Chinese Medicine Combined with Adjuvant Chemotherapy for Improving Myelosuppression in Colorectal Cancer Patients: A Systematic Review and Network Meta-Analysis.

OBJECTIVE: To assess the effectiveness of Chinese herbal medicine (CHM) combined with adjuvant chemotherapy on myelosuppression for colorectal cancer (CRC) patients using network meta-analysis (NMA). METHODS: Literature searches in both international (PubMed, Embase, Web of Science, and Cochrane Library) and Chinese (China Science and Technology Journal Database, Wanfang Data, China National Knowledge Infrastructure) databases for relevant randomized controlled trials (RCTs) were conducted from inception until October 10, 2022. We included RCTs of patients who received CHM combined with chemotherapy, including FOLFOX, XELOX, FOLFIRI, and other relevant regimens in the CHM treatment group. The outcomes included the incidence of myelosuppression, leukopenia, hemoglobin reduction, and thrombocytopenia. Two reviewers independently screened the databases, extracted the data, and assessed the risk of bias and credibility of evidence. RevMan 5.4.1 software and STATA 14.0 were used to perform the NMA. RESULTS: A total of 31 RCTs were included, published from 2008 to 2021 in Chinese. Among these, 2,314 participants comparing the following 9 CHMs were identified: Shengbai Recipe (SBR), Bazhen Decoction (BZD), Jianpi Jiedu Recipe (JJR), Jianpi Recipe (JR), Compound Cantharis Capsule (CCC), Zaofan Pill (ZFP), Guilu Erxian Gel (GL), Buzhong Tiaogan Decoction (BZ), and Qiamagu Capsule (QM). The results of NMA found an indirect comparison. Based on the surface under the cumulative ranking curve (SUCRA), the ZFP+ chemotherapy group had the lowest incidence of myelosuppression, with an odds ratio (OR) of 0.08 [95% confidence interval (CI): 0.01, 0.76], whereas the GL+ chemotherapy group had the lowest incidence of leukopenia, hemoglobin reduction, and thrombocytopenia, with an OR of 5.25 (95% CI: 2.41, 11.43), 4.66 (95% CI: 2.23, 9.72), and 0.27 (95% CI: 0.13, 0.54), respectively. Moreover, BZD + chemotherapy could alleviate leukopenia, hemoglobin reduction, and thrombocytopenia (P<0.01). Pairwise comparison showed that there was no difference in the efficacy among the 8 CHMs+ chemotherapy group. The comparison and adjustment funnel plot indicated that small-study effect had no impact on these outcomes. CONCLUSIONS: This NMA provided evidence to support that patients with CRC benefit from receiving different combination of CHM chemotherapies. Among these, GL plus chemotherapy and BZD plus chemotherapy were the more effective for myelosuppression in patients; however, as the qualtiy of evidence is insufficient, further research is needed. (PROSPERO, No. CRD42022369025).

Effect of Jianpi Bushen Sequential Formula on Adjuvant Chemotherapy of Colon Cancer: Study Protocol for a Randomized Controlled Trial.

BACKGROUND: The side effects of chemotherapy-induced nausea and vomiting (CINV) and myelosuppression reduce the cancer patients' adherence to chemotherapy. Many Chinese patients choose Chinese medicine (CM) during chemotherapy to reduce side effects; however, the evidence is lacking. The efficacy of a CM herbal treatment protocol, Jianpi Bushen Sequential Formula (, JBSF) will be evaluated on chemotherapy completion rate among patients with colon cancer. METHODS: A multi-center double-blind randomized controlled trial (RCT) will be conducted on 400 patients with colon cancer who will receive 8 cycles of adjuvant chemotherapy with oxaliplatin and capecitabine (CAPEOX). Patients will be randomized 1:1 to receive the JBSF or placebo formula. The primary outcome is the overall chemotherapy completion rate. The secondary outcomes include individual chemotherapy completion rate, 4-cycle completion rate of chemotherapy, time to treatment failure, relative dose intensity and treatment toxicity. Follow-up visits will be scheduled before every and after last chemotherapy. DISCUSSION: This study will provide evidence on whether JBSF can improve the chemotherapy completion rate and reduce side effects among patients with colon cancer. (Trial registration: ClinicalTrials.gov, No. NCT03716518).

Effectiveness of Herbal Medicine for Leukopenia/Neutropenia Induced by Chemotherapy in Adults with Colorectal Cancer: A Systematic Review and Meta-analysis.

OBJECTIVE: To evaluate the effectiveness of Chinese Herbal Medicine (CHM) on leukopenia/neutropenia induced by chemotherapy in adults with colorectal cancer (CRC). METHODS: Eight electronic databases were searched from their inception to June 2020. Randomized controlled trials with clarified sequence generation were qualified. Two reviewers independently conducted the screening and data extraction. Methodological quality was assessed using the Risk of Bias tool. RevMan 5.4 was applied to the meta-analysis. RESULTS: Twenty-seven studies involving 1867 participants were qualified, of which 26 were included in the quantitative synthesis. Meta-analysis showed that CHM significantly reduced the incidence of leukopenia induced by chemotherapy (RR = 0.69; 95% CI 0.59-0.82), as well as the grade 3/4 leukopenia (RR = 0.71; 95% CI 0.55-0.90). Meanwhile,CHM decreased the occurrence of neutropenia (RR = 0.52, 95% CI 0.35-0.77), especially for the grades 3/4 neutropenia (RR = 0.42, 95% CI 0.27-0.64). Twenty-six of the included studies focused on the adverse events related to CHM. CONCLUSION: CHM may relieve neutropenia/leukopenia induced by chemotherapy in adults with colorectal cancer.

Influence of elevated CO2 on nitrification and denitrification in water bodies: A review.

Elevated atmospheric CO2 has imperceptible impacts on carbon cycle in aquatic ecosystems. However, it remains a question how this process will impact nitrogen cycle that is naturally coupled with carbon cycle. The nitrification and denitrification are two critical processes in the nitrogen cycle. It is reasonable to expect that elevated atmospheric CO2 will influence both processes. We reviewed the previous literatures concerning the effects of elevated atmospheric CO2 on the physico-chemical properties, nitrification, denitrification and nitrogen transformation in water bodies. The published results revealed that the elevated CO2 would reduce the water pH, increase CO2 and HCO3- concentrations, but with different effects on the nitrification and denitrification between eutrophic and oligotrophic water. Elevated atmospheric CO2 could inhibit nitrification and denitrification in oligotrophic water, thereby reduce N2O flux from water. The nitrification process in the eutrophic water bodies was also inhibited, but its denitrification might be promoted by the elevated CO2. In the eutrophic water bodies, there could be an increase of N2O flux when pH was maintained in the range of 7-9. These might eventually result in the accumulation of NH4+ and reduction of NO3- in water, producing an impact on the microbial diversity. Based on these reviews, we proposed some research gaps related to the relevant research fields as well as some scientific questions that is worth to be further explored. This review would be helpful to better understanding on how the greenhouse effect caused by the elevated atmospheric CO2 would affect nitrogen cycle in aquatic ecosystem.

Reconstruction of bladder function and prevention of renal deterioration by means of end-to-side neurorrhaphy in rats with neurogenic bladder.

AIMS: To investigate the feasibility of restoring bladder function and prevention of renal deterioration by neurorrhaphy in rats with neurogenic bladder (NB). METHODS: Forty-two rats were assigned to the end-to-side nerve coaptation group (ECG, n = 16), no nerve coaptation group (NCG, n = 16), and control group (CG, n = 10). In the ECG, the left ventral root (VR) and dorsal root (DR) of L6 and S1 were transected, and the distal stump of L6VR was sutured to the lateral face of L4VR. In the NCG, the left VR and DR of L6 and S1 were transected, but coaptation was not performed. In the CG, no operation was performed. Nerve regeneration, bladder function, and renal function were evaluated by FluoroGold (FG) retrograde tract tracing, cystometry, electrical stimulation, MRI, histology and biochemical assays. RESULTS: In the ECG, FG-labeled neurons were observed in the left ventral horn of L4 spinal cord. There was a significant increase in intravesical pressure upon stimulation of the left L4VR proximal to the coaptation. Maximum cystometric capacity, post-void residual urine, bladder compliance and weight, serum creatinine, blood urea nitrogen, and fibrotic area of bladder and kidney were lower in the ECG than in the NCG, but higher than the CG. Hydronephrosis was noticed in ECG and NCG rats. Maximum detrusor voiding pressure was higher in the ECG and CG than in the NCG. CONCLUSIONS: End-to-side neurorrhaphy is a useful method for restoring bladder function and preventing renal injury in rats with NB.

Advances in management and utilization of invasive water hyacinth (Eichhornia crassipes) in aquatic ecosystems - a review.

The objective of this review is to provide a concise summary of literature in the Chinese language since late 1970s and focuses on recent development in global scenarios. This work will replenish the FAO summary of water hyacinth utilization from 1917 to 1979 and review ecological and socioeconomic impacts of the water hyacinth from 1980 to 2010. This review also discusses the debate on whether the growth of the water hyacinth is a problem, a challenge or an opportunity. Literature suggested that integrated technologies and good management may be an effective solution and the perception of water hyacinth could change from that of a notorious aquatic weed to a valuable resource, including its utilization as a biological agent for the application in bioremediation for removing excess nutrients from eutrophic water bodies at low cost. Key aspects on system integration and innovation may focus on low-cost and efficient equipment and the creation of value-added goods from water hyacinth biomass. In the socioeconomic and ecological domain of global development, all the successful and sustainable management inputs for the water hyacinth must generate some sort of social and economic benefit simultaneously, as well as benefiting the ecosystem. Potential challenges exist in linkages between the management of water hyacinth on the large scale to the sustainable development of agriculture based on recycling nutrients, bio-energy production or silage and feed production. Further research and development may focus on more detailed biology of water hyacinth related with its utilization, cost-benefit analysis of middle to large-scale application of the technologies and innovation of the equipment used for harvesting and dehydrating the plant.

[Impacts of Eichhornia crassipes (Mart.) Solms stress on the growth characteristics, microcystins and nutrients release of Microcystis aeruginosa].

Due to the large-scale application of Eichhornia crassipes (Mart.) Solms on the bioremediation of eutrophic lake in China, the influence of growth, physiological characteristics, microcystins production and release of M. aeruginosa by E. crassipes was investigated. Meanwhile, the release risk of nutrients from M. aeruginosa and the accumulation risk of microcystins in E. crassipe were explored through semi-continuous co-existence experiments. Our results indicated that M. aeruginosa was promoted by E. crassipes to undergo the cell death. Under the stress of E. crassipes, direct damage of phycocyanin and phycocyanin/allophycocyanin ratio in M. aeruginosa occurred, while the photosystem II-Hill reaction in M. aeruginosa was not interrupted. The PC/APC levels in the treatment of 10% and 20% water exchange rate were respectively decreased to 54.93% +/- 7.07% and 55.81% +/- 1.97% of the level in their relative controls after 8 days. Then, the final significant decrease of specific superoxide dismutase activity and the striking elevation of malondialdehyde content in M. aeruginosa could be the results of oxidative damage by E. crassipes. Algal malondialdehyde content in the treatment of 10% and 20% water exchange rate were respectively 2.95 +/- 0.074 and 2.22 +/- 0.086 times of the level in their relative controls on day 8. The release of nutrients from M. aeruginosa was accelerated because the decay and lysis of algal cells were promoted by E. crassipes. After 12-day co-existence experiments, the concentration of total dissolved nitrogen in water was brought back to the initial level and the release of total dissolved phosphorus was faster than nitrogen nutrients under the stress of E. crassipes. In addition, the microcystins production in M. aeruginosa was not stimulated and the extracellular microcystins were significantly eliminated by the influence of E. crassipes. The extracellular microcystins contents in the treatment of 10% and 20% water exchange rate were respectively decreased to 12.07 microg x L(-1) +/- 0.63 microg x L(-1) and 11.36 microg x L(-1) +/- 0.04 microg x L(-1) after 12 days. But the microcystins level in the whole plants of E. crassipes co-cultured with M. aeruginosa for 12 days was only about 5.95 ng x g(-1) +/- 0.76 ng x g(-1) FW. The increase of water exchange rate could reduce the damage of M. aeruginosa by E. crassipes, but had no significant effect on the microcystins elimination.

[Treatment of complex tibial plateau fractures with bilateral locking plate and bone graft].

OBJECTIVE: To explore the effective methods for the treatment of complex tibial plateau fractures. METHODS: From May 2008 to April 2011, 28 patients with complex tibial plateau fractures were treated indirect reduction techniques, bilateral locking plate fixation combined with autologous bone grafts. There were 21 males and 7 females, with an average age of 43 years ranging from 21 to 65. There were 11 cases in Schatzker type V, 17 in VI. The effect was evaluated by Rasmussen standard on clinical and radiological. RESULTS: All patients were followed-up for 7 to 36 months (averaged of 21.5 months). Healing time of fracture was from 3 to 8 months (averaged 5.5 months). The results of Rasmussen scores in clinical was 4.50 +/- 1.32 in pain, 4.32 +/- 1.63 in walking ability, 4.07 +/- 1.34 in knee activity, 4.78 +/- 1.27 in stability of the knee, 4.85 +/- 1.12 in stretch knee; the results in radiation was 5.07 +/- 0.92 in articular surface collapse, 5.00 +/- 0.98 in platform widened, 5.14 +/- 0.85 in knee external varus. The effect result was excellent in 8 cases, good in 15, fair in 3 and poor in 2. CONCLUSION: The key for the treatment of complex tibial plateau fractures was to fully assess the damage as much as possible to protect the soft tissue, select the appropriate timing of surgery and surgical incision, application of indirect reduction techniques, limited incision and effective internal fixation to restore joint surface smooth and good limb alignment, early exercise, in order to achieve maximum recovery of joint function.

[Purification effects of large-area planting water hyacinth on water environment of Zhushan Bay, Lake Taihu].

Using water hyacinth and other fast-growing and high biomass of floating plants to purify polluted water has become an efficient and effective ecological restoration method at present. Effects of nutrients adsorption and water purification of planting water hyacinth on water quality in Zhushan Bay were studied. The results indicated that no anoxia was observed in water hyacinth planting areas because of wave disturbance and strong water exchange. Concentrations of TN and TP in water hyacinth planting areas were higher than that in the outside of stocking area (the content ranged 3.03-7.45 mg/L and 0.15-0.38 mg/L, respectively), and the content changes ranged 3.37-8.02 mg/L and 0.15-0.36 mg/L,respectively. The higher concentration of TN and TP in water indicated the water body was heavily polluted. Water hyacinth roots have a strong ability to adsorb suspended solids and algae cells, the concentration of Chl-a in stocking areas was higher than that in stocking fringe and outside, the maximum Chlorophyll in the stocking region in August was 177.01 mg/m3, and at the same time the concentrations in planting fringe and outside were 101.53 mg/m3 and 76.96 mg/m, respectively. Higher Chl-a content on water hyacinth roots indicated that water hyacinth had strong blocking effects on algae cells, and demonstrated it had a great purification effects on eutrophicated water, and it also provides a basis for the larger polluted water bodies purification in using water hyacinth.

Self-assembly and characterization of copper 3,4-pyridinedicarboxylate complexes based on a variety of polynuclear hydroxo clusters.

Self-assembly of copper(ii) ion, 3,4-pyridinedicarboxylate (PDC), and 1,10-phenanthroline (phen) under basic conditions at 100 °C affords four PDC linked copper(ii) complexes, [Cu(4)(µ(2)-OH)(3)(µ(3)-OH)(PDC)(phen)(4)](n)·n(PDC)·11.5 nH2O (1), [Cu(4)(µ(2)-OH)(2)(µ(3)-OH)(2)(PDC)(phen)(4)](n)·n(PDC)· 11.5 nH(2)O (2), [Cu(8)(µ(2)-OH)(2)(µ(3)-OH)(6)(PDC)(2)(phen)(8)]·2(PDC)·23 H(2)O (3), and [Cu(3.5)(µ(2)-OH)(3) (PDC)(2)(phen)](n) (4). 1-4 are copper hydroxo complexes, and 1, 2 and 3 co-crystallized from the one-pot reaction. X-ray single crystal diffraction analyses indicate that complexes 1 and 2 are linkage isomers and contain tetranuclear copper cluster cores with different geometry, and that PDC links the cluster core to form a one-dimensional chain. Complex 3 is a discrete step-like octanuclear copper hydroxo cluster complex. The involvement of hydroxo and phen in the coordination makes some coordination sites of PDC idle, which leads to rich hydrogen bonds and π-π interactions in complexes 1, 2 and 3. Complex 4 contains two types of copper hydroxo cluster cores: chair-like tetranuclear and linear trinuclear units, and the cluster cores are linked by PDC to a double-layer metal-organic framework. Magnetic properties of 1, 3 and 4 were investigated. The results reveal that complexes 3 and 4 exhibit strong antiferromagnetic interactions whereas ferromagnetic coupling is predominant for complex 1. The magnetic properties are analyzed in connection with their structures.

Degradation of microcystin-LR and RR by a Stenotrophomonas sp. strain EMS isolated from Lake Taihu, China.

A bacterial strain EMS with the capability of degrading microcystins (MCs) was isolated from Lake Taihu, China. The bacterium was tentatively identified as a Stenotrophomonas sp. The bacterium could completely consume MC-LR and MC-RR within 24 hours at a concentration of 0.7 microg/mL and 1.7 microg/mL, respectively. The degradation of MC-LR and MC-RR by EMS occurred preferentially in an alkaline environment. In addition, mlrA gene involved in the degradation of MC-LR and MC-RR was detected in EMS. Due to the limited literature this gene has rare homologues. Sequencing analysis of the translated protein from mlrA suggested that MlrA might be a transmembrane protein, which suggests a possible new protease family having unique function.

[Effects of sediment dredging on benthos community structure and water quality in Zhushan Bay].

We surveyed the changes of macro-benthos community composition and nutrients concentration in water in Zhushan Bay after it had been dredged 6 months, which aimed to remove the polluted surface sediments. The results showed that the main benthos in the dredged and un-dredged sediments were Limodrilus hoffmeisteri, Pelopia and Bellamya aeruginosa; compared to the un-dredged sediments, the bio-diversity of dredged areas became lower. However, its biomass became higher than that in un-dredged areas. Concentration range changes of TN and TP in overlying water was 1.64-4.45 mg/L and 0.133-0.258 mg/L, respectively. The post-dredged sediments were still in a higher state of nutrients for the higher concentration nutrients in overlying water, macro-benthos were the species that lived in a serious polluted water environment. Using Shannon-Weaver, Simpson, and Goodnight benthic index to evaluate the results show that the dredged area is in the moderately polluted level, but un-dredged area is in the middle-heavily polluted level. According to the benthos fauna surveys and water quality monitoring results, the effective of sediment dredging could play its role only the strict control on the external pollution resources have been made and reduces the effects of polluted water on the sediments.

[Environment effects of algae-caused black spots: impacts on Fe-Mn-S cycles in water-sediment interface].

The driving effects of algal cells settlement in the water-sediment interface on Fe, Mn, S biogeochemistry in laboratory through static cultivation device. Results showed that dissolved oxygen would be exhausted by algae cells in 50 min after the cyanobacteria cells settled to the sediment surface. Soon the water-sediment interface formed the severe anoxia and Fe-Mn oxides and sulfides were deoxidized quickly in the strong reducing environment. The Fe2+, Mn2+ content in interface increased to the summit at the 4th day and their concentrations were 4.40 mg/L and 2.35 mg/L, respectively. When it comes to the end of the experiment, the Fe2+ content had a little reduction and Mn2+ reduced quickly, their concentrations were 3.37 mg/L and 0.97 mg/L at the end of experiment. However, S2- concentration in interface reached the highest at the 2nd day and its content was 0.63 mg/L, and its concentration was only 0.12 mg/L at the end since it has been reduced. The ORP was--150 mV in the sediment surface and indicated that the sediment environment was a strong reducing environment. Phenomenon of algal cells induced black spots in water bodies was the main driving factors on Fe/Mn oxides and sulfides biogeochemistry cycle, and also the extreme anoxia environment would have great harm on the water body's ecology.

[Environment effects of algae-caused black spots: driving effects on the N, P changes in the water-sediment interface].

The impact and driving effect of deposited algal cells in the water-sediment interface on the N, P changes were studied through continuous extracted pore water with home-made static experiment. Results showed that dissolved oxygen in water-sediment interface was depleted in 50 min after algal cells settled. Soon the dead algal cells formed the anoxia and strong reducing environment and the dead cells had a severe anaerobic mineralization in the water-sediment interface, also the water bodies had a intense black and stink phenomenon. PO4(-3) -P, NH4(+) -N concentration in water-sediment interface increased from the 2nd day after added the algal cells to the sediment interface, and its concentration was 4.00 mg/L and 39.45 mg/L, respectively. Its concentration was the 10 fold and 241 fold higher than that the control experiments at the same time (PO4(-3) -P, NH4(+) -N concentration in control experiments was 0.42 mg/L and 0.16 mg/L, respectively). Anaerobic mineralization of dead cells in sediment surface drove the nutrients diffusing upward the overlying water, added the nutrients concentration in water bodies, and it also supplied the nutrient materials for the algal blooms happened again.

[Effects of large-area planting water hyacinth on macro-benthos community structure and biomass].

The effects on macro-benthos and benthos environment of planting 200 hm2 water hyacinth (E. crassipens) in Zhushan Bay, Lake Taihu, were studied during 8-10 months consecutive surveys. Results indicated that average densities of mollusca (the main species were Bellamya aeruginosa) in far-planting, near-planting and planting area were 276.67, 371.11 and 440.00 ind/m2, respectively, and biomass were 373.15, 486.57 and 672.54 g/m2, respectively, showed that average density and biomass of planting area's were higher than those of others. However, the average density and biomass of Oligochaeta (the main species was Limodrilus hoffmeisteri) and Chironomidae in planting area were lower than that of outside planting area. The density and biomass of three dominant species of benthic animal increased quickly during 8-9 months, decreased quickly in October inside and outside water hyacinth planting area. The reason of this phenomenon could be possible that lots of cyanobacteria cells died and consumed dissolve oxygen in proceed decomposing. Algae cells released lots of phosphorus and nitrogen simultaneously, so macro-benthos died in this environment. The indexes of Shannon-Weaver and Simpson indicated that water environment was in moderate polluted state. On the basis of the survey results, the large-area and high-density planting water hyacinth haven't demonstrated a great impact on macrobenthos and benthos environment in short planting time (about 6 months planting time).