Are personalized tongxie formula based on diagnostic analyses more effective in reducing IBS symptoms?-A randomized controlled trial

OBJECTIVES

To examine the efficacy and safety ofpersonalized tongxie formulas; to decrease type II errors to minimum.

METHODS

Patients were randomized (1:1:1) into three groups given tongxie, placebo, or pinaverium 3 times daily for 4 weeks. Patients in the tongxie group were treated with personalized formulas based on TCM differential diagnosis, i.e., basic type of IBS, IBS due to liver depression and qi stagnation, excess heat in the liver, deficient spleen function, deficient kidney function, and others (groups 1-6). Primary endpoints were significantly greater reductions in abdominal pain and Bristol stool score. Secondary endpoints were reductions in pain and stool frequencies and abdominal discomfort and its frequency.

RESULTS

There were significantly more patients whose stool consistencies were improved than pains were relieved in the entire population (p < 0.001), but there was no significantly difference in subpopulation group 3 (p > 0.05). There were significantly more patients whose stool frequencies were reduced than pain frequencies were reduced in the entire population (p < 0.001), but there were no significantly difference in the subpopulation Groups 1, 3, 4, and 6 (p > 0.05). Multiple active ingredients and their mechanisms of actions to relieve IBS symptoms were identified.

CONCLUSION

The outcomes in subpopulations may be different from those of the entire population, indicating that personalized formulas are important to achieve optimal outcomes; the active ingredients and innovative mechanisms identified in this study can be the candidates for developing new IBS drugs, and used to manage IBS, respectively.

TRIAL REGISTRATION

NCT01641224 (www.ClinicalTrials.gov).

Mo- and W-based organic nanostructures prepared from bulk crystal isomorphs consisted of [(CH3CH2)3NH)]2[MO2(C14H6O4)2] (M = Mo, W)

Two new crystal isomorphs consisting of complexes [(CH3CH2)3NH)]2[MoO2(C14H6O4)2] (1) and [(CH3CH2)3NH)]2[WO2(C14H6O4)2] (2) have been synthesized, respectively, and from which Mo-based flexible and durable nanopipes with diameters of 16 nm and lengths of hundreds of micrometers and W-based rigid and fragile nanotubules with ununiform diameters ranging from 30 to 100 nm and lengths in tens of micrometers have been prepared separately, which revealed that the change of the metal in the coordination center of the isomorphs can result in obvious variation to their nanostructures. The crystals both exhibited multilayered structures by the piling of lamellar repeating motifs through van der Waals forces, which are formed by the parallel alignment of 1D chains through hydrogen bonds, and the 1D chains are assembled by complexes 1 and 2, respectively, through geometrical intercalation and π-π packing. However, under grinding and ultrasonication, crystal 1 disassembled uniformly into longer and narrower nanostrips, whereas crystal 2 were broken at random into shorter and wider nanoribbons; therefore, the two lamellar nanostructures curled into different cylindrical nanospecies. The differences caused by Mo and W are the following: the Mo complex prefers to assemble into more durable one-dimensional structures along Mo-O bonds than W isomorphs; since Mo-O bonds are weaker than Mo═O and W-O bonds, then the weakest Mo-O bonds can be supported by the adjacent molecules through intercalation and π-π packing, which resulted in that the linkages among the Mo complexes are stronger along the Mo-O direction and hence the longer Mo-based cylindrical structure. Moreover, the flexibility of Mo-based nanopipes and the rigidity of W-based nanotubules might be attributed to that Mo possesses a lower melting point than W; therefore, Mo is softer and W is harsher.

Induction of cell death in human papillomavirus 18-positive cervical cancer cells by E6 siRNA

Human cervical cancer is caused by high-risk types of human papillomavirus (HPV) such as HPV16 and HPV18, which possess the E6 and E7 oncogenes, whose concurrent expression is a prerequisite for cancer development and maintaining malignant phenotypes. Silencing these oncogenes is considered to be applicable in molecular therapies of human cervical cancer. However, it remains to be determined whether E6, E7, or both should be silenced to obtain most efficient antitumor activity by an HPV small-interfering RNA (siRNA). Herein, we report two types of siRNAs targeting HPV18 E6, that exerted a negative growth effect on HPV18-positive cervical cancer cells (HeLa and SW756), in part, inducing cell death. One siRNA (Ex-18E6), designed to target both E6-E7 mRNA and its splicing variant, E6*I-E7 mRNA, efficiently knocked down both E6 and E7 expression. The other (Sp-18E6), designed to specifically target E6-E7 mRNA but not E6*I-E7 mRNA, suppressed E6 to a similar level as Ex-18E6; however, it less efficiently inhibited E7 as compared to Ex-18E6. Although both siRNAs induced cell death, Sp-18E6 siRNA induced more prominent cell death than Ex-18E6. Our results suggest that E6-specific suppression may induce more potent anticancer activity than simultaneous E6 and E7 suppression, and that E6-specific targeting is a promising strategy for siRNA-based therapy for HPV-positive cervical cancer.

Eradication of HPV post-surgical treatments, its correlation with specific types, types of surgery and the physical status

Low-risk human papillomaviruses (HPVs) will be completely eradicated as long as most visible lesions are treated. However, it is uncertain whether this is also the case for high-risk HPVs that are capable of causing cervical cancer. Many recent studies have demonstrated a high incidence of HPV persistence during post-conization or loop electrosurgical excision (LEEP) due to high-grade cervical intraepithelial neoplasia (CIN). In this report, we correlated the post-operative HPV status with pre-operative HPV type, types of surgery and HPV's physical status. Post-operative HPV E6 amplification by nested PCR was carried out for 157 female patients with positive pre-operative HPV. They underwent LEEPs, therapeutic laser conizations, and simple or radical hysterectomies. We found that high-risk types of HPVs were eradicated in 26.4% (42/159) of patients after extirpation of the lesions. The clearance rate of HPVs increased to 39.2% (40/102), excluding patients with other high-risk (OHR) kinds of type 31, 52b and 58, since OHR persisted after almost all surgeries. Eradication of HPV after radical hysterectomies are highly expected for patients with invasive cancer (70.0%, when excluding OHR), while more than half of them with CIN continue to carry pre-operative types of HPV or some different types from before treatment. Type 33 is most frequently persistent among types 16, 18 and 33. Persistent high-risk HPVs increase the risk for recurrence of post-surgical treatments of CIN, but the incidence is not high as long as the lesion is completely removed.

In vitro and in vivo growth suppression of human papillomavirus 16-positive cervical cancer cells by E6 siRNA

Human papillomavirus type 16 (HPV16), a causative agent of cervical cancers, encodes the E6 and E7 oncogenes, whose simultaneous expression is pivotal for malignant transformation and maintenance of malignant phenotypes. In the hope of developing a gene-specific therapy for HPV-related cancer, we examined the effects of E6 short-interfering RNA (siRNA) on the expression of these oncogenes and on the cell growth of HPV16-related cervical cancer cells. Using SiHa cervical cancer cells, we demonstrated that E6 siRNA decreased the levels of mRNA encoding E6 as well as that encoding E7 protein and also induced nuclear accumulation of p53, the most important target of E6. E6 siRNA suppressed monolayer and anchorage-independent growth of SiHa cells, which was associated with p21(CIP1/WAF1) induction and hypophosphorylation of retinoblastoma protein. Further, SiHa cells treated with E6 siRNA formed tumors in NOD/SCID mice that were significantly smaller than in those treated with control siRNA. Our results show HPV E6 siRNA as a candidate for gene-specific therapy for HPV-related cervical cancer.

[Physiological characteristics of single K+ channel currents (Ik) in cerebellar cortical neurons of neonatal rat]

The characteristics of single K+ channels in cultured cerebellar granule neurons of neonatal rat were studied by the cell- attached and inside-out configurations of patch clamp technique. The results are as follows: the predominant conductance of single channel was 25PS, the currents amplitude, the mean open time and the open probability were dependent of membrane potential, the open time distribution histograms were fitted by two exponential components, the channel activity was not inactivated during 20 s period, independent of calcium and blocked by tetraethylammonium. These results indicated that the single channel was a delayed rectifier (Ik). It is suggested that the non-inactivating channel with conductance of 25pS which exists in the cerebellar granule cell might be a new subtype of Ik channel.