Multidisciplinary strategies to enhance therapeutic effects of flavonoids from Epimedii Folium:Integration of herbal medicine,enzyme engineering,and nanotechnology

Flavonoids such as baohuoside I and icaritin are the major active compounds in Epimedii Folium(EF)and possess excellent therapeutic effects on various diseases.Encouragingly,in 2022,icaritin soft capsules were approved to reach the market for the treatment of hepatocellular carcinoma(HCC)by National Medical Products Administration(NMPA)of China.Moreover,recent studies demonstrate that icaritin can serve as immune-modulating agent to exert anti-tumor effects.Nonetheless,both production efficiency and clinical applications of epimedium flavonoids have been restrained because of their low content,poor bioavailability,and unfavorable in vivo delivery efficiency.Recently,various strategies,including enzyme engineering and nanotechnology,have been developed to increase productivity and activity,improve delivery efficiency,and enhance therapeutic effects of epimedium flavonoids.In this review,the structure-activity relationship of epimedium flavonoids is described.Then,enzymatic engineering strategies for increasing the productivity of highly active baohuoside I and icaritin are discussed.The nanomedicines for overcoming in vivo delivery barriers and improving therapeutic effects of various diseases are summarized.Finally,the challenges and an outlook on clinical translation of epimedium flavonoids are proposed.

Preventive and Therapeutic Effects of New Fungicides on Rice Blast

[Objectives]The paper was to identify the characteristics and the potency of new fungicides to rice blast disease,and study their preventive and therapeutic effects on the disease.[Methods]Six new and conventional fungicides with different mechanisms of action were selected to compare their preventive and therapeutic effects on rice seedling blast in greenhouse.[Results]The agents which showed to be highly efficacious in blast prevention(greater than 90%)were 25%pyraclostrobin EC,20%fenoxanil SC,75%tricyclazole WP and 50%prochloraz-manganese WP sprayed at the dosages of 112.5-150,180-360,270-450 and 450-600 g/ha,respectively.The therapeutic effect of new fungicides 25%pyraclostrobin EC and 50%prochloraz-manganese WP on rice blast were above 90%when the dosages were 90-150 and 360-600 g/ha,respectively.The therapeutic effect of the conventional fungicide 40%isoprothiolane EC on rice blast was 69.04%when the dosage was 480 g/ha,while those of other fungicides were worse.[Conclusions]Both 25%pyraclostrobin EC and 50%prochloraz-manganese WP have good preventive and therapeutic effects on rice blast,which will provide a reference for the use of these fungicides in the field.

Mechanism of Action and Therapeutic Effect of Modified Qiwei Baishu Powder in Diabetes

Objective:To study the mechanism of action and therapeutic effect of modified Qiwei Baishu powder in diabetic patients.Methods:From January 2021 to January 2022,80 diabetic patients were recruited in our study and divided into two groups by the random number table method.Group A was treated with modified Qiwei Baishu powder,whereas group B was treated with western medicine.The therapeutic effect,traditional Chinese medicine(TCM)syndrome score,blood sugar level,and incidence of adverse reaction were compared between the two groups.Result:The therapeutic effect in group A was significantly higher than that in group B(P<0.05);the TCM syndrome scores of group A were significantly lower than those of group B(P<0.05);the fasting blood glucose(FBG),2 hour-postprandial blood glucose(PBG),and glycosylated hemoglobin(HbA1c)levels of group A were significantly lower than those of group B(P<0.05);the incidence of adverse reaction in group A was significantly lower than that in group B(P<0.05).Conclusion:On the basis of western medicine,the addition of modified Qiwei Baishu powder can maintain stable blood sugar levels in patients and alleviate diabetic symptoms;thus,it is not only effective,but also safe for clinical use in diabetes.

Observation on the Therapeutic Effects of Acupuncture for 60 Cases of Simple Obesity

Simple obesity refers to a disease characterized by body overweight due to excessive calorie intake and over accumulation of adipose tissue in the body. With the improvement of life conditions, obesity has become a factor that impairs the health of the people. From 1997 to 1998, the author had treated 60 cases of simple obesity with acupuncture and obtained satisfactory results. The results of treatment are reported as follows.

Therapeutic effect of mesenchymal stem cells from different sources in the treatment of liver diseases

Hepatitis B Virus(HBV)is still one of the important problems threatening the health and safety of human life.If the virus can not be effectively controlled,it will gradually evolve into chronic hepatitis.Chronic hepatitis will not be treated for a long time,and will gradually develop into liver fibrosis,cirrhosis,liver cancer or even liver failure and other diseases with poor prognosis.However,there is no specific western medicine treatment for liver fibrosis,cirrhosis and other liver diseases.The main treatment methods are symptomatic treatment,internal medicine comprehensive treatment and prevention of complications.In recent years,the medical technology has been continuously developed and improved,scholars at home and abroad have focused on the effective ways to prevent and treat liver diseases.More and more studies have confirmed the mesenchymal stem cells Cell(MSC)plays an important role in the treatment of liver diseases.The author will describe the therapeutic effect of MSC from different sources on liver diseases.

Potential therapeutic effects of thymoquinone on treatment of amphetamine abuse

Dear Editor,The prevalence of drug abuse has diverted from traditional drugs such as opioid and cannabis to modern,synthetic and psychoactive drugs such as amphetamine groups,the amphetamine(AT)and methamphetamine[1].Amphetamine is used medically to treat several disorders such as attention deficit hyperactivity disorder,narcolepsy,depression and minor obesity[2].However,AT has also gained

Therapeutic effect of a dualchamber pacemaker with the optimized program-control mode on long-qt syndrome

Objectives To explore the optimized program-control mode of a dual-chamber pacemaker combined withβ-blocker to treat congenital long QT syndrome(LQTS). Methods 12 LQTS patients in our hospital that still have symptoms despite use of regular drug therapies or that can not endure the therapies were implanted with DDD cardiac pacemaker.The QT/QTc intervals of those patients were measured at different pacing rates respectively.Their cardiac pacemakers were all programmed to selectively turn on and turn off some related functions at the pacing rate of 80 beats/min.The dosage ofβ-blockers was adjusted according to the patients’ PR intervals and blood pressures.The MACE and the cardiac function of the patients were recorded after operation.Results The measured QT / QTc interval decreased with the pacing rate increasing.The pacing rate of 80 beats/min can make QT/QTc interval basically normal. The MACE of the patients were statistically declined(P = 0.003) and no negative effect on cardiac function was found during the follow-up.Conclusions The optimized program-control mode of a dual-chamber pacemaker combined withβ-blocker to treat congenital LQTS are:to pace at the rate of 80 beats/min and program to turn off lag,sleep,automatic preventing PMT and automatic threshold-capture feature and turn on the PVC,rate adaptation and atrioventricular node priority function.

Comprehensive therapeutic effect of the stroke rehabilitation unit in a medium-sized comprehensive community hospital

BACKGROUND: Acute stroke unit (stroke care unit) is developing in some domestic large-sized hospitals, but most stroke patients need stroke rehabilitation unit therapy, so setting stroke rehabilitation unit in medium-sized comprehensive community hospital (secondary hospital), where medical facility is relatively insufficient, is a new pathway to satisfy stroke patients. OBJECTIVE: To observe the comprehensive effect of developing stroke rehabilitation unit based on the facility of secondary hospital and its feasibility.DESIGN: Non-randomized concurrent controlled observation.SETTING: Department of Neurology, Beijing Longfu Hospital.PARTICIPANTS: Totally 264 stroke reconvalescents who suffered stroke for 7 days and received treatment in the Department of Neurology, Beijing Longfu Hospital during June 2003 to June 2005 were involved in the study. All the involved patients were confirmed by CT or MRI. The patients were scored by using Modified Edinbergh-Scandinavia stroke scale (SSS) > 16 points. Written informed consents were obtained from all the patients. The patients were assigned into 2 groups according to the willing of patients and their relatives: ①treatment group, in which, there were 134 patients, 76 males and 58 females, aged 43 to 74 years; cerebral infarction was found in 116 cases and cerebral hemorrhage in 18 cases;② control group, in which, there were 130 patients, 66 males and 64 females, aged 45 to 77 years, cerebral infarction was found in 115 cases and cerebral hemorrhage in 15 cases. There were significant differences in baseline data of the patients between two groups. METHODS: A same basic treatment was conducted in the patients of the two groups. ① Patients in the treatment group admitted to stroke rehabilitation unit and received comprehensive rehabilitation treatment. The rehabilitation flow-sheet: randomization-letting the patients of treatment group go into the unit-making comprehensive assessment in the initial stage-making therapy plan-talking with patients and their other family members-general rehabilitation-making metaphase assessment-adjusting therapy plan-making final assessment-letting the patients discharge and doing follow-up visits. ② The patients in the control group admitted to common wards, and they were encouraged to do activities by themselves in the early stage, but did not receive rehabilitation training under the instructions from professional physicians.MAIN OUTCOME MEASURES: The following assessments were conducted on admission and 7 and 28 days after admission: ① Severity of stroke and motor function: scored as 0 to 45 points by SSS, the higher points, the severer damage. ②Activities of daily living: Evaluated by Barthel index, 110 points in total, 110 points meant normal, 0 point meant extremely poor. ③Mental status: evaluated by Hopkin’s symptom scale with a 5-point scoring. The symptom was scored with low to high points. ④Cognitive function: Quantification measurement was conducted with LOTCA method. The higher points, the better therapeutic effects. RESULTS: ① Three cases dropped out and one died in the treatment group, 11 cases dropped out and 4 died in the control group. ②The neurologic impairment points on 7 and 28 days after therapy in the treatment group were lower than those in the control group separately [7 days:(9.73±6.43) points vs. (12.63±7.87) points, t =2.28, P < 0.05;28 days:(7.88±4.81) points vs. (9.84±7.03)points, t =2.04, P < 0.05]. ③ Barthel index on 7 and 28 days after therapy in the treatment group were higher than those in the control group separately [7 days:(54.28±8.38) points vs. (39.76±7.31) points, t =2.206, P < 0.05; 28 days:(89.72±7.94) points vs. (67.34±8.63) points,t =2.812, P < 0.01]. ④ Patients were allocated into different age groups based on age and evaluated with LOTCA. Results showed that there were no significant differences among different age groups (P > 0.05). ⑤ Totally 160 patients in the two groups accomplished the Hopkin’s test, among them, 94 (58.7%) had different mental disorders; Among the patients with mental disorder, depression, obsessive-compulsive and anxiety were found mostly, being 53.8%, 52.5% and 46.2%, respectively. CONCLUSION: ① Developing stroke rehabilitation unit therapy in the secondary hospital can obviously improve the motor function and activities of daily living of stroke reconvalescents. ② More than half of the stroke reconvalescents accompany the symptoms of depression, obsessive-compulsive, anxiety and other mental disorders. ③ The cognitive function of stroke reconvalescents is not related to age.

PREDICTION OF THE THERAPEUTIC EFFECTIVENESS OF NEW DRUGS FROM CLINICAL PHARMACOLOGY STUDIES

The development of new drugs for therapeutic purposes has become very expensive and time-consuming in American and European countries.It is estimated that on the average 50 to 100 million dollars and 10 or more years from the time of patenting are required to make a new drug available for general prescription. Every new drug needs to be charac-

Therapeutic effects of the Galium verum

Medicinal plants apply become a popular cure between patients with various diseases world.Aim of this review study of investigating of therapeutic effects of Galium verum.In the current review study,PubMed,Scopus,and Google Scholar were searched to provide information have shown the therapeutic effects of G.verum.This plant,is famous,as yellow Bedstraw.G.verum plant belongs to the Rubiaceae family.Analysis of G.verum plant represents that the plant included,chemical therapeutic compounds.Many compounds have been isolated from the Galium species plant so far.G.verum.Plants have been traditionally applied for the cure of many maladies.The former pharmacological researches represented that the G.verum plant possessed antioxidant effect,effects on the central nervous system,antimicrobial effects,endocrine effect,antihaemolytic activity,cytotoxic effects,etc.

Observation on the Therapeutic Effect and Complication Rate of Totally Laparoscopic Total Gastrectomy and Laparoscopic-Assisted Total Gastrectomy in the Treatment of Gastric Cancer

Objective:To investigate the effect and complication rate of totally laparoscopic and laparoscopic-assisted total gastrectomy in the treatment of gastric cancer.Methods:From March 2019 to July 2021,60 patients with gastric cancer were selected as the subjects in this study;the patients in group A underwent laparoscopic-assisted total gastrectomy,whereas those in group B underwent totally laparoscopic total gastrectomy;the treatment effect and complication rate were compared between the two groups.Results:The postoperative recovery of group B was significantly better than that of group A,and the postoperative complications(10.00%)of group B were significantly lower than that of group A(33.33%)(P<0.05).Conclusion:For patients with gastric cancer,totally laparoscopic total gastrectomy has better therapeutic effect and lower postoperative complications,which is worthy of popularization.

Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis

Background: Some depressed patients receive acupuncture as an adjunct to their conventional medications.Objective: This review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategy: English and Chinese databases were searched for randomized controlled trials(RCTs)published until December 1, 2021.Inclusion criteria: RCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysis: Meta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose.The Grading of Recommendations Assessment, Development and Evaluation(GRADE) framework was used to evaluate the overall quality of evidence in the included studies.Results: This review included 16 studies(with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17(HAMD-17) scores(standard mean difference [SMD]-0.44, 95% confidence interval [CI]-0.55 to-0.33, P < 0.01;I^(2)= 14%), Self-rating Depression Scale(SDS) scores(SMD-0.53, 95% CI-0.84 to-0.23, P < 0.01;I^(2)= 79%), and the Side Effect Rating Scale(SERS) scores(SMD-1.11, 95% CI-1.56 to-0.66, P < 0.01;I^(2)= 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores(SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01;I^(2)= 15%), decreased the number of participants who increased their antidepressant dosages(relative risk[RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01;I^(2)= 0%), and resulted in significantly higher remission rates(RR1.52, 95% CI 1.26 to 1.83, P < 0.01;I^(2)= 0%) and treatment responses(RR 1.35, 95% CI 1.24 to 1.47, P < 0.01;I^(2)= 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.Conclusion: Acupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.

Study on Preventive and Therapeutic Effect of Radix Salviae Miltiorrhizae on Recurrence and Metastasis of Liver Cancer

Objective: To study the inhibitory effect of Radix Salviae Miltiorrhizae (RSM) on adhesive and invasive ability of SMMC 7721 liver cancer cells, and on the metastasis and recurrence on post hepatectomy liver cancer in nude mice. Methods: Effect of RSM on SMMC 7721 cell membrane intercellular adhesive molecule 1 (ICAM 1) expression was observed by immunofluorescence flow cytometry; effect on invasive ability and of SMMC 7721 cell and the detachment of which attached to fibronectin (FN) by cell migration experiment; effect on adhesion of SMMC 7721 cell with FN by MTT method and effect on adhesion between 7721 7721, 7721 lymphocyte and 7721 endothelial cell by cell adhesion experiment. LCI D20 human liver cancer metastasis model, after hepatectomy, was used to observe the effect of RSM on recurrence and metastasis of liver carcinoma in nude mice. Results: ICAM 1 expression in SMMC 7721 cells incubated with RSM was significantly lower than that in cells did not treated with RSM. RSM could inhibit the invasive ability of SMMC 7721 cell and made the cells already attached to FN exfoliated. It could also inhibit the adhesion of 7721 7721, 7721 lymphocyte and 7721 endothelial cell. And RSM showed preventive and therapeutic effect on intrahepatic and remote metastasis/recurrence of early and late human post hepatectomy liver cancer in nude mice. Conclusion: RSM could inhibit the invasion and adhesion of SMMC 7721 cell and could also prevent and inhibit metastasis and recurrence of human liver cancer after hepatectomy in nude mice.

Kaempferol and its derivatives:Biological activities and therapeutic potential

Kaempferol,a natural plant-origin flavonoid,exhibits therapeutic anti-inflammatory,antioxidant,anticancer,antidiabetic,and neuroprotective properties.Kaempferol acts within several distinct mechanisms like apoptotic induction in cancer cells,enzymatic inhibition,signalling pathway inhibition,and downregulation in cell viability during the G2/M phase of cell division.This review summarizes the therapeutic effects of kaempferol against several health ailments.The recent progress on kaempferol obtained from fruits and vegetables as an antioxidant,anti-inflammatory,anticancer,antidiabetic,and neuroprotective agent and its mechanisms of action are also discussed.In addition,kaempferol has been reported to be present in wastes and byproducts from post-fruit and vegetable processing.Thus,a paradigm shift towards valorizing fruits and vegetable industrial wastes/byproducts to obtain bioactive kaempferol can support the circular economy pillar for generating wealth from waste and for finding a sustainable alternative source.

Effectiveness and safety of traditional Chinese medicine for diabetic retinopathy:A systematic review and network meta-analysis of randomized clinical trials

BACKGROUND Diabetic retinopathy(DR)is currently recognized as one of the most serious diabetic microangiopathies and a major cause of adult blindness.Commonly used clinical approaches include etiological control,microvascular improvement,and surgical intervention,but they are ineffective and have many side effects.Oral Chinese medicine(OCM)has been used for thousands of years to treat DR and is still widely used today,but it is unclear which OCM is more effective for DR.AIM To estimate relative effectiveness and safety profiles for different classes of OCMs for DR,and provide rankings of the available OCMs.METHODS The search time frame was from the creation of the database to January 2023.RevMan 5.3 and Stata 14.0 software were used to perform the systematic review and Network meta-analyses(NMA).RESULTS A total of 107 studies and 9710 patients were included,including 4767 cases in the test group and 4973 cases in the control group.Based on previous studies and clinical reports,and combined with the recommendations of Chinese guidelines for the prevention and treatment of DR,9 OCMs were finally included in this study,namely Compound Xueshuantong Capsules,Qiming Granules,Compound Danshen Dripping Pills,Hexue Mingmu Tablets(HXMM),Qiju Dihuang Pills(QJDH),Shuangdan Mingmu Capsules(SDMM),Danggui Buxue Decoction(DGBX),Xuefu Zhuyu Decoction and Buyang Huanwu Decoction.When these nine OCMs were analyzed in combination with conventional western medicine treatment(CT)compared with CT alone,the NMA results showed that HXMM+CT has better intervention effect on the overall efficacy of DR patients,HXMM+CT has better effect on improving patients'visual acuity,SDMM+CT has better effect on inhibiting vascular endothelial growth factor,DGBX+CT has better effect on reducing fundus hemorrhage area,HXMM+CT has better effect on reducing fasting blood glucose,and QJDH+CT has better effect on reducing glycated hemoglobin.When there are not enough clinical indicators for reference,SDMM+CT or HXMM+CT treatments can be chosen because they are effective for more indicators and demonstrate multidimensional efficacy.CONCLUSION This study provides evidence that combining OCMs with CT leads to better outcomes in all aspects of DR compared to using CT alone.Based on the findings,we highly recommend the use of SDMM or HXMM for the treatment of DR.These two OCMs have demonstrated outstanding efficacy across multiple indicators.