Objective: To assess the effect and safety of Reyanning Mixture(RYN) in treating asymptomatic or mild severe acute respiratory syndrome coronavirus 2(SARS-Co V-2) infection in children and adolescents. Methods: This i...Objective: To assess the effect and safety of Reyanning Mixture(RYN) in treating asymptomatic or mild severe acute respiratory syndrome coronavirus 2(SARS-Co V-2) infection in children and adolescents. Methods: This is a prospective, open-label, randomized control ed trial. Patients aged 1–17 years and diagnosed with asymptomatic or mild coronavirus disease-2019(COVID-19) were assigned to an intervention group(RYN plus standard care) and a control group(standard care) according to a randomization list. The primary outcomes were SARS-Co V-2 negative conversion time. Secondary outcomes included negative conversion rate on days 3 and 7, hospital length of stay, symptom relief rate, new-onset symptoms of asymptomatic infected patients, and progressive disease rate. The cycle threshold(Ct) values of ORF1ab or N genes were also tested. Results: A total of 214 patients in the intervention group and 217 in the control group were analyzed. The SARS-CoV-2 negative conversion time was significantly shortened in the intervention group [5 days(interquartile range(IQR): 5–6) vs. 7 days(IQR: 6–7), P<0.01]. By days 3 and 7, the negative conversion rates were significantly higher in the intervention group(day 3: 32.7% vs. 21.2%, P=0.007;day 7: 75.2% vs. 60.8%, P=0.001). Ct values significantly increase on day 2 [ORF1ab gene: 35.62(IQR: 29.17–45.00) vs. 34.22(IQR: 28.41–39.41), P=0.03;N gene: 34.97(IQR: 28.50–45.00) vs. 33.51(IQR: 27.70–38.25), P=0.024] and day 3 [ORF1ab gene: 38.00(IQR: 32.72–45.00) vs. 35.81(IQR: 29.96–45.00), P=0.003;N gene: 37.16(IQR: 32.01–45.00) vs. 35.26(IQR: 29.09–45.00), P=0.01]. No significant difference was found in hospital length of stay between the two groups(P>0.05). Symptoms of cough were significantly improved(82.2% vs. 70.0%, P=0.02) and wheezing was significantly reduced(0.7% vs. 12.9%, P<0.01) in the intervention group compared with the control group. During the trial, no disease progression or serious adverse events were reported. Conclusion: Adding RYN to standard care may be a safe and effective treatment for children with asymptomatic and mild SARS-Co V-2 infection.(Registration No. Chi CTR2200060292)展开更多
文摘通过网络药理学筛选黄芪-冬虫夏草治疗IgA肾病(IgA nephropathy,IgAN)的作用靶点和相关信号通路,明确其作用机制,并进行实验验证。应用TCMSP、BATMAN-TCM数据库结合文献挖掘获取黄芪-冬虫夏草的活性成分和作用靶点;通过GeneCards、OMIM数据库获取慢性IgAN的疾病靶点;筛选出与黄芪-冬虫夏草共同的靶点,进而利用Venny 2.1绘制共同靶点韦恩图;利用STRING构建共同靶点互作网络(PPI);应用Cytoscape 3.7.1软件构建成黄芪-冬虫夏草丸活性成分-靶点交集的网络;通过R语言软件对共同靶点进行GO分析和慢性IgA肾病作用靶点的KEGG分析,筛选出潜在通路并分析其作用机制。运用分子对接技术验证黄芪-冬虫夏草活性成分与关键靶点的结合效能。取IgA肾病造模大鼠(分空白组、模型组和黄芪-冬虫夏草中剂量组)分别治疗21天。取肾脏组织,采用酶联免疫法检测各组大鼠肾组织中VEGFA含量。筛选出黄芪-冬虫夏草中生物活性成分5个,作用于37个IgAN的共同靶点,核心靶点为VEGFA、HIF1A、NOS3、CASP3,主要涉及类固醇结合、细胞凋亡过程的半胱氨酸型内肽酶活性、雌激素受体结合、胆固醇结合等生物过程,主要富集在Lipid and atherosclerosis信号通路、AGE-RAGE信号通路、Fluid shear stress and atherosclerosis通路、PI3K-Akt信号通路等信号通路。分子显示主要成分和关键靶点之间具有较好的结合效能。相对于模型组,黄芪-冬虫夏草中剂量组VEGFA含量显著降低(P<0.05)。黄芪-冬虫夏草药对可能作用于VEGFA、HIF1A、NOS3、CASP3等关键靶点,通过抑制纤维化等与IgA肾病疾病相关的信号通路实现对IgA肾病的治疗作用。
基金the National Traditional Chinese Medicine Multidisciplinary Innovation Team Project(No.ZYYCXTD-D-202203)National Traditional Chinese Medicine Emergency Medical Rescue Base Construction(No.ZY(2021-2023)-0101-01)+1 种基金World Federation of Chinese Medicine Societies Project(No.SZL-2022YI010)Emergency Tackle Project on COVID-19 Omicron Infection of Shanghai University of Traditional Chinese Medicine(No.2022YJ-03)。
文摘Objective: To assess the effect and safety of Reyanning Mixture(RYN) in treating asymptomatic or mild severe acute respiratory syndrome coronavirus 2(SARS-Co V-2) infection in children and adolescents. Methods: This is a prospective, open-label, randomized control ed trial. Patients aged 1–17 years and diagnosed with asymptomatic or mild coronavirus disease-2019(COVID-19) were assigned to an intervention group(RYN plus standard care) and a control group(standard care) according to a randomization list. The primary outcomes were SARS-Co V-2 negative conversion time. Secondary outcomes included negative conversion rate on days 3 and 7, hospital length of stay, symptom relief rate, new-onset symptoms of asymptomatic infected patients, and progressive disease rate. The cycle threshold(Ct) values of ORF1ab or N genes were also tested. Results: A total of 214 patients in the intervention group and 217 in the control group were analyzed. The SARS-CoV-2 negative conversion time was significantly shortened in the intervention group [5 days(interquartile range(IQR): 5–6) vs. 7 days(IQR: 6–7), P<0.01]. By days 3 and 7, the negative conversion rates were significantly higher in the intervention group(day 3: 32.7% vs. 21.2%, P=0.007;day 7: 75.2% vs. 60.8%, P=0.001). Ct values significantly increase on day 2 [ORF1ab gene: 35.62(IQR: 29.17–45.00) vs. 34.22(IQR: 28.41–39.41), P=0.03;N gene: 34.97(IQR: 28.50–45.00) vs. 33.51(IQR: 27.70–38.25), P=0.024] and day 3 [ORF1ab gene: 38.00(IQR: 32.72–45.00) vs. 35.81(IQR: 29.96–45.00), P=0.003;N gene: 37.16(IQR: 32.01–45.00) vs. 35.26(IQR: 29.09–45.00), P=0.01]. No significant difference was found in hospital length of stay between the two groups(P>0.05). Symptoms of cough were significantly improved(82.2% vs. 70.0%, P=0.02) and wheezing was significantly reduced(0.7% vs. 12.9%, P<0.01) in the intervention group compared with the control group. During the trial, no disease progression or serious adverse events were reported. Conclusion: Adding RYN to standard care may be a safe and effective treatment for children with asymptomatic and mild SARS-Co V-2 infection.(Registration No. Chi CTR2200060292)
