Safety and efficacy of Yupingfeng granules in children with recurrent respiratory tract infection: A randomized clinical trial

Importance

Recurrent respiratory tract infection (RRTI) is common in children. Inappropriate RRTI treatment will lead to asthma and other diseases, thereby seriously affecting the growth and physical health of children. Immune function modulation can prevent and alleviate childhood RRTI. Yupingfeng (YPF), a patented traditional Chinese medicine (TCM), has immunomodulatory effects and is widely used in China to treat children with RRTI.

Objective

To evaluate the safety and efficacy of YPF monotherapy in treating children with RRTI.

Methods

This multicenter, randomized, double‐blind, double‐simulation, noninferiority clinical trial was conducted from January 2015 to August 2017, with an 8‐week treatment period and 52‐week follow‐up after the drug withdrawal. Children aged 2–6 years with RRTI meeting the inclusion and exclusion criteria were enrolled in 13 hospitals in China and divided randomly into three groups (2:2:1 ratio) to receive YPF, pidotimod, or placebo. The primary outcome was the proportion of RRTI returning to normal standard level during the follow‐up. The secondary outcomes were reduction in the number of RRTI recurrences, effect on clinical symptoms (in accord with TCM practice), effect per symptom, and safety. The trial was registered at the Chinese Clinical Trials Registry (www.chictr.org.cn) under the unique identifier ChiCTR‐IPR‐15006847.

Results

Three hundred and fifty‐one children were enrolled and randomly assigned to 3 groups; 124, 125, and 61 children in the YPF, pidotimod, and placebo groups, respectively, had completed the trial. During the follow‐up, the proportion of RRTI returning to normal standard level was 73.13%, 67.15%, and 38.81% with YPF, pidotimod, and placebo, respectively (P < 0.0001). The proportion of cases who returned to normal standard level in the YPF group was 34.32% higher than that in the placebo group. The safety profile did not significantly differ among the groups.

Interpretation

YPF granules were noninferior to the active control drug pidotimod oral solution for the treatment of RRTI in children, and were superior to placebo, with a high safety profile.

X-ray Intermolecular Structure Factor(XISF): separation of intra- and intermolecular interactions from total X-ray scattering data

XISFis a MATLAB program developed to separate intermolecular structure factors from total X-ray scattering structure factors for molecular liquids and amorphous solids. The program is built on a trust-region-reflective optimization routine with the r.m.s. deviations of atoms physically constrained.XISFhas been optimized for performance and can separate intermolecular structure factors of complex molecules.

Predictive value of ankle-brachial index and blood glucose on the outcomes of six-year all-cause mortality and cardiovascular mortality in a Chinese population of type 2 diabetes patients

AIM

The aim of this paper was to investigate the predictive value of ankle-brachial index (ABI) and blood glucose to estimate mortality in Chinese type 2 diabetes patients.

METHODS

Chinese type 2 diabetes patients (1706 subjects) were followed up for about 6 years,

RESULTS

One thousand four hundred fourteen were included in the final statistical analysis during a median follow-up of 69 months. Overall, 398 patients died during follow-up and 254 deaths were attributable to cardiovascular disease (CVD). Relative risks of all-cause and CVD mortality of patients with ABI≤0.4 were increased by 2.073-fold (95% CI: 1.236-3.478) and 3.086-fold (95% CI: 1.702-5.595), compared with those of patients with ABI>1.0 and ≤1.4. Mortality was significantly increased with increasing plasma glucose and decreasing ABI. All-cause and CVD mortality was the highest (55.6% and 44.4%) with ABI≤0.4 and plasma glucose >10 mmol/L simultaneously. Relative risks of all-cause and CVD mortality in these patients were increased by 3.905-fold (95% CI: 1.334-11.431) and 3.771-fold (95% CI: 1.079-13.171), compared with patients with ABI>1.0 and ≤1.4, and plasma glucose ≤6 mmol/L simultaneously. Models to evaluate additional predictive value of ABI for mortality of type 2 diabetes patients suggested that addition of ABI significantly improved the prediction of the death rate compared with the model including conventional risk factors only.

CONCLUSION

High plasma glucose and low ABI had synergistic effects on increasing mortality of type 2 diabetes patients. The addition of ABI can significantly improve the prediction of mortality compared to protocol using conventional risk factors only.