Effect of coil diameter on water disinfection efficiency in a helical photoreactor using ultraviolet-C light emitting diodes.

This study investigated the disinfection efficiency of a photoreactor equipped with a helical water flow channel and ultraviolet-C (UV-C) light emitting diodes (LEDs). Theoretical simulations and biodosimetry tests were conducted to investigate the effects of coil diameter and flow rate on the reactor's performance in inactivating Escherichia coli. The interplay between hydrodynamics and UV radiation was analyzed to determine the UV fluence absorbed by the microbes. The simulations revealed that, primarily due to the specific radiation pattern of the UV LEDs, the coil diameter strongly influenced the distribution of irradiance in the water and the UV fluence received by microbes. The experimental results indicated that the photoreactor achieved the highest inactivation value of 2.8 log when the coil diameter was 48 mm for a flow rate of 40 mL/min; this log value was superior to those for coil diameters of 16, 32, 64, and 80 mm by approximately 1.9, 0.4, 0.5, and 0.7 log units, respectively. This optimal coil diameter leading to the maximal UV irradiance and the highest degree of irradiance uniformity along the flow channel. This study offers design guidelines for constructing a high-efficiency water disinfection reactor with a helical flow channel configuration.

Bacillus coagulans TCI711 Supplementation Improved Nonalcoholic Fatty Liver by Modulating Gut Microbiota: A Randomized, Placebo-Controlled, Clinical Trial.

Background: Nonalcoholic fatty liver disease (NAFLD) has become one of the major problems of chronic liver disease worldwide. It not only causes damage to the liver but also engenders chronic hepatitis and cirrhosis. Recent studies have shown that regulating Bacillus coagulans can improve NAFLD. Objectives: This trial explores whether B. coagulans TCI711 (BCT) could ameliorate NAFLD. Methods: A total of 57 patients with NAFLD were recruited through FibroScan liver fibrosis scanner and divided into placebo (n = 28) and BCT-supplemented groups (n = 29). Specifically, 1 BCT probiotic capsule was supplemented daily for 8 wk. Furthermore, the blood, stool, and fatty liver content were then examined. Results: Parameters evaluated for liver and kidney indicators showed no side effects after supplementing BCT. A significant reduction of 8.7% in the fatty liver was achieved by effectively suppressing the grade of fatty liver as revealed by controlled attenuation parameter. BCT also regulated gut microbiota profiles, with significant increases observed in Bifidobacterium, Eubacterium, Ruminococcaceae, and Sellimonas compared with the baseline. Conclusions: BCT may improve NAFLD by regulating gut microbiota, and parameters evaluated for liver and kidney indicate no side effects.

Strategies for subtyping primary aldosteronism.

Adrenal venous sampling (AVS) is a crucial method for the lateralization of primary aldosteronism (PA). It is advised to halt the use of the patient's antihypertensive medications and correct hypokalemia prior to undergoing AVS. Hospitals equipped to conduct AVS should establish their own diagnostic criteria based on current guidelines. If the patient's antihypertensive medications cannot be discontinued, AVS can be performed as long as the serum renin level is suppressed. The Task Force of Taiwan PA recommends using a combination of adrenocorticotropic hormone stimulation, quick cortisol assay, and C-arm cone-beam computed tomography to maximize the success of AVS and minimize errors by using the simultaneous sampling technique. If AVS is not successful, an NP-59 (131 I-6-ß-iodomethyl-19-norcholesterol) scan can be used as an alternative method to lateralize PA. We depicted the details of the lateralization procedures (mainly AVS, and alternatively NP-59) and their tips and tricks for confirmed PA patients who would consider to undergo surgical treatment (unilateral adrenalectomy) if the subtyping shows unilateral disease.

Mandatory monthly outpatient visits could improve therapeutic inertia in patients with poorly controlled type 2 diabetes.

AIMS/INTRODUCTION: Delayed intensification of treatment, or therapeutic inertia, increases the risk of diabetic complications and death. The aim of this study was to determine the effect of mandatory monthly outpatient visits on therapeutic inertia in patients with suboptimal control of type 2 diabetes. MATERIALS AND METHODS: This retrospective cohort study used data from the Chang Gung Research Database and defined two study periods: the baseline period and the intervention period. The intervention period began when the Kaohsiung branch initiated a mandatory monthly outpatient visits program. Type 2 diabetes patients with baseline glycated hemoglobin (HbA1c) >7% and a follow-up HbA1c measurement were enrolled in each period, and divided into a Kaohsiung branch (intervention) group and the other branches (control) group. Therapy intensification was evaluated by comparing prescriptions after the follow-up HbA1c measurement with the prescriptions after the baseline HbA1c measurement. RESULTS: A total of 5,045 patients at the Kaohsiung branch and 13,400 participants at other branches were enrolled in the baseline period; and 5,573 and 15,603 patients, respectively, were enrolled in the intervention period. The adjusted odds ratio (AOR) for therapy intensification in patients with baseline HbA1c ≥9% was not significantly higher at 1.21 (95% CI, 1.00-1.47) in the intervention period at the Kaohsiung branch, but was significantly higher (AOR, 1.53; 95% CI, 1.02-2.30) in the subgroup with worsened HbA1c. CONCLUSIONS: Mandatory monthly outpatient visits could improve therapeutic inertia in patients with poorly controlled type 2 diabetes, especially in those with worsened control. The trajectory of HbA1c could significantly influence the assessment of the prevalence of therapeutic inertia.

Effectiveness of Fish Roe, Snow Fungus, and Yeast Supplementation for Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

The brain is one of the most critical organs in the human body, regulating functions such as thinking, memory, learning, and perception. Studies have indicated that fish roe, snow fungus, and yeast may have the potential to modulate cognitive, memory, and emotional functions. However, more relevant clinical research in this area still needs to be conducted. This study explored the cognition-enhancing potential of a formula beverage including fish roe, snow fungus, and yeast. Sixty-four subjects were divided into a placebo group (n = 32) and a formula-drink group (n = 32), who consumed the product for 8 weeks. Cognitive tests were administered and analyzed at weeks 0, 4, and 8. After 4 and 8 weeks, there was a significant increase in the number of memory cards, and the response times among those who consumed the formula beverage were significantly faster than those in the placebo group. The subjects remembered the old items better and were more impressed with similar items based on the week effect. There was a significant increase in the cue effect of happy facial expressions after the subjects consumed the formula beverage for 8 weeks. In addition, there was a significant decrease in anxiety and fatigue, and improved quality of life. This formula beverage is a promising option that could be used to prevent further cognitive decline in adults with subjective cognitive complaints.

Safety and efficacy of hyaluronic acid injectable filler in the treatment of nasolabial fold wrinkle: a randomized, double-blind, self-controlled clinical trial.

INTRODUCTION: The injectable skin fillers available for soft tissue augmentation are constantly growing, providing esthetic surgeons with more options in the treatment of scars, lines, and wrinkles. Hyaluronic acid (HA)-derived injectable fillers are ideal to reduce the appearance of nasolabial folding. This study investigated the efficacy and safety of the commercially available HA filler from Maxigen Biotech Inc. (MBI-FD) in the treatment of nasolabial folds (NLFs). METHODS: We analyzed 1,4-butanediol diglycidyl ether (BDDE) residues and injection force test and observed the protein content in MBI-FD, and then was cultured in fibroblast L929 cells and examined for cytotoxicity. Finally, 95 healthy participants underwent dermal filler injection therapy to evaluate the efficacy and safety for 24 and 52 weeks, respectively. RESULTS: BDDE residues in MBI-FD was <0.125 µg/mL. MBI-FD was fitted using 27- and 30-G injection needles with an average pushing force of 14.30 ± 2.07 and 36.43 ± 3.11 N, respectively. Sodium hyaluronate protein in MBI-FD was 7.19 µg/g. The cell viabilities of 1× and 0.5× MBI-FD were 83.25% ± 3.58% and 82.23% ± 1.85%, respectively, indicating MBI-FD had no cytotoxicity, and decreased NLF wrinkles with no serious adverse events. CONCLUSION: MBI-FD is an effective filler for tissue augmentation of the NLFs and may be a suitable candidate as an injectable dermal filler for tissue augmentation in humans in the future.

Novel compounds of Djulis (Chenopodium formosanum Koidz) increases collagen, antioxidants, inhibits adipogenesis.

Djulis (Chenopodium formosanum Koidz), is rich in nutrients and contains various bioactive components such as polyphenols and alkaloids. The new compound has a broad application prospect, including food additives, health products, drugs, etc. The purpose of this study was to find out new compounds from Djulis. It was found that 24 compounds including 7 phenols, 11 flavonoids, 4 plant alkaloids, 2 sterols. Among those, TCI-CF-22-S (Methyl 3,6-dihydroxy-2-oxo-1,2,3,4-tetrahydroquinoline-3-carboxylate), TCI-CF-23-S (Methyl 6-hydroxy-2-oxo-1,2,3,4-tetrahydroquinoline-3-carboxylate), TCI-CF-24-S (Kaempferol-3-O-b-D-apifuranosyl-(1→2)-a-L-arabinopyranoside) were isolated from djulis sources for the first time, and the structures of compounds were assigned by 1D, 2D NMR spectroscopy. TCI-CF-01(Caffeic acid), TCI-CF-02 (20-Hydroxyecdysone), TCI-CF-03 (Japonicone), TCI-CF-04 (3,4-Dihydroxyphenylacetiate), TCI-CF-05 (Quercetin-3-O-rutinoside-7-O-rhamnopyranoside), TCI-CF-06 (Guanosine), TCI-CF-07(Adenine), TCI-CF-08 (Coumaric acid) increased collagen production, and TCI-CF-03 (Japonicone), TCI-CF-04 (3,4-Dihydroxyphenylacetiate), TCI-CF-06 (Guanosine), TCI-CF-17 (Rutin), TCI-CF-20 (Protocatechuic acid) decreased advanced glycation end products (AGEs). In addition, TCI-CF-22-S (Methyl 6-hydroxy-2-oxo-1,2,3,4-tetrahydroquinoline-3-carboxylate), TCI-CF-23-S (Methyl 3,6-dihydroxy-2-oxo-1,2,3,4-tetrahydroquinoline-3-carboxylate) inhibited the formation of fatty oil droplets. Djulis has 24 compounds that may have various applications, including increasing collagen production and reducing advanced glycation end products and fatty oil droplets.

Synthesis of Nano-Structured Ge as Transmissive or Reflective Saturable Absorber for Mode-Locked Fiber Laser.

Amorphous-Ge (α-Ge) or free-standing nanoparticles (NPs) synthesized via hydrogen-free plasma-enhanced chemical vapor deposition (PECVD) were applied as transmissive or reflective saturable absorbers, respectively, for starting up passively mode-locked erbium-doped fiber lasers (EDFLs). Under a threshold pumping power of 41 mW for mode-locking the EDFL, the transmissive α-Ge film could serve as a saturable absorber with a modulation depth of 52-58%, self-starting EDFL pulsation with a pulsewidth of approximately 700 fs. Under a high power of 155 mW, the pulsewidth of the EDFL mode-locked by the 15 s-grown α-Ge was suppressed to 290 fs, with a corresponding spectral linewidth of 8.95 nm due to the soliton compression induced by intra-cavity self-phase modulation. The Ge-NP-on-Au (Ge-NP/Au) films could also serve as a reflective-type saturable absorber to passively mode-lock the EDFL with a broadened pulsewidth of 3.7-3.9 ps under a high-gain operation with 250 mW pumping power. The reflection-type Ge-NP/Au film was an imperfect mode-locker, owing to their strong surface-scattered deflection in the near-infrared wavelength region. From the abovementioned results, both ultra-thin α-Ge film and free-standing Ge NP exhibit potential as transmissive and reflective saturable absorbers, respectively, for ultrafast fiber lasers.

Effects of Fermented Citrus Peel on Ameliorating Obesity in Rats Fed with High-Fat Diet.

Although citrus peel is a waste material, it contains a variety of bioactive components. As our preliminary findings showed that citrus peels fermented with Saccharomyces cerevisiae T1 contained increased levels of anti-obesity flavonoids, the objective of this study was to prepare fermented citrus peel and to investigate its effect on ameliorating obesity in Sprague Dawley (SD) rats fed with a high-fat diet (HFD). After fermentation, the amounts of limonene, nobiletin and 3-methoxynobiletin in citrus peel were markedly increased. SD rats were fed with an HFD for 10 weeks, followed by fermented citrus peel-containing HFD (0.3% or 0.9% w/w) for 6 weeks. Compared with those fed with an HFD alone, lower levels of body weight, visceral fat, body fat percentage, blood triglyceride, total cholesterol, low-density lipoprotein, malondialdehyde and hepatic adipose accumulation were observed in rats fed with fermented citrus peel. In parallel, hepatic levels of acetyl-CoA carboxylase and fatty acid synthase were diminished, and the level of hormone sensitivity lipase in visceral fat was elevated. These results reveal fermented citrus peel is a promising natural product with beneficial effects of alleviating HFD-induced obesity.

Lactobacillus delbrueckii subsp. bulgaricus strain TCI904 reduces body weight gain, modulates immune response, improves metabolism and anxiety in high fat diet-induced obese mice.

The multiple probiotic characteristics of strain TCI904 isolated in this study from natural fermented milk were investigated using a mouse model. TCI904 was identified as Lactobacillus delbrueckii subsp. bulgaricu (LDB), a well-known lactic acid starter bacterium found in yogurt. TCI904 exhibited an outstanding pancreatic lipase inhibition activity among several strains of lactic acid bacteria in vitro. Its in vivo effects were further studied. In a comparison of mice fed a high-fat diet (HFD) and those fed a HFD combined with TCI904 for 9 weeks, differences were observed in various aspects of health, and the adverse effects of a HFD were prevented in the latter group. TCI904 effectively prevented fat and body weight accumulation without reducing food intake; it also modulated innate immunity and increased the level of IgA in feces, reversing the increased blood sugar and insulin levels and attenuated the hyperlipidemia caused by a HFD. Based on biochemical test data, compared with the HFD group, a HFD combined with TCI904 induced significant lowering of insulin resistance indicator, homeostasis model assessment-insulin resistance (HOMA-IR) and atherogenic indices of plasma (AIP), the atherogenic coefficient (AC) and cardiac risk ratio (CRR) and increased the cardioprotective index (CPI). In addition, the administration of TCI904 alleviated mood disorders caused by a HFD. Taking the recommended human dose of TCI904 did not affect the liver or kidney function, indicating that TCI904 has sufficient in vivo safety. Taken together, the results of the present study contributed towards validation of the probiotic benefits of lactic acid starter microflora. Orally taken TCI904 exhibited positive immune- and metabolic-modulating, and anxiolytic properties, especially in HFD-induced obesity. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-022-03356-3.

Supplementation of Lactobacillus plantarum (TCI227) Prevented Potassium-Oxonate-Induced Hyperuricemia in Rats.

Hyperuricemia (HC) is one of the important risk factors for gout, arteriosclerosis, and cardiovascular disease. Animal studies have shown that Lactobacillus plantarum can improve microbiota and immune regulation, as well as inhibit uric acid production. However, it is not clear whether L. plantarum can improve HC and intestinal microbiota. We used potassium oxonate (PO) to induce HC in male SD rats and then treated them with L. plantarum TCI227 in a dose-dependent manner (HC + LD, HC + MD, HC + HD) for 4 weeks. We examined organ weight, conducted biochemical examinations of blood and urine, and analyzed the intestinal microbiota in feces through a 16s rDNA sequence analysis. In this study, TCI227 improved body weight, decreased creatinine and serum uric acid, and increased urine uric acid compared to the HC group. Furthermore, TCI227 increased short-chain fatty acids (SCFAs). In the fecal microbiota (family), TCI227 increased the level of Lactobacillaceae and then decreased the levels of Deferribacteres and Prevotellaceae compared to the HC group. Finally, in the fecal microbiota (genus), TCI227 decreased the level of Prevotella and then increased the levels of Lactobacillus and Ruminococcus compared to the HC group. This study suggested that TCI227 can improve HC and can change the composition of intestinal microbiota in PO-induced male HC SD rats.

Double Nutri (Liposomal Encapsulation) Enhances Bioavailability of Vitamin C and Extends Its Half-Life in Plasma.

Vitamin C is an important antioxidant in the human body that plays a role in many body functions. Liposomal encapsulation is a technology commonly used in food processing and medicine. This study determines whether Double Nutri (liposomal encapsulation) increases the absorption rate for vitamin C supplementation. Subjects enrolled in this study took vitamin C without liposome; then, 14 d washout was given with liposomal process A vitamin C. After 14 d washout, the subjects took liposomal process B vitamin C (Double Nutri) was given. After taking the test sample, the vitamin C concentration in venous blood was measured from the baseline (0 h), 0.5, 1, 2, 3, 4, and 8 h. Eleven healthy subjects were recruited for three tests. The vitamin C concentration for liposomal process B vitamin C (Double Nutri) group is higher (7.26±3.52, p<0.01) than that for the liposomal process A vitamin C group (6.41±3.80, p<0.05) and for vitamin C without liposome (2.21±4.07). This shows that Double Nutri has better bioavailability and can last up in the body to 8 hours. In addition, this study shows that Double Nutri increases the half-life of vitamin C in plasma and has higher bioavailability.

Protective Effect of Djulis (Chenopodium formosanum) Extract against UV- and AGEs-Induced Skin Aging via Alleviating Oxidative Stress and Collagen Degradation.

Skin aging is a complex process involving photoaging and glycation stress, which share some fundamental pathways and have common mediators. They can cause skin damage and collagen degradation by inducing oxidative stress and the accumulation of reactive oxygen species (ROS). Chenopodium formosanum (CF), also known as Djulis, is a traditional cereal in Taiwan. This study investigated the protection mechanisms of CF extract against ultraviolet (UV) radiation and advanced glycation end products (AGEs)-induced stress. The results indicated that CF extract had strong antioxidant and free radical scavenging effects. It could reduce UV-induced intracellular ROS generation and initiate the antioxidant defense system by activating the nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) signaling pathway in human skin fibroblasts. CF extract modulated mitogen-activated protein kinase (MAPK) and transformed growth factor-beta (TGF-ß) signaling pathways to alleviate oxidative stress-induced skin aging. Moreover, the results revealed that CF extract not only promoted collagen synthesis but also improved aging-induced collagen degradation. CF extract attenuated AGEs-induced ROS production and the upregulation of receptor for AGEs (RAGE). The overall results suggest that CF extract provides an effective anti-aging strategy by preventing skin damage from oxidative stress and collagen loss with potent antioxidant, anti-photoaging, and antiglycation activities.

The potential of immature poken (Citrus reticulata) extract in the weight management, lipid and glucose metabolism.

OBJECTIVES: The prevalence of obesity was increasing globally, with nearly half a billion of the world's population now considered to be overweight or obese. The immature poken (Citrus reticulata) was a good source of flavonoids and phenolic acids, which may exert an anti-obesity effect. However, the current efficacy in clinical trials was still unclear. Thus, the object of this study was to explore whether immature poken had an anti-obesity effect in the clinical trial. METHODS: In this study, we identified nine major compounds from immature poken extract (IPE), and most compounds significantly decreased the lipid accumulation in adipocytes. In addition, 20 subjects with body mass index (BMI) ≥ 24 or body fat > 30 were recruited and randomly allocated to placebo and experimental (IPE) groups for 6 week intervention and 2 week follow-up. RESULTS: In comparison with the baseline results (week 0), the body weight, body fat, and waist circumference at week 6 in the IPE group were significantly decreased by 1.49 kg, 0.33%, 2.1 cm. Moreover, in blood biochemical analysis, total cholesterol (TC), triglyceride (TG), fasting blood sugar (FBS), and insulin levels at week 6 in IPE group were also decreased by 3.6, 4.6, 2.1 (mg/dL), and 2.9 (µU/mL), respectively. CONCLUSIONS: The finding showed that immature poken had important roles in fat metabolism by suppressing adipogenesis, and immature poken may provide new weight loss strategies for obese people.

Collagen formula with Djulis for improvement of skin hydration, brightness, texture, crow's feet, and collagen content: A double-blind, randomized, placebo-controlled trial.

BACKGROUND: The efficacy of Djulis for skin care is currently based on cellular or animal models, and the clinical aspect is not in place. AIM: This clinical study is to investigate the synergistic effect of fish collagen and Djulis (Chenopodium formosanum Koidz.) for improvement of skin parameters. We used the combination of hydrolyzed collagen and Djulis to develop a new functional formula for skin improvement. PATIENTS/METHODS: Fifty volunteers were randomly allocated (in a 1:1 ratio) to the placebo or collagen drink group. Volunteers were required to consume a 50 mL of a collagen drink or placebo drink daily for 8 weeks. For measurements, the indexes of skin conditions were measured at the baseline and 4 and 8 weeks. RESULTS: The improvements of skin hydration, brightness, crow's feet, texture, wrinkles, pores, spots, and collagen content after 8 weeks in collagen group were 17.8%, 5.4%, 14.9%, 9.9%, 29.3%, 10.4%, 9.9%, and 22.3%, respectively. Noticeably, over 68% of subjects got improved for their skin parameters after 8-week intake of collagen drink. The improvement levels indicated competitive skin improvement effects in comparison with previous studies. CONCLUSION: This clinical study demonstrates the synergistic effect of fish collagen and Djulis (the main components) for the substantial improvements in hydration, brightness, crow's feet, texture, wrinkles, pores, surface spots, and collagen content in skin. The collagen drink comprehensively improved skin parameters for most subjects after 4-week intake and manifested competitive efficiency in comparison with other similar studies. We convince that the collagen drink may delay skin aging process and improve skin aging parameters.

The applications of B. coagulans TCI711 in alcohol elimination.

This study demonstrates the applications of Bacillus coagulans in alcohol elimination. Bacillus coagulans has recently drawn tremendous interest in the food industry and medicine considering its great environmental tolerance and beneficial effects on improving gastrointestinal diseases. However, few scientific reports connect its utilities with alcohol elimination. In this study, we introduced the unique strain B. coagulans TCI711 for such exploration. TCI711 contained alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) by mass spectrum and resisted gastric acid and bile acid. Also, taking TCI711 capsules for a week can significantly improve alcohol metabolism in humans (breath alcohol level indicated 0 mg/kg in 2 h after drinking 75 mL of whisky). In brief, this exploratory research unveiled the potent applications of B. coagulans in alcohol elimination in humans.

Investigation of the Synergistic Effect of Brown Sugar, Longan, Ginger, and Jujube (Brown Sugar Longan Ginger Tea) on Antioxidation and Anti-Inflammation in In Vitro Models.

This research unveils the synergistic effect of brown sugar, longan, ginger, and jujube on the beneficial effects of antioxidation and anti-inflammation. Longan, ginger, and jujube are ubiquitous herbs in traditional Chinese medicine (TCM) and are frequently used in folk remedies. Longan and ginger have been reported to be beneficial for antioxidation, anti-inflammation, ant-obesity, and nonalcoholic fatty liver disease (NAFLD) improvements. However, the potential scientific and medical benefits of their combination Brown Sugar Longan Ginger Tea (BSLGT), a popular drink in Chinese cultures, are elusive. Through the in vitro methodologies, we discovered that BSLGT could significantly improve the mitochondrial activity, antioxidant capacity, lipid content, and inflammatory response in human hepatocytes. In addition, BSLGT also exerted positive effects on the downregulation of atherosclerosis-associated, vasoconstrictor, and thrombosis-related gene expression in human umbilical vein endothelial cells. In short, our experimental results successfully revealed that the antioxidative and anti-inflammatory effects of BSLGT may have the potential to improve liver metabolism and cardiovascular inflammation although solid evidence requires further investigation.

Use of Traditional Chinese Medicine May Delay the Need for Insulin Treatment in Patients with Type 2 Diabetes: A Population-Based Cohort Study.

Objectives: Traditional Chinese medicine (TCM) has been shown to reduce insulin resistance and improve beta cell function in previous studies. The aim of this study was to assess whether the use of TCM can delay the need for insulin therapy in patients with type 2 diabetes. Design: Data on patients with type 2 diabetes who received medical treatment for the first time between 2000 and 2003 were obtained from National Health Insurance Research Database (NHIRD) in Taiwan. Among these patients, those with a cumulative use of TCM of more than 28 days were defined as TCM users, and the others as non-users. Kaplan-Meier analysis was used to evaluate the cumulative risk of initiating insulin therapy. Cox proportional hazards models with and without competing risk events were used to evaluate the association between the use of TCM and insulin therapy. Settings/Location: Data were obtained from National Health Insurance Research Database (NHIRD) in Taiwan. Subjects: Patients with type 2 diabetes who received medical treatment for the first time between 2000 and 2003. Interventions: Among these patients, those with a cumulative use of TCM of more than 28 days were defined as TCM users, and the others as non-users. Outcome measures: After 1:1 propensity score matching, both groups were tracked until the initiation of insulin therapy, death, or the end of 2013. Results: We identified 6524 TCM users and 6524 non-users. The TCM users had a significantly lower risk of insulin initiation in a dose-dependent manner (log-rank test p < 0.001). This effect was consistent across subgroups with different severities of diabetes, and remained significant in competing risk analysis (for TCM users with 28 to 83 days cumulative use, HR 0.78 [0.70-0.87], p < 0.0001; for TCM users with ≥ 84 days cumulative use, HR 0.47 [0.42-0.53], p < 0.0001). Conclusions: The use of TCM in addition to standard diabetes treatment may delay the need for insulin treatment in patients who received medical treatment for type 2 diabetes for the first time. This benefit was strongly dose-dependent and applicable in patients with different severities of diabetes.

Oral intake of Streptococcus thermophil us improves knee osteoarthritis degeneration: A randomized, double-blind, placebo-controlled clinical study.

This preliminary clinical study demonstrates the possibility of a new species of probiotic for improvement of the degeneration of knee osteoarthritis (KOA). TCI633 (Streptococcus thermophil us) is a newly founded bacterium from human breast milk, and it is able to produce hyaluronate (HA) in gastrointestinal (GI) tract. A recent study has proved that TCI633 can substantially alleviate synovial tissue inflammation and cartilage damage in the animal models, but so far it has never been applied in clinical intervention. In this study, we recruited 80 subjects and conducted 12 weeks clinical trial to validate the efficacy of TCI633 for improvement of the progression of KOA. TCI633 could improve serum collagen type II C-telopeptide (sCTX-II) and serum C-reactive protein (sCRP) by 41.58% and 39.58%, respectively, after the study. The improvement rates for sCTX-II and sCRP in TCI633 group were 54% and 57%, respectively, at 12 weeks. Compared to the results of placebo, the indistinct improvement progresses of sCTX-II and sCRP might be caused by the uneventful distribution of K/L populations between the TCI633 and placebo groups, a short term of study period, and few recruited subjects. Moreover, the results of Western Ontario and McMaster Universities (WOMAC) questionnaires show that TCI633 might retard the progression and development of KOA after the trial. In brief, this preliminary research may provide an alternative approach to the improvement of KOA by probiotics although more detailed investigations should be conducted for solid conclusions.