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Ethnopharmacological relevance Huangqi Guizhi Wuwu Decoction(HQGZWWD) is a Traditional Chinese Medicine formula from Synopsis of Golden Chamber used to treat blood arthralgia. According to the principle that the same treatment can be used for different diseases, HQGZWWD has proven effective for IgA nephropathy (IgAN) associated with spleen and kidney yang deficiency. Aim of the study In this study, we investigated the mechanism by which HQGZWWD alleviates proteinuria and protects renal function in rats with IgAN by regulating the AT1R/Nephrin/c-Abl pathway. Methods Rats were randomly divided into six groups: control, IgAN model, IgAN model treated with low-dose HQGZWWD, IgAN model treated with medium-dose HQGZWWD, IgAN model treated with high-dose HQGZWWD, and IgAN model treated with valsartan. IgAN was induced using bovine γ-globulin. We evaluated the mediating effects of HQGZWWD on podocyte cytoskeletal proteins, the AT1R/Nephrin/c-Abl pathway, upstream tumor necrosis factor-α (TNF-α), and TNF-α receptor-1 (TNFR1). Results The IgAN rats displayed proteinuria, IgA deposition in the mesangial region, and podocyte cytoskeletal protein damage. The expression of TNF-α, TNFR1, AT1R, and c-Abl was increased in the IgAN rat kidney, whereas the expression of nephrin, podocin, ACTN4, and phosphorylated nephrin (p-nephrin) was reduced. HQGZWWD treatment significantly alleviated podocyte cytoskeletal protein damage in the IgAN rats, upregulated the expression of nephrin, podocin, and ACTN4, and the colocalized expression of F-actin and nephrin. This study demonstrates that HQGZWWD attenuates podocyte cytoskeletal protein damage by regulating the AT1R–nephrin– c-Abl pathway, upregulating the expression of p-nephrin, and downregulating the expression of AT1R and c-Abl. Conclusions These results indicate that HQGZWWD attenuates podocyte cytoskeletal protein damage in IgAN rats by regulating the AT1R/Nephrin/c-Abl pathway, providing a potential therapeutic approach for IgAN.

Background Jiangniaosuan formula (JNSF) is commonly used in China for treating hyperuricemia, but there is little research-based evidence to support its use. This randomized controlled trial aims to assess the efficacy and safety of JNSF. Methods A total of 72 patients with hyperuricemia will be selected and randomly assigned in a ratio of 1:2 to receive either Western medicine, i.e., febuxostat 40 mg (WG group; n = 24), or Chinese herbal medicine, i.e., Jiangniaosuan formula + febuxostat 20 mg (WJNSG group; n = 48). After 12 weeks, the WJNSG will be randomly divided into two groups of 24 patients each; one group (WJNSG; n = 24) still will receive febuxostat 20 mg + Jiangniaosuan formula, and the other group (JNSG; n = 24) will continue to receive Jiangniaosuan formula + placebo. Participants will be followed up at 4-week intervals. The primary outcome will be the change in serum uric acid level, and the secondary outcome will be the change in traditional Chinese medicine (TCM) syndrome scores. Serum creatinine, blood glucose, and insulin levels will also be measured. Discussion We hypothesize that patients with hyperuricemia will benefit from JNSF. This study will provide evidence-based recommendations for clinicians. Dissemination The results will be published in a peer-reviewed journal and disseminated by academic conferences. The datasets analyzed during the current study are available from the corresponding author on reasonable request. Trial registration Chinese Clinical Trials Register ChiCTR2000041083. Registered on 3 May 2021. The protocol version number is V3.0, 20210301.

Background The prevalence rates of gout worldwide have increased annually. Acute gouty arthritis (AGA) accounts for a large proportion of gout patients and causes severe physical and mental pain in patients. Controlling the occurrence and development of gout inflammation is the first step in the treatment of gout. The main treatment drugs in gout are Non-Steroid Anti-Inflammatory Drugs (NSAIDS), colchicine and glucocorticoids, but these treatments have many adverse reactions which limit their clinical application. Baihu and Guizhi decoction (BHGZ) is one of the classic prescriptions in the Synopsis of the Golden Chamber, and is a good prescription for AGA. Previous clinical studies have shown that BHGZ confers a strong benefit for treating AGA. However, the literature shows a lack of high-quality RCT research on BHGZ with respect to AGA. Therefore, in this study, we use a randomized, double-blind, controlled study with a placebo to evaluate the clinical efficacy and safety of BHGZ on the AGA of moist heat arthralgia spasm syndrome. Methods This study is a randomized, double-blind, controlled clinical trial. A total of 102 adult participants with AGA of moist heat arthralgia spasm syndrome will be enrolled, with balanced treatment allocation (1:1). The experimental intervention will be BHGZ plus the low-dose colchicine and the control intervention will be placebo plus the low-dose colchicine for 10 days. To study the clinical efficacy (including VAS score; joint tenderness, joint swelling, joint movement disorder; TCM evidence efficacy score) and the changes of inflammatory indexes. At the same time, the improvement of joint inflammation in patients with AGA will be observed from musculoskeletal ultrasound imaging, and the safety evaluation will be carried out. Discussion This study will be the first placebo-controlled RCT to assess whether BHGZ plus low-dose colchicine have beneficial effects on changing reducing inflammation of joints for patients with AGA of moist heat arthralgia spasm syndrome. The results of this trial will help to provide evidence-based recommendations for clinicians. Trial registration: Chinese Clinical Trials Register, ChiCTR1900024974. Registered on 5 August 2019.

BACKGROUND: We aimed to examine whether body mass index (BMI) had an impact on clinical outcomes of laparoscopic radical cystectomy with intracorporeal urinary diversion. Furthermore, we analyzed the optimization of enhanced recovery protocols (ERPs) on the impact of BMI on clinical outcomes. METHODS: By searching our database, data of 83 consecutive patients were retrospectively collected, including 37 patients with a BMI 0.05). The 30-day overall complication rate, operative time, and length of stay were similar between the two groups (P>0.05). But post-operative nausea and vomiting (PONV) was higher in group A than in group B (32.4% vs. 8.7%, P=0.014). Group A was associated with lower serum albumin level pre-operatively and on post-operative days 1–3. ΔALB(min) was higher in group A than in group B (33.08%±9.88% vs. 27.92%±8.52%, P0.05). Multivariable analysis showed that PONV and CRPs were independently associated with ΔALB(min) ≥34% (P

Freeform progressive addition lenses (PALs) are mainly divided into distance vision zone, near vision zone, astigmatism channel and peripheral astigmatism zone. The purpose of this study was to compare the effect of the width of the astigmatism channel by changing the near vision area of PALs on the basis of the minimal model method. The change of the near vision area was mainly achieved by changing the distribution function of the main curvature difference and the average curvature weight. Firstly, two weight distribution matrices of different near vision areas were designed, and the second-order partial differential equations of the minimized model were solved by the finite element method. The surface shape of two PALs was obtained. Secondly, the freeform verifier software (FFV) (ROTLEX, Israel) was used to simulate the shapes of the obtained surfaces, and used computer numerical control machine tools to process two groups of PALs. Finally, the Visionix VM-2500 lens measuring instrument was used to measure the PALs. The simulated and measured power and astigmatism distribution contours showed that the width of the astigmatism channel increased with the increase of the near vision area, however, the peripheral astigmatism was increased. Therefore, the near vision zone with an appropriate area can provide a reference for the optimal design of PALs.

There are upper airway abnormalities in patients with obstructive sleep apnea (OSA), and their speech signal characteristics are different from those of unaffected people. In this study, the severity of OSA was evaluated automatically by machine learning technology based on the speech signals of Chinese people. In total, 151 adult male Mandarin native speakers who had suspected OSA completed polysomnography to assess the severity of the disease. Chinese vowels and nasal sounds were recorded in sitting and supine positions, and the accuracy of predicting the apnea-hypopnea index (AHI) of the participants using a machine learning method was analyzed based on features extracted from the speech signals. Among the 151 participants, 75 had AHI > 30 events/h, and 76 had AHI ≤ 30 events/h. Various features including linear prediction cepstral coefficients (LPCC) were extracted from the data collected from participants recorded in the sitting and supine positions and by using a linear support vector machine (SVM); we classified the participants with thresholds of AHI = 30 and AHI = 10 events/h. The accuracies of the classifications were both 78.8%, the sensitivities were 77.3% and 79.1%, and the specificities were 80.3% and 78.0%, respectively. This study constructed a severity evaluation model of OSA based on speech signal processing and machine learning, which can be used as an effective method to screen patients with OSA. In addition, it was found that Chinese pronunciation can be used as an effective feature to predict OSA.

Toroidal, spherocylindrical, ellipsoidal, and combined surfaces were used to correct astigmatism in aspheric spectacle lenses, and the differences among the proposed techniques were compared. Four astigmatic spectacle lenses were designed with the same optical parameters. A freeform measuring machine was used to evaluate posterior surfaces of aspheric spectacle lenses, and spherical and cylindrical power maps were generated and compared. The measured data were analyzed via commercial software. The toroidal lens helped to extend the clear vision range around the lens, and the ellipsoidal and spherocylindrical surfaces resulted in a more accurate centering of the lens around the optical axis of the eye, avoided astigmatism, and provided better visual perception.

Background Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common potentially life-threatening inherited kidney diseases. It is the fourth most common cause of end-stage renal disease requiring renal replacement therapy. There are few management options for controlling disease progression. Hence, identification of alternative treatments for patients is important. The Chinese herbal yinang formulation (YNF), which is derived from a Chinese patent medicine, appears to have a satisfactory effect in treating ADPKD. Because a considerable proportion of ADPKD patients presenting with chronic kidney disease (CKD) stages III–IV are diagnosed with the spleen, kidney deficiency, and blood stasis syndrome according to the diagnostic criteria of traditional Chinese medicine (TCM), we hypothesize that YNF may be a complementary drug for ADPKD patients with the corresponding syndrome. Therefore, we have designed a strict clinical trial to evaluate the safety and efficacy of YNF for ADPKD patients with CKD stages III–IV exhibiting the TCM syndrome of spleen, kidney deficiency, and blood stasis. Methods/design This is a multi-center prospective double-blind randomized controlled trial. The total target sample size is planned to be 72 participants, with a balanced treatment allocation (1:1). The experimental intervention will be YNF plus conventional therapy and the control intervention will be a placebo plus conventional therapy for 24 weeks. An additional 24 weeks of follow-up will be conducted after treatment completion. The primary outcome will be the estimated glomerular filtration rate (eGFR). Changes in total kidney volume (TKV), serum creatinine (Scr), blood urea nitrogen (BUN), TCM symptoms, and pain will be the secondary outcomes. Adverse events (AEs) will be monitored throughout the trial. Discussion This study will be the first placebo-controlled randomized controlled trial to assess whether YNF plus conventional therapy has a beneficial effect on eGFR, TKV, Scr, and BUN, and whether it can alleviate TCM clinical symptoms, reduce ADPKD-related pain, and reduce the frequency of AEs for ADPKD patients with CKD stages III–IV with the spleen, kidney deficiency, and blood stasis syndrome. The results of this trial may provide an evidence-based recommendation for clinicians. Trial registration Chinese Clinical Trials Register, ChiCTR-INR-16009914. Registered on 18 November 2016. Electronic supplementary material The online version of this article (10.1186/s13063-019-3563-5) contains supplementary material, which is available to authorized users.

We employed two-dimensional convolution processing and spline interpolation methods to process the weight distributions (WDs) of the spherical and cylindrical power deviations, and assess their effect in designing progressive addition lenses (PALs), based on the minimized error function. Eight power deviation and astigmatism WDs were constructed with different convolution processing schemes and transition area widths connecting the high- and low-weight areas, respectively. Correspondingly, eight PALs were designed, simulated, machined, and evaluated by commercial software. The results show that the number of multiple convolution processing changes from 0 to 15, areas of the far and near areas increase by 35.7% and 76.5%, and maximum peripheral astigmatism increases from 0.75 to 1.5 addition power, respectively. When the width of the transition zone changes from 0 mm to 9 mm, the area of the far and near regions increase by 27.2% and 58.2%, respectively, and the maximum peripheral astigmatism increases from the original value of 1 addition power to 1.25 addition power, respectively.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has caused serious damage to public health. COVID-19 has no vaccine or specific therapy; its mortality rate increases significantly once patients deteriorate. Furthermore, intensive monitoring of COVID-19 is limited by insufficient medical resources and increased risks of exposure to medical staff. We therefore aim to build an early warning and rapid response system (EWRRS) to address these problems. METHOD: The research is designed as a prospective cohort study, to verify a dynamic and interactive evaluation system; it includes patient self-reporting, active monitoring, early alarming and treatment recommendations. Adult patients diagnosed with COVID-19 will be recruited from Sept 2020 to Aug 2021 at a tertiary contagious hospital. Patients with life expectancy

Objective. Renal anemia in patients with end-stage chronic kidney disease is closely related to the deterioration of cardiac function, renal function, and quality of life. This study involved adenine-induced renal anemic rat models and evaluated the treatment effect of Siwu granules and/or erythropoietin (EPO). Methods. Fifty SD rats were randomly divided into 5 groups: control, model, Siwu, EPO, and Siwu plus EPO groups. The expression levels of NO, MDA, SOD, CAT, IL-6, TNF-α, EPO, EPOR, α-SMA, and TGF-β1 were detected in rats after 8 weeks of treatment with Siwu granules and/or EPO. Results. After modeling, 47 rats entered the stage of treatment. Siwu plus EPO treatment significantly increased the rat hemoglobin content (p<0.05) and reduced blood urea nitrogen (p<0.05) and serum creatinine (p<0.001). Compared with the control group, the expression of EPO and EPOR in the kidney of rats with renal failure was significantly decreased (p<0.05). Moreover, the Siwu plus EPO group improved the level of oxidative stress in rats with chronic renal failure and reduced the expression of inflammatory factors. The expression of α-SMA and TGF-β1 in rats with renal failure was higher, but there was no expression in the control group. Conclusion. Combined treatment of Siwu granules with EPO increased the expression of EPO and EPOR in the renal tissues and inhibited oxidative stress and inflammatory factors, improving the renal function and anemia.

Objective. Uric acid (UA) activates the NLRP3-ASC-caspase-1 axis and triggers cascade inflammatory that leads to hyperuricemic nephropathy and hyperuricemia-induced renal tubular injury. The original study aims to verify the positive effects of the traditional Chinese medicinal formula Shizhifang (SZF) on ameliorating the hyperuricemia, tubular injury, and inflammasome infiltration in the kidneys of hyperuricemic lab rats. Method. Twenty-eight male Sprague-Dawley rats were divided into four groups: control group, oxonic acid potassium (OA) model group, OA + SZF group, and OA + Allopurinol group. We evaluated the mediating effects of SZF on renal mitochondrial reactive oxygen species (ROS) and oxidative stress (OS) products, protein expression of NLRP3-ASC-caspase-1 axis, and downstream inflammatory factors IL-1β and IL-18 after 7 weeks of animals feeding. Result. SZF alleviated OA-induced hyperuricemia and inhibited OS in hyperuricemic rats (P<0.05). SZF effectively suppressed the expression of gene and protein of the NLRP3-ASC-caspase-1 axis through accommodating the ROS-TXNIP pathway (P<0.05). Conclusion. Our data suggest that SZF alleviates renal tubular injury and inflammation infiltration by inhibiting NLRP3 inflammasome activation triggered by mitochondrial ROS in the kidneys of hyperuricemic lab rats.

The purpose of this study was to compare the optical properties of different astigmatic optical surfaces by direct physical measurement of their surface shapes. The back-surface heights of different astigmatic optical lenses were measured with a freeform measuring machine (FMM). In order to calculate the function of the part point cloud fitting surface for the dispersed data points of the astigmatic lenses, the measured shape data were modeled through surface fitting of a bicubic spline. The principal curvatures of each point on the surface were calculated, and the optical properties of each surface and their combinations were generated as contour plots using custom MATLAB routines. The fitting surface of the actual measurement points was compared with the design surface to determine the surface error. Analyses showed that this nonoptical method using an FMM can be used to effectively evaluate a cylindrical lens by surface height measurements alone. Compared to the optical measurement method, the optical properties derived directly from the surface shape can provide information not accessible by other methods. Therefore, this approach is potentially useful to clinicians who want to better understand the design of astigmatic optical lenses for making better recommendations to their clients.

Background Chronic kidney disease poses a serious health problem worldwide with increasing prevalence and lack of effective treatment. This study aimed to investigate the mechanism of icariin in alleviating chronic renal failure induced by 5/6 nephrectomy in rats. Methods The chronic renal failure model was established by a two-phased 5/6 nephrectomy procedure. The model rats were given daily doses of water or icariin for 8 weeks. The kidney morphology was checked by HE staining. The levels of blood urea nitrogen, serum creatinine, and serum uric acid were measured by colometric methods. The expression of specified genes was analyzed by quantitative real-time PCR and immunohistochemical staining. The number of renal stem/progenitor cells was analyzed by CD133 and CD24 immunohistochemical staining. Results Icariin protected against CDK-caused damages to kidney histology and improved renal function, significantly reduced levels of BUN, creatinine, and uric acid. Icariin inhibited the expression level of TGF-β1 whereas upregulated HGF, BMP-7, WT-1, and Pax2 expression. Moreover, ccariin significantly increased the expression of CD24, CD133, Osr1, and Nanog in remnant kidney and the numbers of CD133+/CD24+ renal stem/progenitor cells. Conclusions These data demonstrated that icariin effectively alleviated 5/6 nephrectomy induced chronic renal failure through increasing renal stem/progenitor cells.