Development of a Computerized Adaptive Test for Quantifying Chinese Medicine Syndrome of Myasthenia Gravis on Basis of Multidimensional Item Response Theory

Immunomodulatory activities of polysaccharides isolated from Amauroderma rugosum (Blume and T. Nees) Torrend and their structural characterization

Amauroderma rugosum (Blume and T. Nees) Torrend is a traditionally well-known mushroom that is used for the treatment of cancer. In order to evaluate the pharmacological activities of A. rugosum polysaccharides, the mushroom powder was subjected to hot water extraction and pure polysaccharides (ARPs) were isolated by gel-filtration method. Three important APRs called ARP-1, ARP-2 and ARP-5 were identified with average molecular weights of 1494, 450, and 7 kDa respectively. Their antioxidant abilities were estimated by examining free radical scavenging potential against 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid radical (ABTS●+), 2,2-diphenyl-1-picrylhydrazyl radical (DPPH●), and hydroxyl radical. Immunomodulatory potentials of these ARPs were determined using murine macrophage cells. These polysaccharides exhibited high antioxidant abilities and stimulated mouse macrophages leading to the generation of tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Excellent activities were displayed by ARP-1 and APR-2. Gas chromatography and spectroscopic (FT-IR and NMR) methods were employed in order to carry out their structural characterisation. The two high molecular weight ARPs (ARP-1 and ARP-2) displayed β-(1 → 3)-D-glucan backbone structure with branching of β-(1 → 6)-d-glucopyranosyl. These observations suggest high potential of ARPs for immunotherapeutic applications.

Management of dysmenorrhea through yoga: A narrative review

Menstrual pain also known as dysmenorrhea is one of the most common and underrated gynecological disorders affecting menstruating women. Although the symptoms and impact might vary greatly, it is defined by cramps in the lower abdomen and pain that radiates to lower back and thighs. In some cases it is also accompanied by nausea, loose stool, dizziness etc. A primary narrative review was conducted on the impact of yoga on dysmenorrhea experienced by women. The English-language literature published until 2022 was searched across databases such as PubMed, Google Scholar and Scopus. “Yoga” and “menstrual pain” OR “dysmenorrhea” were used as keywords for the search across several databases. A total of 816 title searches were obtained across all the database searches. This review article included 10 studies based on the selection criteria. The studies examined the impact of a varied set of 39 asanas, 5 pranayamas and Yoga nidra on dysmenorrhea. The studies demonstrated a significant relief in dysmenorrhea among those who practiced Yoga (asanas/pranayama/yoga nidra) with improved pain tolerance and reduced stress levels. Regulating the stress pathways through yoga was found to be a key in regulating hormonal balance and reduction in dysmenorrhea.

Effects of Baduanjin exercise in nasopharyngeal carcinoma patients after chemoradiotherapy: a randomized controlled trial

OBJECTIVE

To evaluate the effects of traditional Chinese Baduanjin Qigong exercises on the physical and psychological recovery of patients with nasopharyngeal carcinoma after chemoradiotherapy.

METHODS

Eighty-eight nasopharyngeal carcinoma patients who had completed chemoradiotherapy were randomly divided into the Baduanjin intervention group (n = 44) and the control group (n = 44). Patients in the intervention group practised Baduanjin exercise for 12 weeks, with the frequency of 40 min a day and 5 days a week after discharge from the hospital. Participants in the control group received usual care. Outcome indicators included quality of life (QOL), complications, cancer-related fatigue (CRF), sleep quality, anxiety, and depression. The intention-to-treat and per-protocol populations were compared using univariate analysis of variance. Partial eta squared was used as a measure of the effect size.

RESULTS

A total of 75 patients completed the study. In the intention-to-treat analysis, after 12 weeks of exercise intervention, there were significant increases in the global FACT-H&N (95% CI = 2.09 to 11.47, η_p² = 0.088), social/family well-being (95% CI = 0.13 to 2.26, η_p² = 0.055), emotional well-being (95% CI = 0.34 to 2.44, η_p² = 0.074), and head and neck cancer subscale scores (95% CI = 0.17 to 3.86, η_p² = 0.052) in the Baduanjin group compared with the control group at the 12th week. In the per-protocol analysis, there were significant increases in the global FACT-H&N (95% CI = 4.11 to 11.75, η_p² = 0.190), physical well-being (95% CI: 0.50 to 3.04, η_p² = 0.096), social/family well-being (95% CI: 0.32 to 2.15, η_p² = 0.090), emotional well-being (95% CI: 0.60 to 2.53, η_p² = 0.125), functional well-being (95% CI: 0.25 to 2.49, η_p² = 0.075), and head and neck cancer subscale (95% CI: 1.08 to 4.08, η_p² = 0.139) scores in the Baduanjin group compared with the control group at the 12th week.

CONCLUSION

The findings in this study indicate that Baduanjin exercise is an effective and appropriate intervention for improving quality of life and is worthy of recommendation and implementation by oncology nurses in the rehabilitation process of patients with nasopharyngeal carcinoma.

Metabolomic profiling identifies biomarkers and metabolic impacts of surgery for colorectal cancer

Background

Colorectal cancer (CRC) is one of the most common malignant tumors with recurrence and metastasis after surgical resection. This study aimed to identify the physiological changes after surgery and explore metabolites and metabolic pathways with potential prognostic value for CRC.

Methods

An ultra-high-performance liquid chromatography Q-exactive mass spectrometry was used to profile serum metabolites from 67 CRC patients and 50 healthy volunteers. Principal component analysis (PCA) and orthogonal projections to latent structures-discriminant analysis were used to distinguish the internal characteristics of data in different groups. Multivariate statistics were compiled to screen the significant metabolites and metabolic pathways.

Result

A total of 180 metabolites were detected. Under the conditions of variable importance in projection >1 and p-value <0.05, 46 differentially expressed metabolites were screened for further pathway enrichment analysis. Based on the Kyoto Encyclopedia of Genes and Genomes database and Small Molecule Pathway Database, three metabolic pathways—arginine and proline metabolism, ascorbate and aldarate metabolism, and phenylalanine metabolism—were significantly altered after surgical resection and identified as associated with the removal of CRC. Notably, gamma-linolenic acid was upregulated in the CRC preoperative patients compared with those in healthy volunteers but returned to healthy levels after surgery.

Conclusion

Through serum-based metabolomics, our study demonstrated the differential metabolic characteristics in CRC patients after surgery compared with those before surgery. Our results suggested that metabonomic analysis may be a powerful method for exploring physiological alterations in CRC patients after surgery as well as a useful tool for identifying candidate biomarkers and monitoring disease recurrence.

Anticancer potential of yohimbine in drug-resistant oral cancer KB-ChR-8-5 cells

BACKGROUND

The demand for environmentally friendly and cost-effective plant-based products for the development of cancer therapeutics has been increasing. Yohimbine (α₂-adrenergic receptor antagonist) is a stimulant and aphrodisiac used to improve erectile dysfunction. In this study, we aimed to evaluate the anticancer potential of yohimbine in drug-resistant oral cancer KB-ChR-8-5 cells using different biomolecular techniques.

METHODS

We estimated the anticancer efficacy of yohimbine using different assays, such as MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) cell cytotoxicity, cell morphology, cell apoptosis, reactive oxygen species (ROS) formation, and modulation in the mitochondrial membrane potential (MMP).

RESULTS

Yohimbine showed a dose-dependent increase in cytotoxicity with a 50% inhibitory concentration (IC₅₀) of 44 µM against KB-ChR-8-5 cancer cell lines. Yohimbine treatment at 40 µM and 50 µM resulted in a considerable change in cell morphology, including shrinkage, detachment, membrane blebbing, and deformed shape. Moreover, at the dose of IC₅₀ and above, a significant induction was observed in the generation of ROS and depolarization of MMP. The possible mechanisms of action of yohimbine underlying the dose-dependent increase in cytotoxicity may be due to the induction of apoptosis, ROS generation, and modulation of MMP.

CONCLUSION

Overall, yohimbine showed a significant anticancer potential against drug-resistant oral cancer KB-ChR-8-5 cells. Our study suggests that besides being an aphrodisiac, yohimbine can be used as a drug repurposing agent. However, more research is required in different in vitro and in vivo models to confirm the feasibility of yohimbine in clinics.

Outcome of the efficacy of Chinese herbal medicine for functional constipation: A systematic review and meta-analysis

BACKGROUND

Functional constipation (FC) is a common and chronic gastrointestinal disease and its treatment remains challenging.

AIM

To evaluate the efficacy and safety of Chinese herbal medicine (CHM) on efficacy rate, global symptoms, bowel movements and the Bristol Stool Scale score in patients with FC by summarizing current available randomized controlled trials (RCTs).

METHODS

RCTs with CHM to treat FC were identified by a systematic search of six databases from inception to October 20, 2020. Two independent reviewers assessed the quality of the included articles and extracted data. Meta-analyses were performed to odds ratio (OR), mean differences (MD) and 95% confidence interval (CI) using random-effects models. Subgroup analyses and sensitivity analyses were used to explore and interpret the sources of heterogeneity. The funnel plot, Begg’s test and Egger’s test were used to detect publication bias.

RESULTS

Ninety-seven studies involving 8693 patients were included in this work. CHM was significantly associated with a higher efficacy rate (OR: 3.62, 95%CI: 3.19-4.11, P < 0.00001) less severe global symptoms (OR: 4.03, 95%CI: 3.49-4.65, P < 0.00001) compared with control treatment, with the low heterogeneity between studies (I² = 0%, P = 0.76). CHM was also associated with more frequent bowel movements (MD 0.83, 95%CI: 0.67-0.98, P < 0.00001), a lower score on the Bristol Stool Scale (OR: 1.63, 95%CI: 1.15-2.32, P < 0.006), and a not significant recurrence rate (OR: 0.47, 95%CI: 0.22-0.99, P = 0.05). No serious adverse effects of CHM were reported.

CONCLUSION

In this meta-analysis, we found that CHM may have potential benefits in increasing the number of bowel movements, improving stool characteristics and alleviating global symptoms in FC patients. However, a firm conclusion could not be reached because of the poor quality of the included trials. Further trials with higher quality are required.

Burnout, Anxiety, Stress, and Depression Among Iranian Nurses: Before and During the First Wave of the COVID-19 Pandemic

Background: Nurses are the major healthcare workforce in an epidemic and have the most contact with patients. Frontline nurses face many health challenges during the COVID-19 epidemic, are directly at risk when treating and caring for COVID-19 patients, and thus experience severe stress and problems in the workplace leading to physical, mental, and social disorders, as well as burnout, anxiety, stress, and depression. The purpose of this study was to compare burnout, anxiety, stress, and depression in nurses before and during the first wave of the COVID-19 pandemic. Methods: This was a cross sectional study. We assessed 266 frontline nurses before and 242 frontline nurses during the first wave of the COVID-19 pandemic with one year apart in 2019 and 2020 (two-stage sampling). The data were collected using demographic questionnaire, Maslach Burnout Questionnaire and Depression, Anxiety and Stress Scale (DASS-21) in public hospitals in Southern Iran. Results: There were no significant differences between groups in subscales of burnout (p > 0.05). Anxiety, stress and depression scores significantly increased during the first wave of the COVID-19 pandemic compared with before the COVID-19 outbreak (p < 0.05). There were significant differences between groups in level of anxiety (p < 0.001) and stress (p = 0.04). Before the COVID-19 outbreak, burnout predicted 11, 15, and 13% of the variance of anxiety, stress and depression, respectively. In addition, stress, monthly working hours and shift were variables that predicted 16% of the variance of burnout before COVID-19. Conclusion: The results of the present study showed that burnout during the first wave of the COVID-19 pandemic did not change significantly compared with before COVID-19. Anxiety, stress and depression increased significantly first wave of the COVID-19 pandemic.