance Measure (COPM) scores with improvements in passive joint motion. Post-intervention questionnaire found that many participants liked SilverTune games due to its novelty, audio/visual effects and that it helped them to stay focused during therapy. SilverTune can be potentially used as a telerehabilitation tool for the current COVID-19 pandemic situation to support a safe high-quality care at a reduced cost. © 2021 IEEE.
ABSTRACT
Qingfei Paidu decoction (QFPD) is a Chinese herbal medicine newly formulated for the treatment of COVID-19. QFPD significantly enhances the therapeutic effects of stan- dard pharmacotherapy in mild to critically ill patients with COVID-19. However, limited information is available on the immunological mechanisms underlying the efficacy of QFPD. In addition, the feasibility of the prophylactic administration of QFPD to uninfected individuals remains unconfirmed. To obtain insight into these issues, an open-label, single-arm pilot study was conducted using 19 healthy uninfected individuals as subjects, and the effects of QFPD ingestion at a dose lower than that recommended for therapeutic use on hematological and immunological parameters were examined. QFPD was prepared according to the Chinese official clinical guideline, except that the dose of each herb was reduced to 1/30 and administered orally to the participants twice daily for 3 days. Low-dose QFPD ingestion significantly increased the plasma levels of pro-inflammatory cytokines, tumor necrosis factor (TNF)-α (P=0.000107), interleukin (IL)-1β (P=0.000982), IL-18 (P=0.00105), IL-2 (P=0.0483) and IL-8 (P=0.000191), key mediators of a broad spectrum of antiviral immunity. No apparent adverse effects were observed during the trial. These findings suggest that the clinical efficacy of QFPD against COVID-19 is, at least in part, associated with its immunological activity to mimic the blood cytokine environ- ment produced by early antiviral immune responses, which are shown to be profoundly suppressed during the early stages of COVID-19. The daily ingestion of low-dose QFPD may thus be a possible option for the prevention of COVID-19 during the epidemic. The present study was prospectively registered at the University Hospital Medical Information Network-Clinical Trials Registry (UMIN-CTR) under the trial no. UMIN000040341 on May 9, 2020. © 2021 Spandidos Publications. All rights reserved.