Efficacy and safety of Shenyankangfu Tablet, a Chinese patent medicine, for primary glomerulonephritis: A multicenter randomized controlled trial

BACKGROUND

Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.

OBJECTIVE

This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTION

This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m², and 24-hour proteinuria level of 0.5-3.0 g, were recruited in 41 hospitals across 19 provinces in China and were randomly divided into five groups: SYKFT, losartan potassium 50 mg or 100 mg, SYKFT plus losartan potassium 50 mg or 100 mg.

MAIN OUTCOME MEASURES

The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment.

RESULTS

A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group.

CONCLUSION

SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.

TRIAL REGISTRATION NUMBER

NCT02063100 on ClinicalTrials.gov.

[Analysis of clinicopathological features of patients with simple breast cancer and breast cancer with thyroid cancer]

Objective: To investigate the relationship between breast cancer and thyroid cancer. Methods: A cohort of 747 female patients with stage Ⅰ-Ⅲ invasive breast cancer were enrolled in this retrospective study. The differences of clinical and pathological data were compared between the simple breast cancer group (723 cases) and the breast cancer with thyroid cancer group (24 cases), to analyze the relevant factors of second primary thyroid cancer in patients with breast cancer. Results: There were significant differences in the menstrual status and estrogen receptor (ER) status between the group of patients with breast cancer only and breast cancer patients with secondary primary thyroid cancer (P<0.05). Breast cancer patients with secondary primary thyroid cancer were more likely to be premenopausal (75%) and ER-positive (83.3%). Multivariate logistic regression analysis showed that the patient's menstrual status (compared with premenopausal patients, peri-menopausal odds ratio=0.53, 95% CI 0.07-4.25; post-menopausal odds ration=0.23, 95%CI 0.08-0.65) and body mass index (BMI, odds ratio=1.14, 95%CI 1.02-1.28) were independent risk factors for secondary primary thyroid cancer in patients with breast cancer. Conclusion: Thyroid cancer is associated with breast cancer, and is more likely to occur in obesity patients and premenopausal patients.

Evaluation of the water soluble extractive of astragali radix with different growth patterns using 1H-NMR spectroscopy

Astragali radix (AR), known in China as huangqi, is commonly used in traditional Chinese medicine. Water soluble extractive (WSE) values play an important role in the quality evaluation of herbal drugs. In this study, WSE of wild and cultivated AR were compared systematically. The WSE value of cultivated AR was significantly higher than that of the wild AR, and their UV-absorbance in the range of 250–400 nm was also different. The chemical compositions of different WSE were further compared by 1H NMR spectroscopy combined with multivariate analysis. Results from the principal component analysis and the hierarchical cluster analysis showed a clear separation between the WSEs of wild and cultivated AR. The differential metabolites responsible for the separation were identified by orthogonal projections to latent structures discriminant analysis and recursive support vector machine. The WSE of wild AR contained more arginine, valine, threonine, asparagine, succinate, and glutamine, while the cultivated AR contained more sucrose. Thus, the WSE can be used as a simple and reliable method for discrimination of wild and cultivated ARs, and the results obtained in this study extend the potential use of WSE in the quality evaluation of herbal drugs.

Effect of verbascoside on decreasing concentration of oxygen free radicals and lipid peroxidation in skeletal muscle

AIM

To detect the effects of verbascoside on decreasing the concentration of oxygen free radicals (OFR) and lipid peroxidation in skeletal muscle resulting from exhaustive exercise.

METHODS

Electron spin resonance (ESR) technique and thiobarbituric acid reaction (TBAR) method were used to detect the concentration of OFR in intact gastrocnemius muscle and the contents of milondialdehyde (MDA) in muscle homogenate.

RESULTS

Verbascoside decreased the concentration of OFR (P < 0.05) and the level of lipid peroxidation (P < 0.05) in muscle caused by exercise.

CONCLUSION

Verbascoside has the effects of reducing oxidative stress in muscle caused by exhaustive exercise by decreasing the concentration of free radicals and the level of lipid peroxidation.