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Trends in Clinical Research on Herbal Medicine Treatment in Pediatric Asthma - Focusing on Randomized Controlled Clinical Trials in Traditional Chinese Medicine (소아 천식의 한약 치료에 대한 임상연구 동향 - 중의학 무작위 대조군 임상시험을 중심으로)

  • Seo Lin;Jang Subi;Choi Bom;Choi Bom;Cheon Jin Hong
    • The Journal of Pediatrics of Korean Medicine
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    • v.37 no.4
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    • pp.70-90
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    • 2023
  • Objective This study analyzed randomized clinical trials (RCTs) on pediatric asthma using traditional Chinese medicine (TCM) to determine its efficacy and safety. Methods We searched electronic databases in English, Chinese, Japanese, and Korean and evaluated 35 articles published up to December 28, 2022. Based on data from the literature, we analyzed treatments, results, composition of herbal medicine, frequency of medicinal herbs, and decoction. Results TCM for pediatric asthma was compared to supportive therapy, inhaled corticosteroids, and standardized treatments. Of the 35 studies, 32 showed that TCM treatments were effective in alleviating asthma symptoms. Furthermore, TCM treatment was considered safe compared to common asthma treatments. Among the TCM treatments for pediatric asthma, the most frequent decoctions were Gamisaganmahwangtang (加味射干麻黃湯) and Saganmahwangtang (射干麻黃湯). Ephedra Herba (麻黄), Armeniacae Semen (杏仁), Asiasari Radix et Rhizoma (細辛), Belamcandae Rhizoma (射干) were herbs that were frequently used for asthma in TCM decoctions. Conclusion This review showed that TCM is effective in treating pediatric asthma. More clinical RCTs are needed to confirm the efficacy and safety of TCM treatment.

Use of Magnetic Resonance Imaging for Evaluating Residual Breast Tissue After Robotic-Assisted Nipple-Sparing Mastectomy in Women With Early Breast Cancer

  • Wen-Pei Wu;Hung-Wen Lai;Chiung-Ying Liao;Joseph Lin;Hsin-I Huang;Shou-Tung Chen;Chen-Te Chou;Dar-Ren Chen
    • Korean Journal of Radiology
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    • v.24 no.7
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    • pp.640-646
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    • 2023
  • Objective: Prospective studies on postoperative residual breast tissue (RBT) after robotic-assisted nipple-sparing mastectomy (R-NSM) for breast cancer are limited. RBT presents an unknown risk of local recurrence or the development of new cancer after curative or risk-reducing mastectomies. This study investigated the technical feasibility of using magnetic resonance imaging (MRI) to evaluate RBT after R-NSM in women with breast cancer. Materials and Methods: In this prospective pilot study, 105 patients, who underwent R-NSM for breast cancer at Changhua Christian Hospital between March 2017 and May 2022, were subjected to postoperative breast MRI to evaluate the presence and location of RBT. The postoperative MRI scans of 43 patients (age, 47.8 ± 8.5 years), with existing preoperative MRI scans, were evaluated for the presence and location of RBT. In total, 54 R-NSM procedures were performed. In parallel, we reviewed the literature on RBT after nipple-sparing mastectomy, considering its prevalence. Results: RBT was detected in 7 (13.0%) of the 54 mastectomies (6 of the 48 therapeutic mastectomies and 1 of the 6 prophylactic mastectomies). The most common location for RBT was behind the nipple-areolar complex (5 of 7 [71.4%]). Another RBT was found in the upper inner quadrant (2 of 7 [28.6%]). Among the six patients who underwent RBT after therapeutic mastectomies, one patient developed a local recurrence of the skin flap. The other five patients with RBT after therapeutic mastectomies remained disease-free. Conclusion: R-NSM, a surgical innovation, does not seem to increase the prevalence of RBT, and breast MRI showed feasibility as a noninvasive imaging tool for evaluating the presence and location of RBT.

Network Pharmacology Analysis and Efficacy Prediction of GunryeongTang Constituents in Diabetic Complications (당뇨 합병증과 군령탕 구성성분의 네트워크 약리학 분석 및 효능 예측)

  • Jung Joo Yoon;Hye Yoom Kim;Ai Lin Tai;Ho Sub Lee;Dae Gill Kang
    • Herbal Formula Science
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    • v.32 no.1
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    • pp.11-28
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    • 2024
  • Objectives : GunRyeong-Tang(GRT) is a traditional herbal prescription that combines Oryeongsan and Sagunja-tang. This study employed network analysis methods on the components of GRT and target genes related to diabetes complications to predict the improvement effects of GRT on diabetes complications. Methods : The collection of active compounds of GRT and related target genes involved the utilization of public databases and the PubChem database. We selected diabetes complication-related genes using GeneCards and confirmed their correlation through comparative analysis with the target genes of GRT. We constructed a network using Cytoscape 3.9.1 and conducted topological analysis. To predict the mechanism, we performed functional enrichment analysis based on Gene Ontology (GO) biological processes and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Results : Through network analysis, 234 active compounds and 1361 related genes were collected from GRT. A total of 9,136 genes related to diabetes complications were collected, and 1,039 target genes overlapping with the components of GRT were identified. The core genes of this network were TP53, INS, AKT1, ALB, and EGFR. In addition, GRT significantly reduced the H9c2 cell size and the expression of myocardial hypertrophy biomarkers (ANP, BNP), which were increased by high glucose (HG). Conclusions : Through this study, we were able to predict the activity and mechanism of action of GRT on diabetes and diabetic complications, and confirmed the potential of GRT as a treatment for diabetes complications through the effect of GRT on improving myocardial hypertrophy for diabetic cardiomyopathy.

Engineering of the Phytase YiAPPA to Improve Thermostability and Activity and Its Application Potential in Dephytinization of Food Ingredients

  • Jing Zeng;Jianjun Guo;Lin Yuan
    • Journal of Microbiology and Biotechnology
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    • v.34 no.8
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    • pp.1660-1670
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    • 2024
  • The aim of this study was to modify phytase YiAPPA via protein surficial residue mutation to obtain phytase mutants with improved thermostability and activity, enhancing its application potential in the food industry. First, homology modeling of YiAPPA was performed. By adopting the strategy of protein surficial residue mutation, the lysine (Lys) and glycine (Gly) residues on the protein surface were selected for site-directed mutagenesis to construct single-site mutants. Thermostability screening was performed to obtain mutants (K189R and K216R) with significantly elevated thermostability. The combined mutant K189R/K216R was constructed via beneficial mutation site stacking and characterized. Compared with those of YiAPPA, the half-life of K189R/K216R at 80℃ was extended from 14.81 min to 23.35 min, half-inactivation temperature (T5030) was increased from 55.12℃ to 62.44℃, and Tm value was increased from 48.36℃ to 53.18℃. Meanwhile, the specific activity of K189R/K216R at 37℃ and pH 4.5 increased from 3960.81 to 4469.13 U/mg. Molecular structure modeling analysis and molecular dynamics simulation showed that new hydrogen bonds were introduced into K189R/K216R, improving the stability of certain structural units of the phytase and its thermostability. The enhanced activity was primarily attributed to reduced enzyme-substrate binding energy and shorter nucleophilic attack distance between the catalytic residue His28 and the phytate substrate. Additionally, the K189R/K216R mutant increased the hydrolysis efficiency of phytate in food ingredients by 1.73-2.36 times. This study established an effective method for the molecular modification of phytase thermostability and activity, providing the food industry with an efficient phytase for hydrolyzing phytate in food ingredients.

Quality Characteristics and Mineral, Oxalate and Phytate Contents of Tofu Manufactured by Recommended Soybean Cultivars in Korea (국산 장려콩으로 만든 두부의 Mineral, Oxalate 및 Phytate 함량과 품질특성)

  • Kim, Ki-Chan;Hwang, In-Guk;Kim, Hyun-Young;Song, Hang-Lin;Kim, Hong-Sig;Jang, Keum-Il;Lee, Jun-Soo;Jeong, Heon-Sang
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.7
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    • pp.986-991
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    • 2010
  • This study was conducted to investigate the changes of mineral, oxalate and phytate during tofu processing with Korean recommended soybean cultivars. Fourteen cultivars were selected by distribution of calcium, oxalate and phytate contents. Tofu was manufactured and analyzed for quality characteristics, mineral, oxalate and phytate contents. The yield and moisture contents of tofu ranged from 137.77% in Anpyeongkong to 201.91% of Geomjeongkong 4, and 74.42 (Bongeuikong)~80.01% (Hojangkong), respectively. The lightness (L-value), redness (a-value) and yellowness (b-value) ranged from 53.05 (Dawonkong) to 86.16 (Jipumkong 2), -2.04~5.85, and from 3.28 in Geomjeongkong 4 to 16.17 of Cheongjakong, respectively. The hardness of tofu with selected soybean cultivar ranged from 537.36 g (Dongpuktae) to 1696.05 g (Jinpumkong 2). The highest calcium content was 1.488 mg/g in Dawonkong, oxalate and phytate in tofu were high at 0.40 mg/g in Geomjeongkong 4 and 0.41 mg/g in Dawonkong, respectively. The transfer ratios of oxalate and phytate from soybean to tofu were ranged from 0.31~19.70 and 0.41~19.70%, respectively.

Bio-Conjugated Polycaprolactone Membranes: A Novel Wound Dressing

  • Cai, Elijah Zhengyang;Teo, Erin Yiling;Jing, Lim;Koh, Yun Pei;Qian, Tan Si;Wen, Feng;Lee, James Wai Kit;Hing, Eileen Chor Hoong;Yap, Yan Lin;Lee, Hanjing;Lee, Chuen Neng;Teoh, Swee-Hin;Lim, Jane;Lim, Thiam Chye
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.638-646
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    • 2014
  • Background The combination of polycaprolactone and hyaluronic acid creates an ideal environment for wound healing. Hyaluronic acid maintains a moist wound environment and accelerates the in-growth of granulation tissue. Polycaprolactone has excellent mechanical strength, limits inflammation and is biocompatible. This study evaluates the safety and efficacy of bio-conjugated polycaprolactone membranes (BPM) as a wound dressing. Methods 16 New Zealand white rabbits were sedated and local anaesthesia was administered. Two $3.0{\times}3.0cm$ full-thickness wounds were created on the dorsum of each rabbit, between the lowest rib and the pelvic bone. The wounds were dressed with either BPM (n=12) or Mepitel (n=12) (control), a polyamide-silicon wound dressing. These were evaluated macroscopically on the 7th, 14th, 21st, and 28th postoperative days for granulation, re-epithelialization, infection, and wound size, and histologically for epidermal and dermal regeneration. Results Both groups showed a comparable extent of granulation and re-epithelialization. No signs of infection were observed. There was no significant difference (P>0.05) in wound size between the two groups. BPM (n=6): $8.33cm^2$, $4.90cm^2$, $3.12cm^2$, $1.84cm^2$; Mepitel (n=6): $10.29cm^2$, $5.53cm^2$, $3.63cm^2$, $2.02cm^2$; at the 7th, 14th, 21st, and 28th postoperative days. The extents of epidermal and dermal regeneration were comparable between the two groups. Conclusions BPM is comparable to Mepitel as a safe and efficacious wound dressing.

Significant Efficacy of Additional Concurrent Chemotherapy with Radiotherapy for Postoperative Cervical Cancer with Risk Factors: a Systematic Review and Meta-analysis

  • Qin, Ai-Qiu;Liang, Zhong-Guo;Ye, Jia-Xiang;Li, Jing;Wang, Jian-Li;Chen, Chang-Xian;Song, Hong-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3945-3951
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    • 2016
  • Background: Whether concurrent chemotherapy treatment is superior to radiotherapy alone as an adjuvant regimen for postoperative cervical carcinoma with risk factors remains controversial. Materials and Methods: A literature search strategy examined Pubmed, Embase, the Cochrane Library, the China National Knowledge Internet Web, the Chinese Biomedical Database and the Wanfang Database. Article reference lists and scientific meeting abstracts were also screened. Controlled trials comparing concurrent chemoradiotherapy versus radiotherapy alone in postoperative cervical cancer were included. The methodological quality of non-randomized controlled trials was evaluated using the Newcastle-Ottawa Scale. Randomized controlled studies were evaluated with the Cochrane handbook. A meta-analysis was performed with RevMan 5.3. Results: A total of 1,073 patients from 11 clinical trials were analysed, with 582 patients in the concurrent chemoradiotherapy group and 491 patients in the radiotherapy group. Hazard ratios (HR) of 0.47 (95% CI 0.31-0.72) and 0.50 (95% CI 0.35-0.72) were observed for overall survival and progression-free survival, indicating a benefit from the additional use of concurrent chemotherapy. Subgroup analyses demonstrated that cervical cancer with high risk factors significantly benefitted from concurrent chemotherapy when examining overall survival (HR 0.44, 95% CI 0.28-0.67) and progression-free survival (HR 0.48, 95% CI 0.33-0.70), but patients with intermediate risk factors showed no benefit from concurrent chemotherapy in overall survival (HR 1.72, 95% CI 0.28-10.41) and progression-free survival (HR 1.09, 95% CI 0.19-6.14). No significant differences were observed for grade 3-4 anaemia (risk ratio (RR) 3.87, 95% CI 0.69-21.84), grade 3-4 thrombocytopenia (RR 3.04, 95% CI 0.88-10.58), grade 3-4 vomiting or nausea (RR 1.71, 95% CI 0.27-10.96), or grade 3-4 diarrhoea (RR 1.40, 95% CI 0.69-2.83). Significant differences were observed for grade 3-4 neutropenia in favour of the radiotherapy group (RR 7.23, 95% CI 3.94-13.26). Conclusions: In conclusion, concurrent chemoradiotherapy improves survival in postoperative cervical cancer with high risk factors but not in those with intermediate risk factors.

Creatine Kinase (CK)-MB-to-Total-CK Ratio: a Laboratory Indicator for Primary Cancer Screening

  • Chang, Chih-Chun;Liou, Ching-Biau;Su, Ming-Jang;Lee, Yi-Chen;Liang, Chai-Ting;Ho, Jung-Li;Tsai, Huang-Wen;Yen, Tzung-Hai;Chu, Fang-Yeh
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6599-6603
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    • 2015
  • Background: For the determination of creatine kinase (CK)-MB, the immunoinhibition method is utilized most commonly. However, the estimated CK-MB activity may be influenced by the presence of CK isoenzymes in some conditions like cancer. Thus, a CK-MB-to-total-CK ratio more than 1.0 could be found in such a situation. The study aimed to explore the relationship of cancer to high CK-MB-to-total-CK ratio. Materials and Methods: From January 2011 to December 2014, laboratory data on all CK-MB and total CK test requests were extracted at Far Eastern Memorial Hospital (88,415 requests). Patients with a CK-MB-to-total-CK ratio more than 1.0 were registered in this study. Clinical data including tumor location, tumor TNM stage and metastatic status were also collected. Results: A total of 846 patients were identified with a CK-MB-to-total-CK ratio more than 1.0. Of these, 339 (40.1%) were diagnosed with malignancies. The mean CK-MB-to-total-CK ratio was significantly higher in malignancy than in non-malignancy ($1.35{\pm}0.28$ vs $1.25{\pm}0.23$, p<0.001) groups. The most frequent malignancy with a CK-MB-to-total-CK ratio more than 1.0 was colorectal cancer ($1.42{\pm}0.28$, 16.5%, n=56), followed by lung cancer ($1.38{\pm}0.24$, 15.9%, n=54) and hepatocellular carcinoma (14.5%, n=49). Higher CK-MB-to-total-CK ratios in hematological malignancies ($1.44{\pm}0.41$)were also noted. Additionally, the CK-MB-to-total-CK ratio was markedly higher in advanced stage malignancy than in early stage ($1.37{\pm}0.26$ vs. $1.29{\pm}0.31$, p=0.014) and significantly higher in liver metastasis than in non-liver metastasis ($1.48{\pm}0.30$ vs. $1.30{\pm}0.21$, p<0.001). Conclusions: The CK-MB-to-total-CK ratio is an easily available indicator and could be clinically utilized as a primary screening tool for cancer. Higher ratio of CK-MB-to-total-CK was specifically associated with certain malignancies, like colorectal cancer, lung cancer and hepatocellular carcinoma, as well as some cancer-associated status factors such as advanced stage and liver metastasis.

Effect of Cryopreservation Medium and Freezing Method on Post-thaw Motility of Human Sperm : Comparison of Different Type of CASA (동결보존액의 종류와 동결방법에 따른 해동후 인간정자 운동성의 비교분석)

  • 전윤정
    • Development and Reproduction
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    • v.2 no.1
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    • pp.63-68
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    • 1998
  • This study was done to find optimal cryopreservation medium and method to improve the post-thaw motility of human sperm. Thirty three semaen samples were included in the study. Of these, nineteen Samples showing normal semen profile were frozen using three cryprotectants (TYB, TYB+DTT and KS II)to compare post-thaw motility. Fourteen samples were frozen with vapor freezing and programmable freezing methods to compare post-thaw motility in correlation with freezing method. After 24 hrs of cryostorage , the vials were thawed and the post-thaw sperm motility was assessed by two kinds of computer-aededsperm analysis (CASA; SAIS and Hamilton Thorn). As a result, the post-thaw motility of the KS II group was higher than the TYB or TYB+DTT group in normal semen(34.8%, 28.3% and 23.0%, respectively). In the asthenospermia group, a significantly hither post-thaw motility was observed in the KS II (18.5%) compared to those of TYB or TYB+DTT group (13.6%, 10.0%, respectively). No difference was observed between vapor freezing group and computerized freezing group in normal semen (27.8%, 33.2%, respectively) and semen group showing asthenospermia (12.8%, 12.9%, respectively). In conclusion, our results indicate that KS II medium is reliable for cryopreservation of human sperm and vapor freezing and programmable freezing were equally effective in terms of the recovery of motile spermatozoa.

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Sensitivity of Plasmodium falciparum to Antimalarial Drugs in Hainan Island, China

  • Wang, Shan-Qing;Wang, Guang-Ze;Li, Yu-Chun;Meng, Feng;Lin, Shi-Gan;Zhu, Zhen-Hu;Sun, Ding-Wei;He, Chang-Hua;Hu, Xi-Min;Du, Jian-Wei
    • Parasites, Hosts and Diseases
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    • v.53 no.1
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    • pp.35-41
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    • 2015
  • Pyronaridine and artesunate have been shown to be effective in falciparum malaria treatment. However, pyronaridine is rarely used in Hainan Island clinically, and artesunate is not widely used as a therapeutic agent. Instead, conventional antimalarial drugs, chloroquine and piperaquine, are used, explaining the emergence of chloroquine-resistant Plasmodium falciparum. In this article, we investigated the sensitivity of P. falciparum to antimalarial drugs used in Hainan Island for rational drug therapy. We performed in vivo (28 days) and in vitro tests to determine the sensitivity of P. falciparum to antimalarial drugs. Total 46 patients with falciparum malaria were treated with dihydroartemisinin/piperaquine phosphate (DUO-COTECXIN) and followed up for 28 day. The cure rate was 97.8%. The mean fever clearance time ($22.5{\pm}10.6hr$) and the mean parasite clearance time ($27.3{\pm}12.2hr$) showed no statistical significance with different genders, ages, temperatures, or parasite density (P>0.05). The resistance rates of chloroquine, piperaquine, pyronarididine, and artesunate detected in vitro were 71.9%, 40.6%, 12.5%, and 0%, respectively (P<0.0001). The resistance intensities decreased as follows: chloroquine>piperaquine>pyronarididine>artesunate. The inhibitory dose 50 ($IC_{50}$) was $3.77{\times}10^{-6}mol/L$, $2.09{\times}10^{-6}mol/L$, $0.09{\times}10^{-6}mol/L$, and $0.05{\times}10^{-6}mol/L$, and the mean concentrations for complete inhibition (CIMC) of schizont formation were $5.60{\times}10^{-6}mol/L$, $9.26{\times}10^{-6}mol/L$, $0.55{\times}10^{-6}mol/L$, and $0.07{\times}10^{-6}mol/L$, respectively. Dihydroartemisinin showed a strong therapeutic effect against falciparum malaria with a low toxicity.