Iron‐chelating effect of silymarin in patients with β‐thalassemia major: A crossover randomised control trial

This study aimed to determine the potential iron‐chelating effects of silymarin in patients with β‐thalassemia major receiving standard iron‐chelation therapy. We evaluated whether addition of silymarin to standard iron‐chelation therapy could improve iron burden markers and liver and cardiac function in these patients, via a placebo‐controlled, crossover clinical study. Silymarin (140 mg) or placebo were administered thrice daily to all patients (n = 82) for 12 weeks, and after a 2‐week washout period, patients were crossed over to the other groups. Silymarin efficacy was assessed by measuring serum iron level, ferritin level, total iron‐binding capacity and liver and cardiac function on magnetic resonance imaging. Silymarin treatment resulted in a negative change in the serum iron and ferritin levels and a positive change in the total iron‐binding capacity levels (treatment effect, p < .001, p = .06, and p = .05, respectively). Silymarin treatment led to positive changes in cardiac and liver function in both treatment sequences of study; however, this was not statistically significant. There was a negative change in liver iron concentration in both treatment sequences (treatment effect, p = .02). In conclusion, combined iron‐chelation and silymarin therapy was effective for improving the iron‐burden status in patients with β‐thalassemia major.     

Does turmeric/curcumin supplementation improve serum alanine aminotransferase and aspartate aminotransferase levels in patients with nonalcoholic fatty liver disease? A systematic review and meta‐analysis of randomized controlled trials

We performed a meta‐analysis to evaluate the efficacy of turmeric/curcumin supplementation on serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in patients with nonalcoholic fatty liver disease (NAFLD). We searched PubMed, Scopus, Cochrane Library, ISI Web of Science, and Google Scholar up to November 20, 2018. Studies that examined the effect of turmeric/curcumin on serum concentrations of ALT and AST among patients with NAFLD were included. The mean difference and standard deviation (SD) of changes in ALT and AST between intervention and control groups were used as effect size for the meta‐analysis. A total of six randomized controlled trials (RCTs) were eligible for meta‐analysis. Results from pooled analysis revealed that turmeric/curcumin supplementation reduced ALT (MD: ?7.31 UL/L, 95% CI [?13.16, ?1.47], p = 0.014) and AST (MD: ?4.68 UL/L, 95% CI [?8.75 ?0.60], p = 0.026). When RCTs stratified on the basis of their treatment duration, the significant reduction in serum concentrations of ALT and AST was observed only in studies lasting less than 12 weeks. This review suggests that turmeric/curcumin might have a favorable effect on serum concentrations of ALT and AST in patients with NAFLD. However, further clinical trials are needed to confirm these findings.     

Amelioration of oxidative stress in red blood cells from patients with β‐thalassemia major and intermedia and E‐β‐thalassemia following administration of a fermented papaya preparation

In β‐hemoglobinopathies, such as β‐thalassemia (thal) and sickle cell anemia, the primary defects are mutations in the β‐globin gene. However, many aspects of the pathophysiology are mediated by oxidative stress. Fermented papaya preparation (FPP), a natural health food product obtained by biofermentation of carica papaya, has been shown to limit oxidative stress both in vitro and in vivo. We studied the effect of FPP on two groups of β‐thal patients: β‐thal, major and intermedia, (in Israel) and E‐β‐thal (in Singapore). The results indicated that in both groups FPP treatment increased the content of reduced glutathione (GSH) in red blood cells (RBC), and decreased their reactive oxygen species (ROS) generation, membrane lipid peroxidation, and externalization of phosphatidylserine (PS), indicating amelioration of their oxidative status, without a significant change in the hematological parameters. Since the turnover of the erythron is relatively slow, it is possible that longer duration of treatment, probably with the addition of an iron chelator, is required in order to achieve the latter goals. Copyright © 2010 John Wiley & Sons, Ltd.     

The effects of curcumin supplementation on high‐sensitivity C‐reactive protein,serum adiponectin,and lipid profile in patients with type 2 diabetes: A randomized,double‐blind,placebo‐controlled trial

Diabetes mellitus is one of the most common and important metabolic diseases in human. Curcumin, which is a natural polyphenol found in turmeric, can be used in treatment of diabetes complications for its antidiabetic, anti‐inflammatory, and antioxidant properties. In this double‐blind randomized clinical trial, 44 patients with Type 2 diabetes randomly assigned to curcumin or placebo group. Patients consumed either 1,500‐mg curcumin or placebo daily for 10 weeks. Anthropometric measurements were measured at baseline and at the end of the study. Serum concentrations of triglyceride (TG), total cholesterol, high‐density lipoprotein cholesterol, low‐density lipoprotein cholesterol, high‐sensitivity C‐reactive protein, and adiponectin were determined after 12‐hr fasting at the beginning and end of study. The mean serum level of TG decreased in curcumin group compared with baseline (109 ± 36 vs. 124 ± 36; p < 0.05). At the end of study, the mean concentration of high‐sensitivity C‐reactive protein decreased in the curcumin group compared to the control (2.9 ± 2.9 vs. 3.4 ± 4.2; p < 0.05). The mean serum concentration of adiponectin increased (64 ± 3 vs. 63 ± 4; p < 0.05) in the treatment group compared with the placebo at the end of the study. The results of the current study indicate that curcumin consumption may reduce diabetes complications through decreasing TG level as well as indicators of inflammation.     

Lipid‐Lowering Effects of Curcumin in Patients with Metabolic Syndrome: A Randomized,Double‐Blind,Placebo‐Controlled Trial

Human studies of curcumin extract on lipid‐lowering effect have not been completely investigated and have had controversy results. This study tested the effect of daily curcumin extract for 12 weeks on weight, glucose, and lipid profiles in patients with metabolic syndrome. Sixty‐five patients were randomized into two groups; 33 patients taking curcumin extract capsule (630 mg thrice daily) and 32 patients taking a placebo capsule thrice daily for 12 weeks. At 12 weeks after the curcumin extract consumption, the level of high‐density lipoprotein cholesterol (HDL‐C) significantly increased from 40.96 ± 8.59 to 43.76 ± 2.79 mg/dL (p < 0.05), and the level of low‐density lipoprotein cholesterol (LDL) was significantly reduced (120.55 ± 36.81 to 106.51 ± 25.02 mg/dL, p < 0.05). The triglyceride‐lowering effect, a reduction of 65 mg/dL, was also found in this study. In subgroups analysis, the consumption of curcumin may have a lowering cholesterol effect in male patients and an increasing HDL‐C effect in female patients, both of which result in a decrease of T‐Chol/HDL‐C ratio. The intake of the curcumin extract of 1890 mg/day for 12 weeks was associated with lipid‐lowering effect but did not improve weight and glucose homeostasis in the patients with metabolic syndrome. Daily curcumin consumption may be an alternative choice to modify cholesterol‐related parameters, especially in metabolic syndrome patients. Copyright © 2014 John Wiley & Sons, Ltd.     

Effect of curcumin supplementation on disease severity in patients with liver cirrhosis: A randomized controlled trial

Recent reports indicated that curcumin had beneficial effects in animal models of liver injury and cirrhosis. Current study aimed to investigate the effects of curcumin supplementation in patients with liver cirrhosis. In this randomized double‐blind placebo‐controlled trial, 70 patients with liver cirrhosis aged 20–70 years were randomly divided into two groups to receive 1,000 mg/day curcumin (n = 35) or placebo (n = 35) for 3 months. Model for end‐stage liver disease (MELD) (i), MELD, MELD‐Na, and Child–Pugh scores were used to assess the severity of cirrhosis. Sixty patients (29 in the curcumin group and 31 in the placebo group) completed the study. MELD(i) (15.55 ± 3.78 to 12.41 ± 3.07), MELD (15.31 ± 3.07 to 12.03 ± 2.79), MELD‐Na (15.97 ± 4.02 to 13.55 ± 3.51), and Child–Pugh (7.17 ± 1.54 to 6.72 ± 1.31) scores decreased significantly in the curcumin group after 3‐month intervention (p < .001, p < .001, p = .001, and p = .051, respectively), whereas they increased significantly in the placebo group (p < .001, p < .001, p < .001, p = .001, respectively). Significant differences were only observed between the two groups in MELD(i), MELD, MELD‐Na, and Child–Pugh scores after 3‐month intervention (p < .001 for all of them). In this pilot study, beneficial effects of curcumin supplementation were observed in decreasing disease activity scores and severity of cirrhosis in patients with cirrhosis.     

Effect of Rubus Occidentalis Extract on Metabolic Parameters in Subjects with Prediabetes: A Proof‐of‐concept,Randomized, Double‐blind,Placebo‐controlled Clinical Trial

Rubus occidentalis (RO) has beneficial effects on glucose and lipid profiles in vitro. The aim of the study was to investigate RO extract effect on metabolic parameters in prediabetic patients, adopting a 12‐week, randomized, double‐blind, placebo‐controlled trial. Forty‐four patients (age 59.0 ± 8.2 years, 70.5% females, HbA1c 5.8 ± 0.4%) were divided into placebo (n = 13), low‐dose RO extract (LRE; n = 14), or high‐dose RO extract (HRE; n = 17) groups. Either 900 or 1800 mg per day of RO extract was administered orally. Area under the curve for glucose obtained 2 h after a 75‐g oral glucose tolerance test was significantly decreased in the HRE group, compared with the placebo group (?28.1 ± 42.4 vs. +13.4 ± 52.6 mg/dL, p < 0.05). Homoeostasis model assessment‐B was increased (+17.11 ± 10.69, +5.24 ± 4.10, and +0.86 ± 6.01 in HRE, LRE, and placebo, respectively, p < 0.05). Serum levels of monocyte chemoattractant protein‐1 and oxidized low‐density lipoprotein were significantly decreased by treatment in a dose‐dependent manner (monocyte chemoattractant protein‐1: ?35.0 ± 21.2, +8.4 ± 18.1, and +24.2 ± 14.5; oxidized low‐density lipoprotein: ?19.7 ± 8.5, ?13.1 ± 7.2, and ?2.2 ± 11.0 in the HRE, LRE, and placebo, respectively, p < 0.05). The results support the beneficial effects of RO extract on the control of glycemia and vascular inflammation in prediabetic patients. (ClinicalTrials.gov: NCT01964703). Copyright © 2016 John Wiley & Sons, Ltd.     

Efficacy of artichoke leaf extract in non‐alcoholic fatty liver disease: A pilot double‐blind randomized controlled trial

Non‐alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and is potentially treatable, though there are few therapeutic agents available. Artichoke leaf extract (ALE) has shown potential as a hepatoprotective agent. This study sought to determine if ALE had therapeutic utility in patients with established NAFLD. In this randomized double‐blind placebo‐controlled parallel‐group trial, 100 subjects with ultrasound‐diagnosed NAFLD were randomized to either ALE 600 mg daily or placebo for a 2‐month period. NAFLD response was assessed by liver ultrasound and serological markers including the aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio and AST to platelet ratio index (APRI) score. Ninety patients completed the study (49 ALE and 41 placebo) with no side effects reported. ALE treatment compared with placebo: Doppler sonography showed increased hepatic vein flow (p < .001), reduced portal vein diameter (p < .001) and liver size (p < .001), reduction in serum ALT (p < .001) and AST (p < .001) levels, improvement in AST/ALT ratio and APRI scores (p < .01), and reduction in total bilirubin. ALE supplementation reduced total cholesterol, low‐density lipoprotein cholesterol, high‐density lipoprotein cholesterol, non‐high‐density lipoprotein cholesterol, and triglyceride concentrations (p = .01). This study has shown beneficial effects of ALE supplementation on both ultrasound liver parameters and liver serum parameters (ALT, AST, APRI ratio, and total bilirubin) in patients with NAFLD.     

β‐secretase inhibitory effects of furanocoumarins from the root of Angelica dahurica

In the course of screening antidementia agents from natural products, five β‐secretase (BACE1) inhibitors were isolated from the root extract of Angelica dahurica (Umbelliferae). They were identified as furanocoumarins, isoimperatorin (1), imperatorin (2), (+)‐oxypeucedanin (3), (+)‐byakangelicol (4) and (+)‐byakangelicin (5). Among them, compounds 2 and 4 showed significant inhibitory activity against β‐secretase (BACE1) with IC₅₀ values of 91.8 ± 7.5 and 104.9 ± 2.4 μM , respectively. Compounds 1‐5 inhibited BACE1 activity in a dose‐dependent manner. Copyright © 2009 John Wiley & Sons, Ltd.     

Effects of garlic supplementation on liver enzymes: A systematic review and meta‐analysis of randomized controlled trials

Current evidence on the beneficial effects of garlic on liver enzymes is contradictory. Therefore, the aim of this systematic review and meta‐analysis is to evaluate the effect of garlic supplementation on human liver enzymes, such as Alanine Transaminase (ALT/SGPT) and Aspartate Transaminase (AST/SGOT). To collect the required data, PubMed, Scopus, ISI Web of Science, and Google scholar databases were systematically searched from inception to June 2019. A meta‐analysis was conducted using the random‐effects model to evaluate the effects of garlic supplementation on ALT and AST levels. The Cochran's Q‐test and inconsistency index were also used to evaluate heterogeneity among the studies. Among a total of 15,514 identified articles, six studies (containing 301 participants) met the inclusion criteria. Results of the meta‐analysis showed that garlic supplementation significantly decreased AST level (Hedges' g = ?0.36, 95% confidence interval [CI]: ?0.72, ?0.004, p = .047); whereas, it had no significant effect on ALT level (Hedges' g = ?0.22, 95% CI: ?0.64, 0.20, p = .310). Results showed that garlic supplementation reduced AST levels significantly; however, had no significant effect on ALT levels. Further studies are still needed to confirm the results.     

The effect of saffron supplement on clinical outcomes and metabolic profiles in patients with active rheumatoid arthritis: A randomized,double‐blind,placebo‐controlled clinical trial

Rheumatoid arthritis (RA) is a systemic autoimmune and inflammatory disease. Our study aimed to determine the effect of saffron supplement on clinical outcomes and metabolic profiles in patients with active RA. In this randomized, double‐blind, placebo‐controlled trial, 66 women older than 18 years old received 100 mg/day either saffron supplement in the intervention group (n = 33) or matched placebo in the placebo group (n = 33) for a period of 12 weeks. Sixty‐one patients (30 in the control and 31 in the saffron group) remained for the final analysis. No adverse effects were reported by the patients. Saffron supplementation significantly decreased the number of tender (?1.38 ± 1.66 vs. 0.10 ± 0.40, p < .001) and swollen (?2.12 ± 2.34 vs. 0.63 ± 2.79, p < .001) joints, pain intensity based on visual analogue scale (?18.36 ± 15.07 vs. ?2.33 ± 5.04), p < .001), and disease activity score (DAS28) (?0.75 ± 0.67 vs. 0.26 ± 0.77, p < .001) at the end of intervention between the two groups and in saffron group compared with baseline values. Physician Global Assessment (p = .002) and erythrocyte sedimentation rate were significantly improved after intervention (24.06 ± 12.66 vs. 32.00 ± 14.75, p = 0.028). High‐sensitivity C‐reactive protein reduced at the end of the intervention in the saffron group compared with baseline values (12.00 ± 7.40 vs. 8.82 ± 7.930, p = .004). Tumor necrosis factor alpha, interferon gamma, and malondialdehyde were decreased, and total antioxidant capacity were increased, but their differences between the two groups were not significant (p > .05). According to the results, saffron supplements could positively and significantly improve clinical outcomes in RA patients.     

The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta‐Analysis of Clinical Trials

Major depression is a common, recurrent, and chronic disease that negatively affects the quality of life and increases the risk of mortality. Several studies have demonstrated that curcumin, the yellow‐pigmented substance of the turmeric, possesses antidepressant properties. The aim of this review is to meta‐analytically assess the antidepressant effect of curcumin in patients with major depressive disorders. We extensively searched the literature until August 2015. The random‐effect model was used to calculate the pooled standardized difference of means (SMD). Subgroup analyses were also performed to examine the effect of different study characteristics on the overall model. Six clinical trials met the inclusion criteria. Overall, curcumin administration showed a significantly higher reduction in depression symptoms [SMD = ?0.34; 95% confidence interval (CI) = ?0.56, ?0.13; p = 0.002]. Subgroup analyses showed that curcumin had the highest effect when given to middle‐aged patients (SMD = ?0.36; 95% CI = ?0.59; ?0.13; p = 0.002), for longer duration of administration (SMD = ?0.40; 95% CI = ?0.64, ?0.16; p = 0.001), and at higher doses (SMD = ?0.36; 95% CI = ?0.59, ?0.13; p = 0.002). The administration of new formulation of curcumin (BCM‐95) had non‐significantly higher effect on depression as compared with the conventional curcumin–piperine formula. We conclude that there is supporting evidence that curcumin administration reduces depressive symptoms in patients with major depression. Copyright © 2015 John Wiley & Sons, Ltd.     

Anti‐Diabetic Properties of Rice‐Based Herbal Porridges in Diabetic Wistar Rats

The present study aims to investigate anti‐hyperglycaemic, anti‐hyperlipidaemic and toxic effects of long‐term consumption of selected green leafy porridges in a streptozotocin‐induced diabetic Wistar rat model. Porridges made with Asparagus racemosus Willd. (AR), Hemidesmus indicus (L) R. Br. W. T. Aiton (HI), Scoparia dulcis L. (SD) and coconut milk porridge (CM) were incorporated into diets of diabetic Wistar rats. Diabetic control (DM) and normal control groups (NC) were provided with standard rat diet. Fasting blood glucose (FBG), HbA_1c, C reactive protein (CRP), total cholesterol (TC), high‐density lipoprotein cholesterol (HDL‐C), liver enzymes and creatinine were measured. Feed and water intake among diabetic groups were significantly high when compared with those of NC (p < 0.05). All rats in SD (mean = 39 ± 19 g) and NC (mean = 114 ± 7 g) groups gained weight, whereas most rats in other diabetic groups lost weight. Among the diabetic groups, SD group had the lowest mean FBG, FBG increment percentage (45%) and HbA_1c (5.8 ± 2.1). FBG increment percentage and HbA_1c of SD group were not significantly different to those of NC (38%; 4.7 ± 0.7) (p > 0.05). Among the diabetic groups, lowest TC (119 ± 20.6 mg/dL) and highest HDL‐C (33 ± 6.3 mg/dL) were also detected in SD group. Alanine transaminase and creatinine were not significantly different (p > 0.05) among diabetic groups but significant when compared with those of NC. When compared with those of NC, aspartate transaminase levels were significantly (p < 0.05) high in SD, CM and DM groups. Body weight : liver weight and body weight : pancreas weight ratios and CRP were not significantly different among all groups. The study proved that SD porridge reduced weight loss, elicited hypoglycaemic and hypolipidaemic properties, and caused no toxicity in diabetes‐induced Wistar rats. Copyright © 2014 John Wiley & Sons, Ltd.     

芪芩汤联合拉米夫定治疗肝郁脾虚兼湿热型慢性乙型肝炎临床研究

目的：评价芪芩汤联合拉米夫定治疗肝郁脾虚兼湿热型慢性乙型肝炎的疗效。方法将符合入选标准的70例慢性乙型肝炎患者采用随机数字表法分为2组,每组35例。对照组单纯口服拉米夫定,观察组在对照组基础上加服芪芩汤。采用荧光定量PCR法检测乙肝病毒脱氧核糖核酸(hepatitis B virus deoxyribonucleic acid, HBV-DNA),采用全自动生化分析仪检测血清ALT、AST水平;比较2组患者证候评分变化,记录治疗过程中的耐药性,评价临床疗效。结果治疗后,观察组 HBV-DNA 转阴率为77.1%(27/35)、对照组为54.3%(19/35),2组比较差异有统计学意义(χ2＝4.136,P＝0.041);观察组耐药率为11.4%(4/35)、对照组为31.4%(11/35),2组比较差异有统计学意义(χ2＝4.297,P＝0.043)。治疗后,观察组血清 ALT[(29.1±13.2)U/L 比(121.8±50.2)U/L,t＝5.982]、AST[(28.5±10.9)U/L 比(98.3±46.1)U/L,t＝8.263]水平及证候评分[(4.8±3.1)分比(11.5±7.9)分,t＝5.982]均低于对照组(P＜0.01)。观察组总有效率为88.6%(31/35)、对照组为57.2%(20/35),2组比较差异有统计学意义(χ2＝4.248,P＝0.003)。结论芪芩汤联合拉米夫定可有效降低肝郁脾虚兼湿热型慢性乙型肝炎患者 HBV-DNA 及血清ALT、AST水平,提高临床疗效。     

Rosemary extracts improve flow‐mediated dilatation of the brachial artery and plasma PAI‐1 activity in healthy young volunteers

Polyphenol antioxidants decrease the risk of atherosclerosis. The study aimed to evaluate prospectively in healthy young participants the effect of oral rosemary extracts (RE), consisting of diphenols, upon endothelial dysfunction (ED), preceding structural atherosclerosis. Nineteen healthy young volunteers were studied prospectively, who received oral RE (77.7 mg) for 21 days, consisting of active substances carnosol (0.97 mg), carnosic (8.60 mg) and rosmarinic acid (10.30 mg). Before and after RE treatment, the study evaluated fasting serum levels of plasminogen‐activator‐inhibitor‐1 (PAI‐1), vascular cell adhesion molecule 1 (VCAM‐1), inter‐cellular adhesion molecule 1 (ICAM‐1), superoxide dismutase (SOD), glutathione peroxidase (GPX), fibrinogen, high‐sensitivity capsular reactive protein (hs‐CRP), tumor‐necrosis factor α (TNF‐α), the lipid profile and ED, characterized as flow‐mediated dilatation (FMD) in the brachial artery of <4.5%, estimated by ultrasound measurements. After 21 days, any side effects were registered, the mean FMD increased nonsignificantly (6.51 ± 5.96% vs 7.78 ± 4.56%, p = 0.546) and ED decreased significantly (66.6% vs 16.6%, p = 0.040). Among the serum markers, only the mean PAI‐1 level decreased significantly (4.25 ± 1.46 U/mL vs 3.0 ± 0.61 U/mL, p = 0.012) after 21‐day RE supplementation. It is concluded that oral RE supplementation has the potential to improve serum PAI‐1 activity and ED in young and healthy individuals. Copyright © 2010 John Wiley & Sons, Ltd.     

An In Vitro and Molecular Informatics Study to Evaluate the Antioxidative and β‐hydroxy‐β‐methylglutaryl‐CoA Reductase Inhibitory Property of Ficus virens Ait

The present study is initially intended to evaluate antioxidant and β‐hydroxy‐β‐methylglutaryl‐CoA reductase (HMGR) inhibitory property of Ficus virens Ait., first by in vitro analyses followed by a corroboratory molecular informatics study. Our results show that of all the sequentially extracted fraction of F. virens bark and leaves extract, F. virens bark methanol extract exhibits strong radical scavenging, antioxidant and oxidative DNA damage protective activity, which is well correlated with its total phenolic content. In addition, F. virens bark methanol extract, which is non‐cytotoxic, significantly and non‐covalently inhibit the HMGR activity (IC₅₀ = 3.45 ± 0.45 µg/ml) in comparison with other extracts. The mechanistic aspect of this inhibition activity is authenticated by molecular docking study of bioactive compounds as revealed from gas chromatography–mass spectrometry data, with HMGR. The analysis for the first time indicates that quinic acid (ΔG: ?8.11 kcal/mol) and paravastatin (ΔG: ?8.22 kcal/mol) exhibit almost same binding energy, while other compounds also showed good binding energy, suggesting that quinic acid alone or in combination with other major bioactive compound is probably responsible for HMGR inhibitory property of the extract and plausibly can be used in in vivo system for the management, prevention, and alleviation of hypercholesterolemia as well as hypercholesterolemia‐induced oxidative stress. Copyright © 2013 John Wiley & Sons, Ltd.     

疏肝健脾化瘀汤联合恩替卡韦治疗乙型肝炎肝硬化临床研究

目的 评价舒肝健脾化瘀汤联合恩替卡韦治疗乙型肝炎肝硬化的疗效.方法 将将符合入选标准的乙型肝炎肝硬化患者150例,采用随机数字表法分为2组,每组75例.对照组采用恩替卡韦治疗,观察组在对照组治疗基础上加用舒肝健脾化瘀汤治疗.观察、比较2组患者治疗前后肝功能指标、肝纤维化指标及症状变化,评价临床疗效.结果 治疗后,观察组肝功能指标AST[(42.88±12.57)U/L比(56.94±14.83)U/L,t=6.263]、ALT[(41.10±10.61)U/L比(53.12±16.78)U/L,t=5.243]、TBiL[(20.15±9.76)μmol/L比(28.35±12.20)μmol/L,t=4.545],以及肝纤维化指标Ⅲ型前胶原[(103.65±22.84)μg/L比(162.44±38.90)μg/L,t=11.287]、Ⅳ型胶原[(106.72±23.41)μg/L比(152.94±30.01)μg/L,t=10.518]、层黏连蛋白[(92.75±25.32)μg/L比(156.64±38.79)μg/L,t=11.945]、透明质酸[(105.58±18.07)μg/L比(159.74±35.50)μg/L,t=11.775]均低于对照组(P<0.05或P<0.01);ALB[(42.67±8.93)g/L比(38.08±8.85)g/L,t=3.221]高于对照组.观察组总有效率为85.33%(64/75),对照组为64.00%(48/75),2组比较差异有统计学意义(χ2=9.023,P=0.003).结论 舒肝健脾化瘀汤联合恩替卡韦治疗乙型肝炎肝硬化疗效优于单纯应用恩替卡韦,且随访的远期效果好.     

红景天苷对肝脏缺血再灌注损伤模型大鼠炎症反应的影响

目的 观察红景天苷对肝脏缺血再灌注损伤模型大鼠的保护作用,探讨其作用机制.方法 采用随机数字表法将90只雄性SD大鼠分为假手术组,模型组,红景天苷低、中、高剂量组,每组18只.红景天苷低、中、高剂量组大鼠分别腹腔注射红景天苷水溶液7.5、15、30 mg/kg,假手术组与模型组腹腔注射等体积生理盐水.1次/d,连续给药7 d后进行造模.除假手术组外,其余各组大鼠建立肝脏缺血再灌注模型,分别于术后4、8、16 h取材,检测血清中AST、ALT水平,采用HE染色观察各组肝组织病理学改变,采用Western Blot检测肝组织丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)、c-Jun氨基末端激酶(c-Jun N-terminal kinase,JNK)、细胞外调节蛋白激酶(extracellular regulated protein kinase,ERK)、NF-κB蛋白的表达.结果 造模后4、8、16 h,红景天苷高剂量组大鼠血清ALT[造模后4、8、16 h分别为(540.67±15.91)U/L比(697.67±5.98)U/L、(307.50±12.97)U/L比(962.50±17.63)U/L、(103.33±3.95)U/L比(198.17±9.73)U/L]、AST[造模后4、8、16 h分别为(651.17±7.39)U/L比(944.67±11.38)U/L、(415.50±10.97)U/L比(1561.83±15.76)U/L、(168.33±5.81)U/L比(280.33±12.35)U/L]水平较模型组降低(P<0.05);造模后,红景天苷高剂量组MAPK[造模后8、16 h分别为(1.28±0.19)比(2.10±0.12)、(1.64±0.14)比(1.89±0.14)]、JNK[造模后8、16 h分别为(1.80±0.10)比(2.42±0.11)、(0.84±0.17)比(3.32±0.19)]、ERK[造模后8、16 h分别为(2.43±0.10)比(5.95±0.09)、(2.07±0.13)比(6.61±0.14)]、NF-κB[造模后8、16 h分别为(2.32±0.16)比(3.08±0.10)、(2.11±0.13)比(2.74±0.17)]表达较模型组降低(P<0.05).结论 红景天苷预处理可减轻肝脏缺血再灌注损伤,抑制MAPK/NF-κB信号通路.     

Beneficial effects of nano‐curcumin supplement on depression and anxiety in diabetic patients with peripheral neuropathy: A randomized,double‐blind,placebo‐controlled clinical trial

Depression in patients with diabetes is associated with poor glycemic control and linked to an increased risk for diabetes complications such as neuropathy. Curcumin has shown potential antidepressant‐like activities in some studies. The present study is the first randomized controlled trial to test the efficacy of nano‐curcumin supplementation on depression, anxiety, and stress in patients with diabetic polyneuropathy. Eighty patients with diabetes were enrolled in this parallel, double‐blind, randomized, placebo‐controlled clinical trial. The participants were allocated randomly to the intervention (n = 40) and control (n = 40) groups. They received 80 mg of nano‐curcumin or placebo capsules daily for 8 weeks. At baseline and end of study, anthropometric measurements, dietary intake, physical activity, glycemic indices, and severity of neuropathy were assessed. The depression, anxiety, and stress level were measured by Depression, Anxiety, Stress Scale (DASS‐21‐items) questionnaire before and after the intervention. After intervention, there was a significant reduction in the mean score of depression in the nano‐curcumin group (from 16.7 [3.1] to 15.3 [2.6]) compared with placebo group (17.5 [3.2] to 17.3 [3.1]; p = .02). In addition, a significant fall was found in the mean score of anxiety in the nano‐curcumin group (from 22.4 [4.03] to 20.6 [3.4]) compared with the placebo group (21.9 [3.5] to 21.2 [3.5]; p = .009). Changes in stress score were not statistically significant between the two groups. These findings suggested that nano‐curcumin supplementation for 8 weeks was effective in reducing depression and anxiety scores in patients with diabetic polyneuropathy.     

Effect of sour tea supplementation on liver enzymes,lipid profile,blood pressure,and antioxidant status in patients with non‐alcoholic fatty liver disease: A double‐blind randomized controlled clinical trial

The aim of this study was to evaluate the efficacy of sour tea supplementation in patients with nonalcoholic fatty liver disease (NAFLD). Seventy NAFLD patients were enrolled in this randomized, double‐blind, placebo‐controlled clinical trial. Participants received sour tea in the form of a 450 mg capsule or a placebo capsule daily for 8 weeks. Anthropometric indices, liver enzymes, lipid profile, blood pressure, and antioxidant status were evaluated at the baseline and at the end of the study. Sixty‐one participants completed the study. After 8 weeks, sour tea administration significantly decreased serum triglyceride (TG) (p = .03), alanine aminotransferase (ALT) (p = .01), and aspartate aminotransferase (AST) (p = .004) levels compared with the placebo. In addition, sour tea supplementation resulted in a significant reduction in systolic blood pressure (SBP) (p = .03) and diastolic blood pressure (DBP) (p = .04), and a significant increase in serum total antioxidant capacity (TAC) levels (p ? .001) compared with the placebo. However, no significant changes in anthropometric measures, total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐c), and high‐density lipoprotein cholesterol (HDL‐c) levels were observed after sour tea supplementation compared with the placebo (p > .05). Sour tea supplementation may be effective in improving serum TG, liver enzymes, and blood pressure in patients diagnosed with NAFLD. Further studies are needed to address the exact mechanism of action of these effects.