Hoshi University

Chronic constipation decreases quality of life; therefore, appropriate treatment measures are crucial. However, current treatments are insufficient to adequately control defecation, necessitating the identification of new strategies that are more effective and safer. We investigated the laxative action mechanism of the Kampo medicine Mashiningan (MNG) and discussed its usefulness in constipation. Rats were orally administered extracts of MNG or its herbal constituents, and defecation was analyzed. Expression levels of aquaporin-3 (AQP3) and inflammation-related genes in the colon were detected. The effects of the herbal medicines on inflammation were analyzed using macrophage-like RAW264.7 cells. Fecal water content significantly increased in rats treated with MNG. Expression of AQP3 protein in the colon of the MNG-treated group reduced to ∼20 % of that in the control group. Examining the effect of compound herbal medicines, only administration of Daio extract increased defecation and reduced colonic expression of AQP3. Treatment with MNG significantly increased the expression of interleukin (IL)-1β and IL-6 in the colon, although this increase was less than that in the group treated with Daio alone. Mashinin, Kyonin, and Kijitsu could significantly suppress the lipopolysaccharide (LPS)-induced increase in IL-1β and IL-6 in RAW264.7 cells. MNG exerted a laxative effect by decreasing AQP3 expression and disturbing water absorption in the colon. This effect was attributed to the herbal compound Daio. Furthermore, MNG contains Mashinin, Kyonin, and Kijitsu, which exert anti-inflammatory effects. Accordingly, MNG is a laxative with fewer side effects, such as abdominal pain.

Oversulfated chondroitin sulfate (OSCS) is a chondroitin sulfate ester in which all hydroxyl groups have been converted to sulfuric acid esters. Here, we describe a rapid, novel synthesis method for OSCS. ¹H-NMR analysis revealed that all signals derived from the protons of N-acetyl-galactosamine and glucuronic acid in the synthesized OSCS were shifted downfield due to sulfonation compared with the chondroitin sulfate (CS) starting material. Comparison of the edited heteronuclear single quantum correlation spectrum of the prepared OSCS with that of the Japanese Pharmacopoeia OSCS reference standard showed excellent agreement between the main correlation peaks. The proposed novel synthesis method for OSCS is faster and simpler than the conventional method.

This study conducted a systematic review of the systematic reviews of readability assessment studies to contribute to future readability research and practice by providing a comprehensive overview of information readability for patients.

We searched multiple databases. We included systematic reviews of studies that quantitatively assessed the readability of health information.

This study included 24 systematic reviews, which assessed the readability of 29,424 materials across 438 studies from 1990 to 2022. All systematic reviews reported that the readability of most materials exceeded the recommended sixth to eight-grade reading level. The readability level did not improve between 2001 and 2022, when the included systematic reviews were published.

We found that the required reading level of information was too high for patients in all clinical areas included in this systematic review. We also identified gaps in readability assessment research in clinical areas and across media types and languages, which should be addressed by future studies.

Health professionals should use available guidelines to make existing patient information easy to read and to write easy-to-read patient information, thereby improving readability. Such efforts are needed regardless of the organizations these professionals work at.