Tropical Journal of Pharmaceutical Research

Antioxidant activity of self-nanoemulsifying drug delivery system (SNEDDS) of Curcuma longa in polycystic ovary syndrome rat model

Alfaina Wahyuni — 2024-10-08

Purpose: To investigate the effect of SNEDDS containing Curcuma longa extract on hormonal and histological improvement of polycystic ovary syndrome (PCOS) rat model.

Method: A total of 36 female Wistar rats, aged between 8 and 10 weeks, were randomly divided into 6 groups, including control (normal rats), PCOS (untreated PCOS rats), PCOS + M (treated with 20 mg/kg bw/day metformin), PCOS + SC25, PCOS + SC50, and PCOS + SC100 (treated with Curcuma longa extract at 25, 50, and 100 mg/kg/day with SNEDDS, respectively). This study used a posttest-only control group design. The rats were euthanized on day 15, and blood samples were taken to examine malondialdehyde (MDA) and anti-mullerian hormone (AMH) levels. Ovarian tissue was prepared on a histological slide, and various follicles were observed. Data was analyzed using analysis of variance (ANOVA) and Kruskal-Wallis tests.

Results: Curcuma longa extract, at 50 and 100 mg/kg, incorporated in SNEDDS resulted in a significant reduction in the corpus luteum number and width of the granulosa layer (p < 0.05). Also, Curcuma longa significantly reduced malondialdehyde (MDA), anti-mullerian hormone (AMH), preantral follicles, and follicular cysts (p < 0.05).

Conclusion: Curcuma longa extract in SNEDDS reduces MDA and AMH levels and improves the histology of the ovaries in PCOS model rats. There is a need to conduct further studies of C. longa extract or isolates in SNEDDS using human cell lines of PCOS model.

Oroxylum indicum Kurz (L) leaf extract exerted antioxidant and anti-inflammatory effects on LPS-stimulated BV2 microglial cells

Nootchanat Mairuae — 2024-10-08

Purpose: To investigate the antioxidant and anti-inflammatory effects of Oroxylum indicum (L.) Kurz leaf extract on lipopolysaccharide (LPS)-activated BV2 microglia.

Methods: BV2 cells were treated with LPS for 24 h in the presence or absence of Oroxylum indicum (O. indicum) leaf extract. The levels of reactive oxygen species (ROS), nitric oxide (NO), and interleukin 6 (IL-6) were quantified with CM-H2DCFDA, Griess reagent assay, and enzyme-linked immunosorbent assay (ELISA) test, respectively. The antioxidant activity of O. indicum leaf extract was assessed in vitro using DPPH, ABTS and FRAP assays.

Results: Treatment with LPS resulted in significant increases in the levels of ROS, NO, and IL-6, when compared to untreated cells. However, co-treatment with O. indicum leaf extract significantly suppressed the production of these inflammatory markers (p < 0.05). In addition, the leaf extract of O. indicum exhibited antioxidant activity in the DPPH, ABTS, and FRAP assays. The contents of flavonoids and phenolics in O. indicum leaf extract were 13.25 ± 0.163 mg QE/g of dried extract and 82.58 ± 1.772 mg QE/g of dried extract, respectively (p < 0.05).

Conclusion: The leaf extract of O. indicum exhibits anti-inflammatory and antioxidant properties in LPS-activated BV2 cells. This finding indicates that the leaf extract of O. indicum has promising potentials as a new source of herbal medication with anti- inflammatory properties. However, there is a need for more studies to unravel the fundamental mechanisms of their actions.

Effect of curcumin and cacao extract on interleukin-6 expression on ribociclib-induced hepatotoxicity in rats

Ali Ata Alsarhan — 2024-10-08

Purpose: To assess the relationship between interleukin-6 (IL-6) expression and the protective effect of curcumin and cacao extract on hepatotoxicity caused by ribociclib.

Method: Sixty adult male albino rats (9 – 10 weeks old) were utilized in this experiment. The rats were separated into six groups (n = 10 each). Group 1 (control) rats received 2 mL of normal saline daily. Group 2 rats were administered 5 mg/kg ribociclib and group 3 rats received 5 mg/kg ribociclib with a cacao dose of 200 mg/kg daily. Group 4 rats were administered 5 mg/kg ribociclib treated with curcumin (200 mg/kg) daily. Groups 5 and 6 were administered cacao and curcumin doses of 200 mg/kg daily. All rats were sacrificed and liver immunohistochemical and histological examinations were performed.

Result: The findings demonstrated that ribociclib administration caused liver damage and morphological changes at a histological level in liver tissue. The immunohistochemical investigation revealed that IL-6 levels were significantly increased in group 2 and control group (p < 0.05). Furthermore, co-administration of curcumin and cacao with ribociclib suppressed the levels of IL-6 expression in the liver tissue of rats compared to control group 1.

Conclusion: Co-administration of curcumin and cacao protects the liver against ribociclib-induced liver damage. It is necessary to determine the effect of long-term administration of these extracts on the functions of some organs such as the liver and kidney.

Memory-enhancing activity of verapamil in murine models of stress

Anthony T. Eduviere — 2024-10-08

Purpose: To evaluate the benefit of verapamil on stress-induced memory impairment in mice.

Methods: Forty-eight (48) mice were used in this study. They were divided into two equal groups based on the two models of stress used in this study (sleep deprivation and hypoxia). Each model was further divided into 4 groups of six animals each. The mice in the sleep deprivation model were suspended on a platform above water while in the hypoxic model, mice were locked in an airless container for 20 min daily throughout the experiment. As for the intervention, 25 and 50 mg/kg verapamil were preadministered via the oral route to study groups, except the normal control group and negative control group in both models. After seven-day stress and intervention, the mice were subjected to behavioural tests (Y-maze and object recognition tests), biochemical assays (for acetylcholinesterase activity) and histochemical analysis.

Results: Stress caused a significant (p < 0.05) impairment in the consolidation and retrieval of working and recognition memories. Also, acetylcholinesterase activity was significantly (p < 0.05) enhanced in the stressed groups when compared to control groups. Similarly, the histological analysis revealed a significant decline in population (p < 0.05), distribution and density of viable neurons in specific areas of the hippocampus and prefrontal cortex. These alterations were significantly (p < 0.05) attenuated in verapamil-treated groups almost in a dose-dependent pattern.

Conclusion: Verapamil displays significant memory-enhancing effects in two (2) murine models of stress. Antihypertensives should therefore be considered a viable prospect in the management of stress-related memory disorders after additional studies have been done to establish the mechanisms of action.

Adipose-derived mesenchymal stem cells mitigate doxorubicin-induced cardiomyopathy in rats

Demet Erciyes — 2024-10-08

Purpose: To investigate the effect of adipose-derived mesenchymal stem cells (ADMSCs) on doxorubicin (DOX)-induced cardiomyopathy in rats.

Methods: A total of 30 male Sprague-Dawley rats were randomized into control (n = 10) and study groups (n = 20). Control group received no intervention while the study group received DOX administered intraperitoneally (i.p.) six times daily at a dose of 2.5 mg/kg/ day. The study group was divided into 2 groups. One group received DOX + normal saline (0.9 %w/v) sodium chloride (NaCl) solution ntraperitoneally at a dose of 1 mL/kg/day. Another group received DOX + ADMSC at a dose of 2.0 x 106 cells/kg intraperitoneally twice a week. Biochemical parameters and histopathological changes in blood and heart tissue samples were compared among groups.

Results: Caspase-3 immuno-expression, plasma malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), growth differentiation factor-15 (GDF-15), pro-brain natriuretic peptide (Pro-BNP), troponin, heart transforming growth factor–β (TGF-β) were significantly lower in DOX+ ADMSC compared to DOX + saline group (p < 0.05). However, caspase-3 immune expression and the number of regularly arranged cardiomyocytes significantly decreased in DOX + ADMSC group compared to DOX + saline group (p < 0.05).

Conclusion: Adipose-derived mesenchymal stem cells (ADMSCs) reduce caspase-3 immunoexpression, restore cardiac histology, and ameliorate DOX- induced cardiac injury. Further investigation and clinical trials are recommended, especially to determine the continued safety and efficacy of AD-MSC-based therapy in cardiac injury.

Ling gui shen fu decoction ameliorates cardiac injury in ischemic heart disease rats by regulating ANP32A/HIF2α/HMGB1 signal route

Juanfen Gong — 2024-10-08

Purpose: To investigate the effect of ling gui shen fu decoction (LGSFD) on cardiac injury and cardiomyocyte apoptosis in rats with ischemic heart disease (IHD), and to elucidate the underlying molecular mechanism.

Methods: An IHD rat model was established by performing coronary artery occlusion surgery on the left anterior descending (LAD) of rats. The rats were assigned equally to 5 groups: sham-operated group (sham group), IHD group, IHD + perindopril group, IHD + low- dose LGSFD group (IHD + LGSFD-L group), and IHD + high-dose LGSFD group (IHD+LGSFD-H group). The LGSFD was given via gavage. A hypoxia-induced cardiomyocyte model was established by subjecting H9C2 cells to hypoxia. Then, LGSFD-containing serum or blank serum was used to treat the hypoxic rat cardiomyocytes (H9C2). The severity of cardiac injury and extent of apoptotic changes in cardiomyocytes was determined using hematoxylin-eosin (H&E) staining and TUNEL staining, while immunoblotting was used to measure the protein expressions of ANP32A, p-AKT, AKT, HIF-2α, p-mTOR, mTOR and HMGB1.

Results: The cardiac injury of rats in the LGSFD groups was significantly reversed, relative to the IHD group (p < 0.05). Moreover, LGSFD reduced the level of apoptosis in hypoxia- induced H9C2 cells and upregulated the concentrations of ANP32A, p-AKT, HIF-2α and p-mTOR. However, the expression levels of HMGB1 were decreased in the heart tissues of IHD rats and hypoxic H9C2 cells. Silencing of ANP32A with ANP32A siRNA (siANP32A) down- regulated ANP32A, p-AKT, HIF-2α and p-mTOR, but up-regulated apoptosis and expression levels of HMGB1 in hypoxic H9C2 cells.

Conclusion: LGSFD ameliorates cardiac injury in IHD rats by inhibiting cardiomyocyte apoptosis via the ANP32A/HIF-2α/HMGB1 axis. Further investigations are recommended into the specific mechanism of LGSFD effect using clinical samples, in order to facilitate its clinical development.

Efficacy of Sini SAN combined with Sijunzi decoction in tic disorder, and intestinal microbiota in children

Jianbo Guo — 2024-10-08

Purpose: To evaluate the efficacy of Sini SAN and Sijunzi decoction in tic disorder, and intestinal microbiota in children.

Methods: This study enrolled 100 children with tic disorder from April 2020 to January 2023 in First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China. The control group (n = 45) was administered tiapride hydrochloride 50 mg daily, (gradually increased to thrice daily over 1 - 3 months, then reduced to once daily for 1 month, with a total treatment duration of 6 months). On the other hand, the study group (n = 55) received tiapride hydrochloride in addition to traditional Chinese medicine (TCM), including Sini San and Sijunzi decoction with specific herbs (Radix pseudostellariae, white peony), for 6 months. Efficacy, TCM syndrome scores, Yale Global Tic Severity Scale (YGTSS) scores, amino acid neurotransmitter levels, and α-diversity of intestinal microbiota were assessed in both groups before treatment and at 4th and 8th weeks after commencement of treatment.

Results: There was no significant difference in baseline characteristics between the study and control groups, indicating comparability (p > 0.05). The study group had a significantly higher total effectiveness/efficacy (p < 0.05). It exhibited greater improvements in Traditional Chinese Medicine (TCM) syndrome scores and YGTSS scores in the 4th and 8th week of treatment compared to control group (p < 0.05). Additionally, the study group exhibited significant decrease in glutamate and aspartate levels and a significant increase (p < 0.05) in α-diversity of intestinal microbiota except for Simpson index (p > 0.05).

Conclusion: The combination of TCM and tiapride hydrochloride improves efficacy, modulates neurotransmitter levels, alleviates symptoms, and improves α-diversity of intestinal microbiota.

Protective effect of evodiamine on acetic acid-induced gastric ulcers in rats through regulation of ROS/ICAM1/Nrf2 signaling pathway

Sailian Li — 2024-10-08

Purpose: To study the effect of evodiamine on the signaling pathway of ROS/ICAM-1/Nrf2 in rats with acetic acid-induced stomach ulcers.

Methods: The rats were randomly assigned to five groups containing 10 rats each. Prior to acetic acidinduction of gastric ulcers, omeprazole (4.0 mg/kg/day), low-dose evodiamine (L-EVD, 20 mg/kg/day), and high-dose evodiamine (H-EVD, 40 mg/kg/day) were orally administered to the respective groups for 15 days. Following ulcer induction, the same treatments continued for an additional 7 days, for a total treatment duration of 22 days. The control (0.9 % saline) and acetic acid (model) groups were administered 0.9 % sodium chloride solution (10 mL/kg) for the same period. Thereafter, oxidative stress, inflammatory markers, macroscopic and microscopic evaluations were conducted on the gastric mucosa.

Results: The acetic acid group showed significantly higher levels of oxidative and inflammatory markers, as well as damage and degeneration of the gastric mucosa when compared to control group (p < 0.05). However, both low-dose and high-dose evodiamine treatment groups demonstrated significant gastric healing. Administration of low-dose and high-dose evodiamine resulted in significantly lower levels of malondialdehyde (MDA), tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), myeloperoxidase (MPO) and intracellular adhesion molecule-1 (ICAM-1, p < 0.05). Furthermore, evodiamine treatment led to significantly increased levels of glutathione (GSH) and nuclear facterythroid factor 2 (Nrf2).

Conclusion: Evodiamine reduces oxidative stress, suppresses inflammatory reactions, and exerts an anti-ulcer effect on acetic acid-induced gastric ulcers in rats by modulating ROS/ ICAM-1/Nrf2 signaling pathway. More studies into the integration of evodiamine into conventional pharmaceutical treatments for gastric ulcers should be conducted.

Anti-inflammatory and antiprotozoal effect of Hedyotis diffusa and Scutellaria barbata

Pham Thi Nhat Trinh — 2024-10-08

Purpose: To investigate the anti-inflammatory and antiprotozoal effects as well as chemical profile of ethanol extracts of Hedyotis diffusa (Rubiaceae) (HDE) and Scutellaria barbata (Lamiaceae) (SBE).

Methods: Dried whole plants collected in Vietnam were extracted with ethanol (30 and 96 %) by maceration for 4 weeks. The resulting extracts obtained after evaporating the solvent were stored in a refrigerator at 4 ^oC. Mouse carrageenan-induced inflammation and mouse macrophage cell line RAW264.7 were used to assess the in vivo and in vitro anti-inflammatory activities, respectively, while ciliate, Tetrahymena pyriformis was used to determine antiprotozoal effects. Ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) was employed to analyze the chemical profiles of the extracts.

Results: All the extracts manifested anti-inflammatory effects in vitro and in vivo. The HDE exhibited significantly higher in vitro anti-inflammatory activity than SBE (p < 0.05). Furthermore, in vivo antiinflammatory activity was higher in SBE compared to HDE. Both extracts exhibited antiprotozoal effects. The 96 % ethanol extract of both plants were more active than the 30 % ethanol extracts. Analysis by UHPLC‐Q‐TOF- MS revealed the presence of chrysin, apigenin and apigenin derivatives, naringenin, wogonin, quercetin and quercetin derivatives, as well as scutellarin.

Conclusion: The HDE and SBE extracts from Vietnam exhibit significant in vivo and in vitro antiinflammatory activities and in addition, antiprotozoal activity against Tetrahymena pyriformis. These plants, therefore, are potential sources of antiprotozoal agents.

Chemical composition, cytotoxic potential and antioxidant properties of Punica granatum peel extract

Sena Bakhti — 2024-10-08

Purpose: To evaluate the antioxidant activity of pomegranate peel extract and its effects on the survival of colorectal cancer cells (Caco-2) and kidney cells (HEK293).

Methods: An ethanol extract was prepared from the outer layer of pomegranate peels. The chemical composition of the extract was examined using high-performance liquid chromatography with diodearray detection (HPLC-DAD) and liquid chromatography with tandem mass spectrometry (LC-MS-MS). Antioxidant activity was determined using DPPH (2,2-diphenyl-1-picrylhydrazyl) and ABTS (2,2'- azinobis(3-ethylbenzothiazoline-6-sulfonic acid)) assays. Cytotoxicity was tested against Caco-2 colorectal cancer cells and HEK293 normal kidney cells using MTT assay.

Results: The pomegranate peel extract was rich in phenolic compounds and demonstrated significant antioxidant activity, with IC50 values comparable to Trolox in DPPH and ABTS assays. The extract exhibited selective and concentration-dependent cytotoxicity against Caco-2 cells, with an EC50 of 121.05 ± 13.12 µg/mL, while showing minimal toxicity towards HEK293 cells.

Conclusion: Pomegranate peel extract's high phenolic content and potent antioxidant properties highlight its potential as a therapeutic agent against colorectal cancer. The findings suggest that this extract could serve as a viable, natural alternative with reduced toxicity for colorectal cancer treatment.

Evaluation of knowledge, attitude and practice (KAP) of pharmacy students’ acceptance of COVID-19 vaccines in South India

Swathy Govindaswamy — 2024-10-08

Purpose: To assess South Indian pharmacy students' knowledge, attitudes and practices (KAP) regarding adherence to COVID-19 immunization guidelines.

Methods: A six-month prospective cross-sectional study was conducted among KMCH College of Pharmacy, Coimbatore pharmacy students. The 39 validated questions on knowledge, attitudes, practices, and concerns about the COVID-19 vaccine were used to grade replies using 3-point and 5- point Likert scales. IBM SPSS Statistics for Windows, Version 23.0, was used to analyze the data.

Results: The survey was completed by a total of 271 pharmacy students. A majority (59 %) of students possessed adequate knowledge (p = 0.0003), and 92 % were willing to receive COVID-19 vaccinations. The majority of respondents have implemented COVID-19-appropriate practices. Majority of information sources (52 %) were from healthcare providers.

Conclusion: Pharmacy students in South India have a fair knowledge of COVID-19 vaccination. More effort is required to improve awareness on this subject.

Efficacy of combined use of octreotide and sodium tanshinone IIA sulfonate in patients with cirrhosis complicated with severe acute pancreatitis

Juanzhi Hao — 2024-10-08

Purpose: To assess the prognosis of liver cirrhosis complicated with severe acute pancreatitis (SAP) after treatment with octreotide in combination with sodium tanshinone IIA sulfonate.

Methods: A total of 164 patients with cirrhosis complicated with SAP were randomly assigned to two groups, each with 82 patients. Serum levels of inflammatory factors, as well as vascular endothelial function and liver function indices were determined. Treatment outcomes in the patients were recorded in terms of abdominal pain relief time, gastrointestinal function recovery time, hospital stay duration, and incidence of complications.

Results: Relative to the control group, there were decreases in concentrations of inflammatory indices in the study cohort. Endothelial function index levels increased in the two groups, but the levels of endothelin (ET) and von Willebrand Factor (vWF) decreased more in the study group of patients, when compared to the control group, while nitric oxide (NO) level was raised (p < 0.05). Liver function improved in both groups. There were marked reductions in serum ALT, AST and total bilirubin (TBIL) in study cohort, relative to the control cohort (p < 0.05). However, albumin (ALB) levels were comparable in the two groups. Abdominal pain relief time, duration of hospitalization and time taken for normal digestive system function were shorter in the study cohort (p < 005). Receiver operating characteristic (ROC) curve analysis revealed that after treatment with octreotide and sodium tanshinone IIA sulfonate, values of area under the curve (AUC) for abdominal pain relief time, gastrointestinal function recovery time and hospital stay were 0.886, 0.918 and 0.794, respectively.

Conclusion: The combined use of octreotide and sodium tanshinone IIA sulfonate inhibits the release of inflammatory factors in cirrhotic patients with SAP, and improves vascular endothelial and liver functions, thereby improving disease prognosis. These data constitute a good scientific basis for the use of octreotide and sodium tanshinone IIA sulfonate in the treatment of liver cirrhosis complicated with SAP.

Evaluation of the effectiveness and safety of Korean red ginseng extract as immune-enhancer in Vietnamese adults: A randomized placebo-controlled trial

Phuong Thanh Mai — 2024-10-08

Purpose: To investigate the safety and immune-enhancing effect of Korean red ginseng (KRG) extract in Vietnamese adults.

Methods: Participants in this randomized, placebo-controlled double-blinded study were administered either 960 mg of KRG extract (n = 51) or placebo capsules (n = 50) for 12 weeks at Hanoi Medical University, Vietnam. The KRG extract was standardized to contain 5.27 mg of 3 ginsenosides (Rg1, Rb1, and Rg3) per gram. Blood samples for assessment of treatment effectiveness were collected from the subjects on days 21 and 84. Immune cytokines were quantified using enzyme-linked immunosorbent assay (ELISA). Blood samples for safety assessment, hematological and biochemical variables, and urinalysis were performed at the beginning and end of the intervention (days 21 and 84, respectively).

Results: The KRG group showed a significant increase in lymph T cell % at the end of the 12-week intervention (p < 0.001). There were significant decreases in numbers of white blood cells (WBC) and natural killer (NK) cells in both groups. However, there were no significant differences in populations of WBC and NK cells between the 2 groups. Serum concentrations of cytokines, i.e., TNF-α, β, γ; IFN- α, γ; IL-1β and 4β were decreased in the KRG group when compared to baseline values. There were no probable or definite adverse events (AEs) related to KRG. A total of 9 participants (4 in KRG group and 5 in placebo group) tested positive for COVID-19 during the trial.

Conclusion: The KRG extract-induced increase in population of T-cells and reductions in cytokine levels following a 12-week exposure may be beneficial for COVID-19 patients.

Efficacy of Qingying decoction and Wuling powder in the treatment of renal hematuria: A traditional Chinese medicine approach

Rui Tao — 2024-10-08

Purpose: To investigate the efficacy of combining Qingying decoction with Wuling powder in the treatment of renal hematuria.

Method: Seventy-six patients diagnosed with renal hematuria in the Emergency General Hospital and Nanmofang Community Health Service Center in Chaoyang District of Beijing, China were randomized equally into study and control groups. Control group received standard Western treatment in addition to Shenyan Rehabilitation tablets while study group received a combination of Qingying decoction and a modified Wuling powder alongside standard treatment for eight weeks. Treatment effectiveness was evaluated using urinary red blood cell count (URBC), urinary albumin-to-creatinine ratio (UACR), urinary β 2-microglobulin (β2-MG) and α 1-microglobulin (α1-MG) levels, serum levels of complement components 3 (C3) and 4 (C4), immunoglobulin A (IgA), and Traditional Chinese Medicine (TCM) syndrome scores.

Results: There was a significant difference in total therapeutic effectiveness between study and control groups (p < 0.01). Study group showed significantly improved hematuria and total syndrome scores (p < 0.01). The study group showed significantly lower URBC, UACR, β 2-MG, α 1-MG, IgA, and C3 levels compared to the control group (p < 0.05).

Conclusion: Treatment with Qingying decoction and Wuling powder demonstrates efficacy in managing renal hematuria, regulates urinary red blood cell counts, reduces symptoms, and lowers early renal impairment. Future studies in multiple centers using larger number of patients to determine the mechanisms of these drug actions and interactions and other related factors would be required.

Comparison of two types of thrombolysis combined with percutaneous transluminal angioplasty for acute thrombosis in arteriovenous fistula and graft

Yuanyuan Wang — 2024-10-08

Purpose: To investigate and compare the efficacy of two different types of thrombolysis combined with percutaneous transluminal angioplasty (PTA) for acute thrombosis in arteriovenous fistula (AVF) and graft (AVG).

Methods: A total of 128 patients on hemodialysis with acute AVF/AVG occlusion, from May 2021 to May 2023 at Jiangmen Central Hospital, Guangdong, were randomly assigned to study group (catheterdirected thrombolysis) (CDT) comprising of 62 patients and control group (scalp needle thrombolysis) comprising of 66 patients. Patients whose thrombolysis was unsuccessful on the first day, received PTA therapy the next day. Thrombolytic success rates, urokinase dosage, PTA therapy rates, mural thrombus occurrence, and post-thrombolytic complications were evaluated and compared.

Result: There was no significant difference in overall thrombolytic success rate, PTA combination rate and incidence of hemorrhage (p > 0.05) between study and control groups. Recanalization rate after urokinase thrombolytic therapy on first day was significantly higher in the study group than in the control group (p < 0.05). Urokinase dosage (first day) of patients whose thrombolytic therapy was successful was significantly lower in the study group than in the control group (p < 0.001).

Conclusion: Mechanical fragmentation by angiography catheter combined with urokinase thrombolysis improves efficacy, but shows no advantage when combined with PTA. Additional studies using a larger patient population on anticoagulant therapy and longer investigation time are recommended to enhance the generalizability of this treatment approach.

Effect of anti-osteoporotic drugs in reducing risk of refracture after percutaneous vertebroplasty

Fengyao Wang — 2024-10-08

Purpose: To investigate the effectiveness of anti-osteoporotic drugs in lowering risk of refracture after percutaneous vertebroplasty. Methods: The study involved 80 patients who underwent percutaneous vertebroplasty in The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China between August 2020 and July 2022. The study group (n = 40) received postoperative rehabilitation in addition to anti-osteoporotic drugs for 6 months), while the control group (n = 40) received routine postoperative rehabilitation from the time of surgery completion to 3 months postoperative. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were compared before surgery, 3 days, 3 months, and 6 months postoperative. Changes in the middle height of the vertebral body and bone density T-score of the surgical and adjacent vertebrae before and at end of follow-up, and refracture rates were compared.
Results: The study group showed significantly lower VAS and ODI scores at 3 and 6 months after surgery compared to control group (p < 0.05). Both groups showed significant increase in vertebral body height before surgery (p < 0.05), with no significant difference at last follow-up (p > 0.05). Also, the study group showed significant increase in bone density in the surgical and adjacent vertebrae compared to control group at last follow-up (p < 0.05). Refracture rate was significantly lower in study group than in the control group (p < 0.05). Conclusion: Administering anti-osteoporotic drugs after percutaneous vertebroplasty significantly alleviates pain, improves vertebral bone density, and reduces risk of refracture. However, a largesample, multicenter, randomized prospective study to validate these findings is recommended.

Lentinan combined with docetaxel and nedaplatin in the treatment of pulmonary tuberculosis complicated by nonsmall cell lung cancer

Dingjun Wang — 2024-10-08

Purpose: To investigate the efficacy and safety of lentinan combined with docetaxel and nedaplatin (DN) in the treatment of pulmonary tuberculosis complicated by non-small cell lung cancer (NSCLC).

Methods: A total of 100 patients diagnosed with pulmonary tuberculosis combined with NSCLC in Ankang People's Hospital, Ankang, China were randomized equally into study and control groups. Control group received standard anti-tuberculosis therapy and intravenous chemotherapy regimen based on docetaxel (75 mg/m² on day 1) and nedaplatin (80 – 100 mg/m²), while the study group received, in addition, lentinan (given intravenously every two days). The patients received a total of 2 courses of treatment. Tumor response, survival, adverse reactions, quality of life score, and pulmonary function indices were compared before and after treatment.

Results: The study group showed significantly higher total response rate than the control group (p < 0.05). Median overall survival and progression-free survival in the study group was significantly higher than in the control group (p < 0.05). Also, the study group showed significantly lower incidence of adverse reactions compared to control group (p < 0.05). Quality of life score, maximum voluntary ventilation (MVV) and peak expiratory flow (PEF) levels in the study group was significantly higher compared to control group (p < 0.05).

Conclusion: Lentinan combination with DN chemotherapy regimen improves response rate, prolongs survival, reduces incidence of adverse reactions, improves quality of life and pulmonary function in patients with pulmonary tuberculosis complicated by NSCLC. These findings provide a new perspective for future studies on the application of lentinan in the treatment of pulmonary tuberculosis complicated by NSCLC.

Effect of sacubitril and valsartan combined with conventional therapy on patients with heart failure

Zhenyu Wu — 2024-10-08

Purpose: To investigate the clinical effectiveness of the combination of sacubitril and valsartan with conventional therapy in the treatment of patients with heart failure.

Methods: This was a retrospective study comprising 100 heart failure patients randomized into study (n = 57) and control groups (n = 43). The study group received sacubitril/valsartan along with conventional drug therapy while control group received only conventional drugs, viz, irbesartan, metoprolol slow release, and furosemide tablets. Echocardiogram showing left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), left anterior descending artery (LAD), Nterminal pro-b-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP), glomerular filtration rate (eGFR), and homocysteine (HCY) of the two groups were compared before and after treatment. Multiple regression was used to analyze the correlation between re-hospitalization and sacubitril/valsartan intervention.

Results: The study group showed significantly lower LVEF, LVESD, LVEDD, LAD, NT-proBNP, and homocysteine levels after treatment compared to control group (p < 0.05). Re-hospitalization for abnormal cardiovascular events between the two groups was significantly different in the adjusted Cox proportional hazards regression model. Furthermore, multiple regression analysis showed that sacubitril/valsartan treatment was the independent variable (p < 0.001).

Conclusion: Sacubitril/valsartan improves heart function, with reduced incidence of adverse effects without affecting renal function. Further studies are required to validate these findings by expanding sample size, strictly controlling data quality and strengthening follow-up.

Effect of N-acetylcysteine in treatment of COPD with pulmonary interstitial fibrosis, inflammatory factors and VEGF levels

Jie Yang — 2024-10-08

Purpose: To investigate the efficacy of N-acetylcysteine as an adjuvant therapy in chronic obstructive pulmonary disease (COPD) with pulmonary interstitial fibrosis (PIF), and its effect on inflammatory factors and serum vascular endothelial growth factor (VEGF) levels.

Methods: A total of 94 patients with COPD-PIF from May 2020 to May 2022 in Wuhan Fourth Hospital, China were equally randomized into study and control groups. Control group was administered conventional treatment while the study group was given N-acetylcysteine in addition to conventional treatment. Therapeutic efficacy, forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, blood gas, pulmonary fibrosis, and oxidative stress were evaluated. Changes in inflammatory factors, serum vascular endothelial growth factor (VEGF), and incidence of adverse drug reactions were compared.

Results: The study group showed significantly higher efficacy, FEV1, FVC, FEV1/FVC compared to control group (p < 0.05). Also, study group showed significantly higher partial pressure of oxygen (PaO2), blood oxygen saturation, superoxide dismutase (SOD), and glutathione (GSH) levels after treatment compared to control group (p < 0.05). Platelet-derived growth factor (PDGF), transforming growth factor (TGF-β), vascular cell adhesion molecule (VCAM), tumor necrosis factor (TNF), interleukin-6 (IL-6), and vascular endothelial growth factor (VEGF) levels after treatment were significantly lower in the study group than in the control group (p < 0.05).

Conclusion: N-acetylcysteine as an adjuvant therapy for COPD-IF is highly effective, improves lung function and oxidative stress, reduces airway inflammation, and VEGF, and attenuates the degree of hypoxia and pulmonary fibrosis with no serious adverse effects. A larger sample size, multicenter, randomized trials to validate these findings and evaluate the downstream regulatory mechanism of Nacetylcysteine in COPD-PIF.

Efficacy of oral roxadustat combined with L-carnitine for dialysis-induced anemia in patients with chronic renal failure

Chun Zhang — 2024-10-08

Purpose: To investigate the efficacy of oral roxadustat plus L-carnitine for dialysis-induced anemia in patients with chronic renal failure (CRF).

Methods: This was a retrospective analysis of 46 patients conducted on 100 CRF cases with dialysisinduced anemia treated at Xinjiang Armed Police Crops Hospital from March 2020 to March 2023. The participants were randomly distributed into study (n = 54) and control groups (n = 46). The control group received oral roxadustat (100 mg for patients weighing 45 - 60 kg, and 120 mg for patients ≥ 60 kg, thrice per week), while the study group was administered roxadustat in combination with L-carnitine (2 g injected using the dialysis machine before the end of each session). Anemia indices, and iron metabolism indices in the two groups were assessed before treatment and 3 months after treatment. Adverse effects were compared between groups.

Results: The study group showed significantly higher red blood cell count, haemoglobin level as well as haematocrit after treatment compared to control group (p > 0.05). Also, total iron binding capacity, and serum iron and ferritin levels were significantly higher in the study group than in the control group (p < 0.05).

Conclusion: Roxadustat combined with L-carnitine significantly reduces anemia and improves iron metabolism without increasing adverse reactions. However, there is a need for additional studies to assess the therapeutic potential of this combined regimen.

Effect of Kangfuxin liquid combined with triamcinolone acetonide in oral submucosal fibrous degeneration

Xinyun Zhang — 2024-10-08

Purpose: To investigate the effect of Kangfuxin liquid combined with triamcinolone acetonide in the treatment of oral submucous fibrous degeneration.

Methods: A total of 140 patients with oral submucosal fibrous degeneration admitted to the outpatient clinic of Haiyan County Stomatological Hospital, China from June 2020 to June 2023 were divided equally into study and control groups. The study group received Kangfuxin liquid in addition to 1 mL triamcinolone acetonide (40 mg/mL) while the control group received 1 mL triamcinolone acetonide; therapeutic effects were compared after 4 weeks of treatment. Visual analogue scale (VAS) score, serum transforming growth factor (TGF-β1), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were determined. Also, whole blood viscosity (WBV), plasma viscosity (PV), erythrocyte sedimentation rate (ESR), and incidence of adverse reactions were evaluated.

Result: The study group showed significantly reduced pain levels compared to the control group, as well as lower mucosal damage areas and improved mouth opening after 4 weeks of treatment compared to control group (p < 0.05). Also, the study group showed significantly lower TGF-β1, TNF-α and IL-6 compared to control group after treatment (p < 0.05). It showed significantly lower WBV, PV, and ESR compared to control group (p < 0.05). Furthermore, the study group showed significantly lower incidence of adverse reactions than the control group (p < 0.05).

Conclusion: Kangfuxin liquid, when combined with triamcinolone acetonide, lowers pain, reduces the levels of STGF-β1, improves hemorheology, and produces minimal adverse effects compared to triamcinolone alone. Future studies should focus on long-term outcomes to better assess the therapeutic potential of this combined regimen.

Effect of intravenous thrombolysis with butylphthalide, edaravone and recombinant tissue plasminogen activator (rt-PA) on serum inflammatory factors in patients with ischemic stroke

Xiao Zhe — 2024-10-08

Purpose: To study the impact of edaravone in combination with edaravone and recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis on serum inflammatory factors in ischemic stroke subjects.

Methods: Eighty ischemic stroke patients in the First Affiliated Hospital of Xi'an Medical University, Xi’an, China were randomly assigned to study and control cohorts, each with 40 subjects. Patients in control cohort were administered edaravone and rt-PA intravenous thrombolysis. The study cohort received butylphthalide in combination with edaravone and rt-PA intravenous thrombolysis. Treatment effectiveness/efficacy, neurological function, self-care ability, inflammatory indicator levels, and blood cell levels were compared between the 2 cohorts.

Results: Efficacy was significantly better in the study cohort than in the control cohort (p < 0.05). After treatment, NIHSS score was significantly lower in the study cohort than in control cohort, while ADL score was significantly higher in the study cohort (p < 0.05). After medication, CRP level was decreased significantly in both cohorts, but was significantly lower level in the study cohort (p < 0.05). Treatment led to significant reductions in white blood cell count, neutrophil count, and NLR ratio in the study cohort, relative to the control cohort (p < 0.05).

Conclusion: The use of butylphthalide in combination with edaravone and rt-PA intravenous thrombolysis produces significant and beneficial effects on ischemic stroke subjects by regulating abnormal levels of inflammatory cells, improving coagulation status and decreasing inflammation. Moreover, it ameliorates neurological defects and improves activities of daily living. There is, however, a need to determine the mechanisms of action of this combination therapy and the influence of other cofounding factors on the activities of the combination therapy.

Knowledge and awareness of ketoacidosis associated with high exposure to acetone-containing products: A crosssectional assessment

Reem Issa — 2024-10-08

Purpose: To assess the knowledge and awareness of the Jordanian public about the hazards associated with high levels of exposure to acetone-containing products.

Methods: The study was conducted between September 2019 and December 2020. An electronic anonymous questionnaire was distributed via different channels to be self-completed by the study population. Socio-demographic characteristics, knowledge about acetone-containing nail polish removers and sterilizing products, and awareness about the risk of ketoacidosis associated with high degree of exposure to these products, were assessed.

Results: The findings revealed that a majority of participants were aware of the presence of acetone in nail polish removers (92.61 %) and sterilizing products (84.41 %), regardless of gender, age, educational type and educational level. In addition, females (70.4 or 83.0 %), youngest age group (70.7 or 83.0 %), those with health-related education (56.6 or 76.0 %), and graduates (72.0 or 83.9 %) were significantly (p < 0.05) more aware about the safety of these products if inhaled or exposed to flame sources, respectively, than their peers. Moreover, concerning the risks of developing ketoacidosis and raised liver ketone levels as hazards associated with the high degree of exposure to acetone-containing products, females (44.2, 41.9 and 50.6 %), those with health-related education (64.1, 63.4 and 73.3 %), youngest age group (47.4, 44.6 and 56.5 %), and graduates (45.3, 43.5 and 52.8 %), respectively, were significantly more aware than the others (p < 0.05).

Conclusion: These findings indicate signs of significantly poor awareness about the serious risks associated with acetone-caused ketoacidosis among the study population. Therefore, well-organized educational campaigns are needed to enlighten graduates with health-related education and to improve public perception of the health hazards associated with human exposure to acetone-containing products.