Efficacy and safety of Qingda granule versus valsartan capsule in Chinese grade 1 hypertensive patients with low-moderate risk: A randomized, double-blind, double dummy, non-inferiority, multi-center trial

BACKGROUND

The efficacy and safety of Qingda granule (QDG) in managing blood pressure (BP) among grade 1 hypertensive patients with low-moderate risk remain uncertain.

METHODS

In the randomized, double-blind, double dummy, non-inferiority and multicenter trial, 552 patients with grade 1 hypertension at low-moderate risk were assigned at a ratio of 1:1 to receive either QDG or valsartan for 4 weeks, followed up by a subsequent 4 weeks.

RESULTS

Post-treatment, clinic systolic/diastolic BPs (SBP/DBP) were reduced by a mean change of 9.18/4.04 mm Hg in the QDG group and 9.85/5.05 mm Hg in the valsartan group (SBP P = 0.47, DBP P = 0.16). Similarly, 24-hour, daytime and nighttime BPs were proportional in both groups (P > 0.05) after 4 weeks treatment. After discontinuing medications for 4 weeks, the mean reduction of clinic SBP/DBP were 0.29/0.57 mm Hg in the QDG group compared to -1.59/-0.48 mm Hg in the valsartan group (SBP P = 0.04, DBP P = 0.04). Simultaneously, the 24-hour SBP/DBP were reduced by 0.9/0.31 mm Hg in the QDG group and -1.66/-1.08 mm Hg in the valsartan group (SBP P = 0.006, DBP P = 0.02). And similar results were observed regarding the outcomes of daytime and nighttime BPs. There was no difference in occurrence of adverse events between two groups (P > 0.05).

CONCLUSION

QDG proves to be efficacious for grade 1 hypertension at a low-to-medium risk, even after discontinuation of the medication for 4 weeks. These findings provide a promising option for managing grade 1 hypertension and suggest the potential for maintaining stable BP through intermittent administration of QDG.

TRIAL REGISTRATION

ChiCTR2000033890.

Reverse genetic study reveals the molecular targets of chordotonal organ TRPV channel modulators

Insecticides have been widely used for the control of insect pests that have a significant impact on agriculture and human health. A better understanding of insecticide targets is needed for effective insecticide design and resistance management. Pymetrozine, afidopyropen and flonicamid are reported to target on proteins that located on insect chordotonal organs, resulting in the disruption of insect coordination and the inhibition of feeding. In this study, we systematically examined the susceptibility of six Drosophila melanogaster mutants (five transient receptor potential channels and one mechanoreceptor) to three commercially used insecticides, in order to identify the receptor subunits critical to the insect's response to insecticides. Our results showed that iav1, nan36aand wtrw1 mutants exhibited significantly reduced susceptibility to pymetrozine and afidopyropen, but not to flonicamid. The number of eggs produced by the three mutant females were significantly less than that of the w1118 strain. Meanwhile, the longevity of all male mutants and females of nan36a and wtrw1 mutants was significantly shorter than that of the w1118 strain as the control. However, we observed no gravitaxis defects in wtrw1 mutants and the anti-gravitaxis of wtrw1 mutants was abolished by pymetrozine. Behavioral assays using thermogenetic tools further confirmed the bioassay results and supported the idea that Nan as a TRPV subfamily member located in Drosophila chordotonal neurons, acting as a target of pymetrozine, which interferes with Drosophila and causes motor deficits with gravitaxis defects. Taken together, this study elucidates the interactions of pymetrozine and afidopyropen with TRPV channels, Nan and Iav, and TRPA channel, Wtrw. Our research provides another evidence that pymetrozine and afidopyropen might target on nan, iav and wtrw channels and provides insights into the development of sustainable pest management strategies.

Differences Between Patients With Diabetes Mellitus and Obese Patients in Occurrence of Peri-Prosthetic Joint Infection: A Systemic Review and Meta-Analysis

Background: To understand the differences between patients with diabetes mellitus and obese patients with respect to the occurrence of peri-prosthetic joint infection (PJI) after lower-extremity joint arthroplasty as well as to identify differences in PJI occurrence at different time periods. Patients and Methods: The Cochrane Library, CINAHL, MEDLINE, and PubMed were searched for literature published between January 2000 and July 2022. Our targets were studies involving patients with PJI who had already been diagnosed as having diabetes mellitus or being obese before receiving lower-extremity joint arthroplasty. Analysis was performed using Comprehensive Meta-Analysis Software (CMA) Version 3 (Biostat, Inc., Englewood, NJ, USA). Results: A total of 53,522 patients with diabetes mellitus and 360,018 obese patients were included. The forest plot for patients with and without diabetes mellitus indicated that patients with diabetes mellitus were more likely to contract PJIs than were patients without diabetes mellitus (odds ratio, 1.84; 95% confidence interval [CI], 1.56-2.16) and that no differences existed among early, delayed, and late PJI occurrence in patients with diabetes mellitus. The forest plot for obese and non-obese patients indicated that obese patients were more likely to contract PJIs than were non-obese patients (odds ratio, 1.86; 95% CI, 1.53-2.14) and that among obese patients, early PJI occurrence was higher than was late PJI occurrence. In addition, the mixed model indicated that obese patients were more likely to develop early PJIs than were patients with diabetes mellitus. Conclusions: Patients with diabetes mellitus and obese patients were more likely to develop PJIs than were patients without diabetes mellitus and non-obese patients, and that obese patients were more likely to develop early PJIs than late PJIs. Also, obese patients were more likely to develop early PJIs than patients with diabetes mellitus.

CRISPR/Cas9-mediated knockout of NlCYP6CS1 gene reveals its role in detoxification of insecticides in Nilaparvata lugens (Hemiptera: Delphacidae)

BACKGROUND

The brown planthopper (Nilaparvata lugens) is one of the major rice insect pests in Asia. Recently, high levels of insecticide resistance have been frequently reported and cytochrome P450 monooxygenase (P450)-mediated metabolic detoxification is a common resistance mechanism in N. lugens. However, there has been no persuasive genetic method to prove the role of P450s in insecticide resistance in N. lugens.

RESULTS

Here, CRISPR/Cas9 system was used to disrupt the P450 gene NlCYP6CS1 to elucidate its role in insecticide resistance in field populations of N. lugens. We successfully constructed a homozygous strain (Nl6CS1-KO) with a 5-bp deletion and 1-bp insertion mutation of NlCYP6CS1. Compared with a background resistant strain (Nl-R), the susceptibility of knockout strain Nl6CS1-KO to imidacloprid, nitenpyram, thiamethoxam, dinotefuran, and pymetrozine was increased by 2.3-, 3.4-, 7.0-, 4.2- and 3.9-fold, respectively, but not significantly changed to triflumezopyrim, chlorpyrifos and buprofezin. Life table analysis demonstrated that the Nl6CS1-KO strain resembled the Nl-R strain in terms of egg and nymph developmental duration and adult lifespan, but differed from the Nl-R strain in the survival rate of eggs and nymphs, reproduction, and body weight.

CONCLUSIONS

Our study demonstrates the effect of functional deletion of NlCYP6CS1 on multiple insecticide resistance in N. lugens. For the first time, we applied CRISPR/Cas9 system to reveal the mechanism of insecticide resistance in N. lugens, which may shed light on similar studies in other hemipteran insects. © 2023 Society of Chemical Industry.

Resistance Monitoring of Nilaparvata lugens to Pymetrozine Based on Reproductive Behavior

On the basis of the inhibition effects of pymetrozine on the reproductive behavior of N. lugens, we established a bioassay method to accurately evaluate the toxicity of pymetrozine in N. lugens and clarified the level of pymetrozine resistance of N. lugens in the field. In this study, pymetrozine's effects on the fecundity of N. lugens were evaluated using the topical application method and rice-seedling-dipping method. Moreover, the resistance of N. lugens to pymetrozine in a pymetrozine-resistant strain (Pym-R) and two field populations (YZ21 and QS21) was determined using the rice-seedling-dipping method and fecundity assay methods. The results showed that treatment of N. lugens third-instar nymphs with LC₁₅, LC₅₀, and LC₈₅ doses of pymetrozine resulted in a significantly reduced fecundity of N. lugens. In addition, N. lugens adults treated with pymetrozine, using the rice-seedling-dipping and topical application method, also exhibited a significantly inhibited fecundity. Using the rice-stem-dipping method, pymetrozine resistance levels were shown to be high in Pym-R (194.6-fold), YZ21 (205.9-fold), and QS21 (212.8-fold), with LC₅₀ values of 522.520 mg/L (Pym-R), 552.962 mg/L (YZ21), and 571.315 (QS21) mg/L. However, when using the rice-seedling-dipping or topical application fecundity assay method, Pym-R (EC₅₀: 14.370 mg/L, RR = 12.4-fold; ED₅₀: 0.560 ng/adult, RR = 10.8-fold), YZ21 (EC₅₀: 12.890 mg/L, RR = 11.2-fold; ED₅₀: 0.280 ng/adult; RR = 5.4-fold), and QS21 (EC₅₀: 13.700 mg/L, RR = 11.9-fold) exhibited moderate or low levels of resistance to pymetrozine. Our studies show that pymetrozine can significantly inhibit the fecundity of N. lugens. The fecundity assay results showed that N. lugens only developed low to moderate levels of resistance to pymetrozine, indicating that pymetrozine can still achieve effective control on the next generation of N. lugens populations.

Growth factor for therapeutic angiogenesis in ischemic heart disease: A meta-analysis of randomized controlled trials

Aim: This study was designed to systematically evaluate the effects of growth factor (GF) for therapeutic angiogenesis on ischemic heart disease (IHD) by pooling the results of randomized controlled trials (RCTs). Methods and Results: PubMed, EMBASE, and CENTRAL databases were searched from inception to October 2022. RCTs, investigating the effects of GF therapy on IHD, were included. The risk bias of included study was assessed according to Cochrane tool. Weighted mean difference (WMD), calculated with fixed effect model or random effect model, was used to evaluate the effects of GF therapy on left ventricular ejection fraction (LVEF) and Canadian Cardiovascular Society (CCS) angina class. Relative risk (RR) was used to evaluate the effects of GF therapy on all-cause mortality, major adverse cardiovascular events (MACE) and revascularization. Meta-analysis, meta-regression analysis and publication bias analysis were performed by RevMan 5.3 or Stata 15.1 software. Twenty-nine studies involving 2899 IHD patients (1,577 patients in GF group and 1,322 patients in control group) were included. Compared with the control group, GF therapy did not reduce all-cause mortality (RR: 0.82; 95% CI: 0.54-1.24; p = 0.341), MACE [(RR: 0.83; 95% CI: 0.61-1.12; p = 0.227), revascularization (RR: 1.27, 95% CI: 0.82-1.96, p = 0.290) and CCS angina class (WMD: -0.08, 95% CI: -0.36 to 0.20, p = 0.560). However, GF therapy could increase LVEF during short-term follow-up (<1 year). Conclusion: GF for therapeutic angiogenesis was beneficial for increasing LVEF during short-term follow-up (<1 year), however, the therapy was not efficacious in decreasing all-cause mortality, MACE and revascularization.

Monitoring, cross-resistance, inheritance, and fitness costs of brown planthoppers, Nilaparvata lugens, resistance to pymetrozine in China

BACKGROUND

The brown planthopper, Nilaparvata lugens, is considered the most destructive pest of rice in many Asian countries including China. Use of pymetrozine in insect resistance management (IRM) has been one strategy to control this pest. In this study, we reported the status of pymetrozine resistance in Nilaparvata lugens (Stål) collected from China over the period 2017-2021 and selected a strain of N. lugens resistant to pymetrozine and evaluated the cross-resistance, inheritance and fitness costs of the resistance.

RESULTS

Monitoring data (2017-2021) showed that field populations of N. lugens in China developed moderate- to high-level pymetrozine resistance during these 5 years. By continuous selection with pymetrozine in the lab, the pymetrozine selected N. lugens strain (Pym-R₉₈ ) developed a 225.2-fold resistance compared to a susceptible strain. The Pym-R₉₈ strain showed high cross-resistance to dinotefuran (66.6-fold) and low cross-resistance to nitenpyram (5.2-fold) and sulfoxaflor (5.8-fold). Inheritance pattern analysis of Pym-R₉₃ revealed that resistance to pymetrozine was polygenic, autosomal and incompletely dominant. Fitness costs of pymetrozine resistance were present in Pym-R₉₀ and WA2020 strains with a relative fitness of 0.72 and 0.60, respectively. The developmental duration of Pym-R₉₀ and WA2020 was significantly longer and hatchability was significantly lower compared to pymetrozine-susceptible strain (Pym-S).

CONCLUSIONS

N. lugens has developed high level of resistance to pymetrozine. Pymetrozine-resistance brown planthopper had cross-resistance with some of neonicotinoids such as dinotefuran, nitenpyram and sulfoxaflor. The autosomal, incompletely dominant and polygenic resistance to pymetrozine in N. lugens and the fitness costs associated with this resistance can be exploited in IRM strategies to preserve the lifetime of pymetrozine for control of N. lugens in China. © 2022 Society of Chemical Industry.

Influence of rotating shifts and fixed night shifts on sleep quality of nurses of different ages: a systematic literature review and meta-analysis

The objective of this study was to understand the influence of rotating shifts and fixed night shifts on the sleep quality of nurses using a systematic literature review and meta-analysis and to determine whether the sleep quality of nurses working rotating shifts or fixed night shifts differs from that of nurses working fixed day shifts. We conducted a meta-analysis on literature that had used the Pittsburgh Sleep Quality Index (PSQI) to gauge sleep quality and had been published between 2000 and 2020 in the Cochrane Library, CINAHL, MEDLINE, and PubMed databases. This study was conducted in accordance with PRISMA, and the quality of the literature was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross Sectional Studies. CMA 3.0 was employed for data analysis, and meta-regression analysis was conducted to examine the differences between the PSQI scores of nurses working fixed day shifts and those working rotating shifts or fixed night shifts. Following assessment, a total of 29 papers (34 items of data) were analyzed. The papers included a total of 3,935 nurses who worked fixed day shifts, 3,777 nurses who worked rotating shifts, and 1,559 nurses who worked fixed night shifts. Our subgroup analysis indicated that the sleep quality of nurses working rotating shifts was poorer than the sleep quality of nurses working fixed day shifts; the standardized mean difference (SMD) was 0.38 (95% CI: 0.24-0.52, p< .001), and the meta-regression analysis found that the difference in sleep quality between nurses over 40 years old working rotating shifts and those working fixed day shifts was significantly smaller than the difference in sleep quality between nurses 40 years old or younger working rotating shifts and those working fixed day shifts (β = -0.368, p= .011). The sleep quality of nurses working fixed night shifts was also poorer than the sleep quality of nurses working fixed day shifts; the SMD was 0.58 (95% CI: 0.38-0.78, p< .001), and the meta-regression analysis revealed that the difference in sleep quality between nurses over 40 years old working fixed night shifts and those working fixed day shifts was not significantly different from the difference in sleep quality between nurses 40 years old or younger working fixed night shifts and those working fixed day shifts (β = -0.118, p= .608). This meta-analysis found that both nurses working rotating shifts and those working fixed night shifts had poorer sleep quality than those working fixed day shifts and that age influenced the difference in sleep quality only between nurses working rotating shifts and those working fixed day shifts; the difference in sleep quality between nurses 40 years old or younger working rotating shifts and those working fixed day shifts was greater than the difference in sleep quality between nurses over 40 years old working rotating shifts and those working fixed day shifts.

Differences between fixed day shift workers and rotating shift workers in gastrointestinal problems: a systematic review and meta-analysis

This study comprised a review and compilation of literature to gain an in-depth understanding of the impact of rotating shift work on gastrointestinal health. PubMed, CINAHL, and the Cochrane Library were searched for studies published between January 1, 1985, and June 30, 2020. Fixed day shifts were defined as work shifts that began between 7:00 and 9:00 in the morning. Shifts beginning at any other time were classified as rotating shifts. A meta-analysis was performed using Comprehensive Meta-Analysis Software (CMA) version 3. In the end, 16 studies were included in the meta-analysis. An odds ratio (OR) of 1.56 (95% confidence interval (CI): 1.24-1.95), indicating that gastrointestinal problems are more common in rotating shift workers than in fixed day shift workers. Four gastrointestinal problems, namely, irritable bowel syndrome, constipation, indigestion, and peptic ulcers, were then analyzed separately. Significant differences between rotating shift workers and fixed day shift workers were found only for indigestion and peptic ulcers. For indigestion, the OR was 1.72 (95% CI: 1.28-2.30). For peptic ulcers, the OR was 1.66 (95% CI: 1.19-2.30). Thus, research indicates that rotating shift work may increase the risk of gastrointestinal problems, particularly indigestion and peptic ulcers.

The Scar-in-a-Jar: studying potential antifibrotic compounds from the epigenetic to extracellular level in a single well

BACKGROUND AND PURPOSE

Fibrosis, a pathological accumulation of collagen in tissues, represents a major global disease burden. Effective characterization of potential antifibrotic drugs has been constrained by poor formation of the extracellular matrix in vitro, due to tardy procollagen processing by collagen C-proteinase/BMP-1, and difficulties in relating this matrix to cell numbers in experimental samples.

EXPERIMENTAL APPROACH

The Scar-in-a-Jar model provided, in vitro, the complete biosynthetic cascade of collagen matrix formation including complete conversion of procollagen by C-proteinase/BMP-1, its subsequent extracellular deposition and lysyl oxidase-mediated cross-linking, achieved by applying the biophysical principle of macromolecular 'crowding'. Collagen matrix deposition, velocity and morphology can be controlled using negatively charged 'crowders' in a rapid (2 days) mode or a mixture of neutral 'crowders' in an accelerated (6 days) mode. Combined with quantitative optical bioimaging, this novel system allows for in situ assessment of the area of deposited collagen(s) per cell.

KEY RESULTS

Optical evaluation of known and novel antifibrotic compounds effective at the epigenetic, post-transcriptional/translational/secretional level correlated excellently with corresponding biochemical analyses. Focusing on quantitation of deposited collagen, the Scar-in-a-Jar was most effective in assessing novel inhibitors that may have multiple targets, such as microRNA29c, found to be a promising antifibrotic agent.

CONCLUSIONS AND IMPLICATIONS

This novel screening system supersedes current in vitro fibroplasia models, as a fast, quantitative and non-destructive technique. This method distinguishes a reduction in collagen I deposition, excluding collagen cross-linking, and allows full evaluation of inhibitors of C-proteinase/BMP-1 and other matrix metalloproteinases.