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Background: Patients on maintenance hemodialysis suffer from diminished physical health. Directly supervised exercise programs have been shown to be effective at improving physical function and optimizing well-being. However, nurses seldom include an exercise intervention in the care plan for hemodialysis patients. Objectives: The purpose of this study was to examine the effects of a 12-week nurse-led case management program on home exercise training for hemodialysis patients. Design: The study was a randomized, two-parallel group trial. Settings: Hemodialysis units in two tertiary hospitals in Nanjing, mainland China. Participants: One hundred and thirteen adult patients who have been in stable condition while on dialysis treatment for more than 3 months were recruited and randomly assigned to either the study group (n = 57) or the control group (n = 56). Methods: Both groups underwent a brief weekly in-center exercise training session before their dialysis sessions for the first 6 weeks. The study group received additional nurse case management weekly for the first 6 weeks and biweekly for the following 6 weeks. The intervention was to facilitate patients in performing regular exercise at home. Outcome measures, including gait speed, 10-repetition sit-to-stand performance, and quality of life were collected at baseline, and at 6 and 12 weeks into the program. Results: The results revealed that patients in the study group demonstrated greater increases in normal gait speed [F(1,111) = 4.42, p = 0.038] than the control group. For the study group, a mean increase of 12.02 (±3.03) centimeters/second from baseline to week 12 was found. With regard to the fast gait speed, there was a marginally significant between-group effect [F(1,111) = 3.93, p = 0.050]. The study group showed a mean improvement of 11.08 (±3.32) cm/s, from baseline to week 12. Patients from both groups showed improvements in their 10-repetition sit-to-stand performance. The between-group differences approached significance [F(1,111) = 3.92, p = 0.050], with the study group showed greater improvement than the control group. The time taken by the patients in the study group to complete the 10-STS test increased by 5.75 (±3.88) s from baseline to week 12. Significant improvements in quality of life across three time points were found only in the study group. Conclusions: Home exercise using a nurse-led case management approach is practical and effective in improving the physical function and self-perceived health of stable hemodialysis patients. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: Modified Dingchuan decoction (MDD) is used in traditional Chinese medicine for the treatment of cough, chronic bronchitis, asthma and viral pneumonia. Aim of the study: To investigate antiviral potentials of MDD in respiratory syncytial virus (RSV) infected mice. Materials and methods: MDD and each component were evaluated for antiviral efficacy against RSV in vitro in cell culture. Mice were were treated with cyclophosphamide and infected with RSV. Then, treatments with MDD at doses of 1.75g/kg, 3.5g/kg and 7.0g/kg, respectively, were oral administrated daily for 5 days after challenge. The levels of Eotaxin, IL-4 and IFN-γ in serum and lung tissue were detected by ELISA, viral loads in lung tissues were detected by RFQ-PCR while expressions of NF-κB and TLR4 mRNA were also detected by RFQ-PCR. Results: A selective index of >36.8 (2.5 times greater than that observed for ribavirin) was determined in the in vitro studies for this herbal medicine. MDD exhibited significant antiviral and anti-inflammatory effects on decreasing levels of Eotaxin, IL-4 and IFN-γ in serum and lung tissue, inhibiting pneumonia, decreasing lung viral loads and reversaling RSV-induced inflammation through down-regulation of TLR4 and NF-κB mRNA expression in the lung tissue of RSV-infected mice. Conclusions: MDD could exhibit antiviral and anti-inflammatory effects on RSV-infected mice as a suppressor of Eotaxin, IL-4 and IFN-γ. These effects appeared to be mediated by inhibitions of TLR4 and NF-κB activation. Therefore, MDD could provide an effective therapeutic approach for RSV and its subsequent viral bronchitis. [Copyright &y& Elsevier]

Abstract: Quercetin''s protective effects on the glomerulosclerosis of diabetic nephropathy (DN) in rat mesangial cells were investigated. The cell cycles, type IV collagen and laminin, TGF-β1 mRNA, Smad 2/3 and Smad 7, and activities of cell antioxidases were measured. Compared with the high glucose group, quercetin may decrease the cell percentages of G0/G1 phase, Smad 2/3 expression, laminin and type IV collagen, and TGF-β1 mRNA level significantly. The antioxidant capacity, the cell percentages of S phase and Smad 7 expression was significantly increased by quercetin. These results suggest that quercetin is a protective agent against glomerulosclerosis in DN. [Copyright &y& Elsevier]

Abstract: Ethnopharmacological relevance: To assess the ability of traditional Chinese medicine Polygonatum sibiricum polysaccharide to prevent bone loss in the ovariectomized rat. Materials and methods: PSP was administered intragastrically to the rats. After 35 days, the total body bone mineral density (BMD) was assessed in all of the rats. All sections were processed for immunohistochemistry and hematoxylin-eosin staining (H.E.). Results: BMD was lower in the ovariectomized group (OVX, 0.163g/cm2), the group that received a moderate dose of PSP on OVX animals (OVX+MP, 0.163g/cm2) and the group that received a low dose of PSP on OVX animals (OVX+LP, 0.162g/cm2) than in the sham-operated group (SHAM, 0.180g/cm2), the OVX+E2 group (OVX+E2, 0.176g/cm2) and the group that received a high dose of PSP on OVX animals (OVX+HP, 0.174g/cm2) (P <0.05). Clear arrangements of bone trabeculae were observed in the OVX+E2 and OVX+HP. The expression of bone morphogenetic proteins (BMP) and basic fibroblast growth factor (bFGF) in the OVX, OVX+MP and OVX+LP was down regulated compared to the SHAM, OVX+E2 and OVX+HP (P <0.05). The rats in the OVX+E2 and OVX+HP had lower levels of bone Gla protein (BGP), bone alkaline phosphatase (BALP), tartrate-resistant acid phosphatase (TRAP) and tumor necrosis factor α(TNF-α) expression than the rats in the OVX, OVX+MP and OVX+LP (P <0.05). Conclusion: This experiment demonstrates that the administration of PSP to ovariectomized rats reverses bone loss and prevents osteoporosis. [Copyright &y& Elsevier]

Abstract: Phlomis umbrosa Turcz has been used as the traditional medicine for thousands of years in China. In this paper, the acetic acid-induced writhing test, the hot plate test, the carrageenan-induced paw edema test, the xylene-induced ear swelling test, and the acetic acid-induced Evans blue leakage and leukocyte infiltration test were used to investigate the antinociceptive and anti-inflammatory activities of the aqueous extract of this plant (25, 50 and 100mg/kg i.p.). Good dose-dependent effects were obtained in most of these tests, except in the hot plate test and the acetic acid-induced Evans blue leakage test. TLC and HPLC analyses showed iridoid glucosides were the main compositions of this extract. These findings suggested that the aqueous extract of P. umbrosa has significant antinociceptive and anti-inflammatory activities. [Copyright &y& Elsevier]

Abstract: Whether rehabilitation outcome can be maintained after discharged from GDH has not been thoroughly investigated. This study was conducted to examine the rehabilitation outcome and its predictors 6 months after discharged from GDH. We studied 418 patients attended a GDH in Hong Kong. All of them had post-6-month assessment. Cognitive status was assessed with Cantonese version of mini-mental state examination (C-MMSE). Functional independence measure (FIM) upon GDH admission (FIM-adm), discharge (FIM-dis) and 6 months after discharge (FIM-p6m) were measured. FIM gain was FIM-dis−FIM-adm while FIM efficiency was FIM gain divided by number of GDH visits. Of the study pool, 164 (39.2%) showed a drop of FIM-p6m. There was a significant drop of FIM-p6m as compared with FIM-dis (p <0.001). However, the FIM-p6m remained significantly higher than FIM-adm (p <0.001). Multivariate analysis revealed that FIM-dis was a negative predictor (p <0.001) while Parkinsonism was a positive predictor for drop of FIM-p6m (p =0.008). A proportion of functional gain can still be maintained 6 months after discharged from GDH. More studies are needed to look for strategies in maintaining functional gain in GDH discharged patients, especially those with Parkinsonism. [Copyright &y& Elsevier]

Abstract: Aim of the study: To compare the anxiolytic activities and flavonoid compositions of the two populations of the species Passiflora edulis, Passiflora edulis ‘edulis’ with purple fruit and Passiflora edulis ‘flavicarpa’ with yellow fruit. Materials and methods: Four samples for each population of Passiflora edulis were collected from different districts of China. Swiss albino mice were used as experimental animals in elevated plus-maze (EPM) test to assay the anxiolytic effects of ethanol extracts of the samples. The conventional parameters and ethological items of the behavior of the mice were recorded and analyzed. Flavonoid compositions of the samples were analyzed by RP-HPLC monitored with diode array detection and the chromatograms were compared. Results: The ethanol extracts of the samples of Passiflora edulis ‘flavicarpa’ displayed anxiolytic activity at 400mg/kg, while those of Passiflora edulis ‘edulis’ exhibited sedative effect at 400mg/kg. The chromatograms of the samples belonging to similar population of Passiflora edulis were identical, but those belonging to different population were distinct from each other. The series of peaks between 16 and 24min in the chromatograms of Passiflora edulis ‘flavicarpa’ did not appear in those of Passiflora edulis ‘edulis’, either did the peaks between 54 and 90min in chromatograms of Passiflora edulis ‘edulis’ not appear in those of Passiflora edulis ‘flavicarpa’. The six major flavonoid compounds isolated from the leaves of Passiflora edulis ‘flavicarpa’, lucenin-2, vicenin-2, isoorientin, isovitexin, luteolin-6-C-chinovoside, and luteolin-6-C-fucoside, had not been detected in Passiflora edulis ‘edulis’. Conclusions: Passiflora edulis ‘flavicarpa’ is extremely different from Passiflora edulis ‘edulis’ and they should be distinguished when pharmacological studies are performed on them. The aerial part of Passiflora edulis ‘flavicarpa’ is possible to be utilized as the resource of Passionflower Extract. [Copyright &y& Elsevier]

Abstract: Ethnopharmacological relevance: Xiang-Fu-Si-Wu Decoction has been widely used to treat blood stasis syndromes in gynecology diseases, such as primary dysmenorrhea in clinical practice for hundreds of years and show great efficacy. The efficient components and mechanism of action on uterus contraction were seldom reported. Aim of the study: The present study was conducted to evaluate the inhibitory effects of active fractions and its main bioactive components of Xiang-Fu-Si-Wu Decoction on uterine contraction. Materials and methods: Model of non-pregnant mice uterine contraction induced by oxytocin was used to evaluate activity. Levels of Ca2+ and nitric oxide (NO) in primary dysmenorrheal model mice uterus were also been detected. Components in active fraction were identified and quantified by HPLC-DAD. Results and conclusions: It was found the active fraction of Xiang-Fu-Si-Wu Decoction may become potential Ca2+ channel blocking agents. Alkaloids like berberine were main active components in bioactive fraction of Xiang-Fu-Si-Wu Decoction for dysmenorrhea on uterus contraction. [Copyright &y& Elsevier]

Ethnopharmacological relevance: Curcuma zedoaria (Berg.) Rosc., a traditional Chinese herb, was used widely but absolutely prohibited for the pregnant in clinic. Based on that there is abundant angiogenesis in endometrium and placenta during gestation period, we hypothesized that some components from it could inhibit angiogenesis and then damaged the supply of oxygen and nutrition to the embryo, which finally led to gestation failure. Aim of the study: This study was set to demonstrate whether essential oil, major components of Curcuma zedoaria had anti-angiogenic effect. Materials and methods: Essential oil of Curcuma zedoaria (EO-CZ) was abstracted by steam distillation extraction. Cell proliferation assay and two angiogenic models, rat aortic ring assay and chick embryo chorioallantoic membrane assay were presented. Furthermore, melanoma growth and experimental lung metastasis assay in mice were performed to evaluate its anti-angiogenesis effect in vivo. Immunohistochemical analysis and enzyme-linked immunosorbent assay (ELISA) were used to respectively detect the expression of CD34 and matrix metalloproteinases (MMPs). Results: EO-CZ exhibited anti-proliferative effect on B16BL6 and SMMC-7721 cells, the IC50, respectively was 41.8μg/ml and 30.7μg/ml, and on HUVEC (Human Umbilical Vein Endothelial Cells) cells with IC50 of far more than 120μg/ml. Both 20μg/ml and 40μg/ml EO-CZ indicated significant suppression on sprouting vessels of aortic ring and formation of microvessels in chick embryo chorioallantoic membrane in vitro. Moreover, solid melanoma grown in left oxter of mice was obviously inhibited after oral intake of 100 and 200mg/kg of EO-CZ a day for 28 days, and CD34 expression indicating angiogenesis in melanoma reduced significantly compared with control; melanoma metastatic nodules in lung were detected to be inhibited, as well as MMP-2 and MMP-9 expression in serum. Conclusions: Essential oil, a fat-soluble fraction of Curcuma zedoaria, presented anti-angiogenic activity in vitro and in vivo, resulting in suppressing melanoma growth and lung metastasis. And this was associated with down-regulating MMPs. [Copyright &y& Elsevier]

To investigate the effect of Acorus gramineus (AG), a supposed ‘delivering servant’ according to traditional Chinese medicine principles governing multi-herb formula preparation and formulation, on facilitating the uptake of ginsenosides Rg1, Re and Rb1 to the brain after oral administration of Kai-Xin-San (KXS) preparations. Materials and methods: Ginseng extracts or KXS with or without AG were administered to rats for pharmacokinetic study and mice for behaviour tests at a dose of 3g ginseng per kg. The concentrations of ginsenosides in plasma and brain were determined by an LC–MS/MS method, whilst the effects of preparations on spatial learning were evaluated using the Morris water maze test. Results: KXS in the presence of AG tended to significantly reverse the learning impairment induced by scopolamine. The presence of AG in the KXS formula led to increases in the initial absorption rate and extent of Rg1 and Re in terms of Cmax1 and AUC0–3h compared to KXS without AG. Although KXS were found to increase the bioavailabilities and brain concentrations of ginsenosides relative to ginseng extract, the brain-to-plasma AUC0–12h ratios appeared not to be affected. Conclusions: The results suggested that the presence of AG in the KXS formula promoted the initial absorption of ginsenosides Rg1 and Re in the gastrointestinal tract, but unlikely affected the brain-to-plasma AUC ratios. [Copyright &y& Elsevier]