Effectiveness and safety of Xingbei Zhike granules in patients with postinfectious cough: A multicenter, randomized, double-blinded, placebo-controlled trial.

BACKGROUND: Postinfectious cough (PIC) is a common symptom following a respiratory tract infection. Xingbei Zhike (XBZK) granules, a Chinese patent medicine, has been widely used for PIC in clinics. However, there is a lack of evidence on the effectiveness. PURPOSE: To investigate whether treatment with XBZK granules is effective for PIC. STUDY DESIGN: A multicenter, randomized, double-blinded, placebo-controlled trial. METHODS: Eligible participants from fourteen hospitals were randomly assigned in 3:1 ratio to receive either XBZK granules or placebo for 14 days. The primary outcome was the area under the curve (AUC) of a visual analogue scale (VAS) for cough symptoms. Secondary outcomes included cough symptom score (CSS), time and probability of recovery from cough, traditional Chinese medicine (TCM) syndrome score, relief rates of individual symptoms, Leicester Cough Questionnaire (LCQ) score, and the use of reliever drug. RESULTS: A total of 235 patients (176 in XBZK and 59 in placebo groups) were included in the analysis. The AUC for cough VAS scores was lower in the XBZK than placebo group (-8.10, 95 % CI -14.12 to -2.07, p = 0.009), indicating superiority. XBZK decreased CSS (-0.68 points, 95 % CI -1.13 to -0.22, p = 0.01), shortened time to cough recovery (-2 days, hazard ratio [HR] 1.48, 95 % CI 1.03 to 2.13, p = 0.02), enhanced the probability of cough recovery (risk ratio [RR] 1.66, 95 % CI 1.07 to 2.58, p = 0.03), lowered TCM syndrome score (-0.99 points, 95 % CI -1.58 to -0.40, p = 0.004), increased the rate of daytime (RR 1.84, 95 % CI 1.07 to 3.15, p = 0.02) and nighttime (RR 2.07, 95 % CI 1.29 to 3.35, p = 0.004) cough recovery, and reduced the viscosity of sputum (RR 2.92, 95 % CI 1.66 to 5.13, p < 0.001) compared to placebo. There were no significant differences in LCQ scores and taking reliever drugs between groups. No severe adverse events were reported in either group. CONCLUSIONS: XBZK granules are a promising therapy against PIC, effective in lowering the overall severity of cough, shortening the time to cough recovery, and reducing the viscosity of sputum.

Meta-Analysis of Prognosis of Different Treatments for Symptomatic Moyamoya Disease.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of surgical revascularization versus conservative treatment and different surgical modalities, in order to provide evidence for the patient with moyamoya disease (MMD) to choose the appropriate treatment. METHODS: We comprehensively searched PubMed, Embase, Web of Science, and the Cochrane Library for articles published regarding MMD treatment. If the I2 value, which evaluated the heterogeneity, was <50%, a fixed-effect model was used; if not, a random effect model was applied. RESULTS: Twenty-seven articles were included in the meta-analysis. The surgery group is more advantageous in reducing the risk of future stroke events than conservative treatment in MMD patients (odds ratio [OR] 0.26, 95% confidence interval [CI] 0.20-0.33, P < 0.001). In addition, the surgical group also had an advantage in terms of increased cerebral perfusion (OR 7.16, 95% CI 3.28-15.64, P < 0.001) and death due to rebleeding (OR 0.27, 95% CI 0.10-0.72, P < 0.01). Direct surgery showed a significant efficacy over indirect surgery (OR 2.03, 95% CI 1.32-3.13, P < 0.01). No obvious difference was found between the direct and indirect bypass subset (OR 0.76, 95% CI 0.51-1.14, P = 0.185). Angiographic results in patients undergoing direct bypass surgery are more pronounced (OR 0.20, 95% CI 0.06-0.67, P < 0.01). CONCLUSIONS: In patients with symptomatic moyamoya disease, bypass surgery is more effective than conservative treatment to prevent future strokes. In surgical patients, direct bypass seems to reduce the risk of stroke more than an indirect bypass.

Evolution and functional divergence of monocarboxylate transporter genes in vertebrates.

Monocarboxylate transporters (MCTs) form a gene family with an ancient past. The identification of MCTs (MCHs) from bacteria, protozoa, fungi, invertebrates, as well as vertebrates, but not from plants and virus, allowed illuminating the phylogenetic and evolutionary history of this gene family. The significant expansion of vertebrate MCT genes should have primarily occurred after the divergence of vertebrates and invertebrates, but before the divergence time between ray-finned fish and mammals. The divergence of insect MCTs should have at least occurred in the common ancestor of fruit fly, beetle, and honeybee. Fungi monocarboxylate transporter homologues (MCHs) might evolve independently from an ancient ancestor. The results of functional divergence analysis provided statistical evidences for shifted evolutionary rate and/or changes of amino acid property after gene duplication. The sliding window analysis of the d(N)/d(S) ratio values showed that strong functional constraints must impose on the N- and C-terminal domains of vertebrate MCTs. These corresponding regions may play crucial roles for functionality of MCT proteins.