Angong Niuhuang pill, a Chinese materia medica preparation, can improve neurological func-tions after acute ischemic stroke. Because of its inconvenient application and toxic components （Cinnabaris andRealgar）, we u...Angong Niuhuang pill, a Chinese materia medica preparation, can improve neurological func-tions after acute ischemic stroke. Because of its inconvenient application and toxic components （Cinnabaris andRealgar）, we used transdermal enhancers to deliverAngong Niuhuang pill by modern technology, which expanded the safe dose range and clinical indications. In this study, Angong Niuhuang stickers administered at different point application doses （1.35, 2.7, and 5.4 g/kg） were administered to theDazhui （DU14）, Qihai（RN6） andMingmen （DU4） of rats with chronic cerebral ischemia, for 4 weeks. The Morris water maze was used to determine the learning and memory ability of rats. Hematoxylin-eosin staining and Nissl staining were used to observe neuronal damage of the cortex and hippocampal CA1 region in rats with chronic cerebral ischemia. The middle- and high-dose point application ofAngong Niuhuangstickers attenuated neuronal damage in the cortex and hippocampal CA1 region, and improved the memory of rats with chronic cerebral ischemia with an efifcacy similar to interventions by electroacupuncture at Dazhui （DU14）,Qihai （RN6） andMingmen （DU4）. Our experimental ifndings indicate that point application withAngong Niuhuang stickers can improve cognitive function after chronic cerebral ischemia in rats and is neuroprotective with an equivalent efifcacy to acupuncture.展开更多
In this study, we extracted and purified components in the Angong Niuhuang pill. Then we applied transdermal enhancers to Angong Niuhuang stickers by modern technology. The Angong Niuhuang sticker includes extracts fr...In this study, we extracted and purified components in the Angong Niuhuang pill. Then we applied transdermal enhancers to Angong Niuhuang stickers by modern technology. The Angong Niuhuang sticker includes extracts from curcuma, berberine hydrochloride, baicalin, geniposide, borneol, and musk. Angong Niuhuang stickers at different point application doses （1.35, 2.7, and 5.4 g/kg） were administered to Dazhui （DU14）, Qihai （RN6） and Mingmen （DU4）. Rats in the different dose point application and acupuncture groups were continuously administered for 7 days. Then a middle cerebral artery occlusion model was prepared for simulating human cerebral ischemia. Twelve hours later, expressions of Bcl-2, Bax and p53 protein in hippocampal CA1 were detected with immunohistochemistry. The expression level of Bcl-2, an anti-apoptotic protein, significantly increased in the high-, medium- and low-dose point application groups and the acupuncture group, while the expression of the pro-apoptotic proteins, Bax and p53, significantly decreased compared with the middle cerebral artery occlusion rats; and the Bcl-2/Bax ratio was significantly increased. The difference was noticeable for the high-dose point application group, which showed statistical difference compared with the low-dose point application group and the acupuncture group. Our experimental findings indicate that point application with Angong Niuhuang stickers promotes the expression of Bcl-2, and inhibits the expressions of Bax and p53 in the hippocampal CA1 area of rats after focal cerebral ischemia. Thus, point application of Angong Niuhang stickers protects brain tissues from cerebral ischemia.展开更多
Background:Angong Niuhuang Pill(ANP)is a famous Chinese materia medica preparation prescribed for treating ischemic stroke.However,the protective mechanisms of ANP in acute ischemic stroke remain unclear and need to b...Background:Angong Niuhuang Pill(ANP)is a famous Chinese materia medica preparation prescribed for treating ischemic stroke.However,the protective mechanisms of ANP in acute ischemic stroke remain unclear and need to be explored.Objective:Our study aims to investigate the therapeutic effects of ANP on focal cerebral ischemia and explore the molecular mechanisms underlying its heat-clearing and detoxifying effects.Methods:The permanent middle cerebral artery occlusion(pMCAO)model was established in C57BL/6 male mice,which were then treated with ANP(25 mg/kg,100 mg/kg,or 400 mg/kg)or 80 mg/kg butylphthalide.To further verify the involvement of mitophagy in ANP function,mice were also treated with the autophagy inhibitor wortmannin or the mitophagy inhibitor mdivi-1 at ischemic onset.Results:Acute administration with 100 mg/kg,or 400 mg/kg ANP significantly improved neurological behavior and decreased cerebral infarct volume,suggesting that ANP conferred neuroprotective effects dose-dependently.Further,western blot analysis showed that ANP treatment significantly decreased the protein levels of cytoplas-mic cytochrome C and Bax,but elevated levels of mitochondrial cytochrome C and Bcl-2.TUNEL staining also indicated that ANP ameliorated cell apoptosis.ANP did not promote ischemia-induced lipidation of LC3,but significantly reduced the protein level of SQSTM1.Moreover,ANP further reduced mitochondrial contents and enhanced translocation of Parkin and SQSTM1 to the mitochondria.Importantly,the neuroprotective effects of ANP could be abolished by wortmannin and mdivi-1,respectively.Conclusion:Our findings showed that ANP exerted protective effects in response to ischemic injury and enhanced selective mitophagy without increasing autophagic flux.展开更多
Persistent vegetative state （PVS） is a clinical condition wherein the cerebral cortex loses its function although brain stem function remains relatively intact. It has high mortality and disability rates. Although t...Persistent vegetative state （PVS） is a clinical condition wherein the cerebral cortex loses its function although brain stem function remains relatively intact. It has high mortality and disability rates. Although treatment for PVS is extensively studied in developed countries, little breakthrough has been made. In China, many PVS patients who were treated with traditional Chinese medicine （TCM） and acupuncture therapy were reported to have regained consciousness. In our department, we have been investigating TCM diagnosis and treatment methods for PVS for many years and have summarized a set of curative programs. Our patient is a male and 5 years and 3 months of age. He had traumatic brain injury and had been unconscious for three months on admission. Considering his condition, we adopted Xingnao Kaiqiao acupuncture, oral Angong Niuhuang Wan, and Xingnaojing intravenous drip. After the 50-day treatment, his health significantly improved and is nearly similar to that of a healthy child, indicating that the treatment is effective for PVS. Therefore, we decided to report the case and treatment methods.展开更多
OBJECTIVE:To systematically evaluate the efficacy and safety of Angong Niuhuang pill(安宫牛黄丸,ANP)in the treatment of acute stroke.This can provide ideas and basis for the treatment of this disease with integrated T...OBJECTIVE:To systematically evaluate the efficacy and safety of Angong Niuhuang pill(安宫牛黄丸,ANP)in the treatment of acute stroke.This can provide ideas and basis for the treatment of this disease with integrated Traditional Chinese and Western Medicine.METHODS:Randomized controlled trials(RCTs)of China National Knowledge Infrastructure Database,Wanfang Database,Chinese BioMedical Literature Database,PubMed,Embase,and the Cochrane Library were searched from the establishment to March 2022.Two researchers screened the literature and extracted the data according to inclusion and exclusion criteria.Meta-analysis was performed using RevMan 5.3 software.RESULTS:A total of 28 RCTs were included,including 2745 patients in the acute stage of stroke(1375 in the experimental group and 1370 in the control group).Metaanalysis showed that compared with conventional treatment,combined treatment with ANP could improve the effective rate of acute stroke patients[relative risk(RR)=1.26,95%confidence interval(CI)(1.21,1.31)],Glasgow Coma Scale scores[mean difference(MD)=2.01,95%CI(1.04,2.98)],Mini-mental State Examination scores[MD=4.79,95%CI(2.22,7.37)],Activities of Daily Living scores[MD=15.70,95%CI(14.05,17.36)]and the Barthel index scores[MD=13.89,95%CI(12.12,15.65)],reduce National Institute of Health stroke scale scores[MD=-3.90,95%CI(-4.96,-2.84)]and serum brain natriuretic peptide[MD=-38.50,95%CI(-46.85,-30.15)].In terms of safety,the incidence of adverse reactions showed no statistical differences between the two groups[RR=0.71,95%CI(0.43,1.15),P=0.16],and no serious adverse reactions/events were observed,indicating a good safety.CONCLUSIONS:Existing clinical research evidence shows that ANP has good efficacy and safety in the treatment of acute stroke,which can provide a basis for the treatment of integrated Traditional Chinese and Western Medicine.However,the quality of included research methodology needs to be improved,and the above conclusions need to be verified by more highquality studies.展开更多
BACKGROUND On June 30,2021,China received certification from the World Health Organization for malaria elimination.However,this certification does not signify the absence of malaria within China.Due to the increasing ...BACKGROUND On June 30,2021,China received certification from the World Health Organization for malaria elimination.However,this certification does not signify the absence of malaria within China.Due to the increasing frequency of international exchanges and collaborations,the threat of imported malaria persists in China.Consequently,the prevention and control of imported malaria have become a primary focus for our country to maintain its malaria elimination status.CASE SUMMARY Herein,we present a case report of a 53-year-old Chinese man who worked in Africa for nearly two years.He was diagnosed with malaria in the Democratic Republic of the Congo between November 19 and November 23,2022.After receiving effective treatment with oral antimalarial drugs,his condition improved,allowing him to return to China.He was later admitted to our hospital on January 12,2023,during the coronavirus disease 2019 pandemic in Huangshi,China.Through a thorough evaluation of the patient's symptoms,clinical signs,imaging and laboratory test results,and epidemiological data,he was rapidly diagnosed with severe cerebral malaria.The patient underwent successful treatment through a series of intensive care unit interventions.CONCLUSION The successful treatment of this imported case of severe cerebral malaria provides a valuable reference for managing patients with similar malaria infections and has significant clinical implications.展开更多
目的探讨安宫牛黄丸辅助再灌注治疗重症急性缺血性卒中(AIS)的疗效。方法回顾性选取2021年5月至2023年5月绍兴市人民医院收治的60例再灌注治疗时间窗内重症AIS患者为研究对象,采用安宫牛黄丸辅助再灌注治疗30例,为观察组;采用单纯再灌...目的探讨安宫牛黄丸辅助再灌注治疗重症急性缺血性卒中(AIS)的疗效。方法回顾性选取2021年5月至2023年5月绍兴市人民医院收治的60例再灌注治疗时间窗内重症AIS患者为研究对象,采用安宫牛黄丸辅助再灌注治疗30例,为观察组;采用单纯再灌注治疗30例,为对照组。观察并比较两组患者治疗后病情及神经功能指标[包括美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷量表(GCS)、改良Rankin量表(mRS)评分以及梗死后加重、梗死后出血、脑疝、神经功能恢复、治疗期间2周内死亡比例]、炎症指标[包括C反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、全身免疫炎症指数(SII)]等。结果观察组患者在90 d NIHSS评分,14、30 d GCS评分,90 d mRS评分以及神经功能恢复比例方面均优于对照组(均P<0.05)。两组患者治疗前后CRP、NLR、PLR、SII等炎症指标比较,差异均无统计学意义(均P>0.05)。结论安宫牛黄丸辅助再灌注治疗AIS有助于促进患者早期意识的恢复和远期神经功能缺损的改善,但对炎症指标影响不大。展开更多
基金supported by the National Natural Science Foundation of China,No.81403458a grant from Cultivation Project Foundation for Youth Technological Talents of Southern Medical University,No.B1012015
文摘Angong Niuhuang pill, a Chinese materia medica preparation, can improve neurological func-tions after acute ischemic stroke. Because of its inconvenient application and toxic components （Cinnabaris andRealgar）, we used transdermal enhancers to deliverAngong Niuhuang pill by modern technology, which expanded the safe dose range and clinical indications. In this study, Angong Niuhuang stickers administered at different point application doses （1.35, 2.7, and 5.4 g/kg） were administered to theDazhui （DU14）, Qihai（RN6） andMingmen （DU4） of rats with chronic cerebral ischemia, for 4 weeks. The Morris water maze was used to determine the learning and memory ability of rats. Hematoxylin-eosin staining and Nissl staining were used to observe neuronal damage of the cortex and hippocampal CA1 region in rats with chronic cerebral ischemia. The middle- and high-dose point application ofAngong Niuhuangstickers attenuated neuronal damage in the cortex and hippocampal CA1 region, and improved the memory of rats with chronic cerebral ischemia with an efifcacy similar to interventions by electroacupuncture at Dazhui （DU14）,Qihai （RN6） andMingmen （DU4）. Our experimental ifndings indicate that point application withAngong Niuhuang stickers can improve cognitive function after chronic cerebral ischemia in rats and is neuroprotective with an equivalent efifcacy to acupuncture.
基金supported by the Research Project of Administration of TCM of Guangdong Province, No. 20111270
文摘In this study, we extracted and purified components in the Angong Niuhuang pill. Then we applied transdermal enhancers to Angong Niuhuang stickers by modern technology. The Angong Niuhuang sticker includes extracts from curcuma, berberine hydrochloride, baicalin, geniposide, borneol, and musk. Angong Niuhuang stickers at different point application doses （1.35, 2.7, and 5.4 g/kg） were administered to Dazhui （DU14）, Qihai （RN6） and Mingmen （DU4）. Rats in the different dose point application and acupuncture groups were continuously administered for 7 days. Then a middle cerebral artery occlusion model was prepared for simulating human cerebral ischemia. Twelve hours later, expressions of Bcl-2, Bax and p53 protein in hippocampal CA1 were detected with immunohistochemistry. The expression level of Bcl-2, an anti-apoptotic protein, significantly increased in the high-, medium- and low-dose point application groups and the acupuncture group, while the expression of the pro-apoptotic proteins, Bax and p53, significantly decreased compared with the middle cerebral artery occlusion rats; and the Bcl-2/Bax ratio was significantly increased. The difference was noticeable for the high-dose point application group, which showed statistical difference compared with the low-dose point application group and the acupuncture group. Our experimental findings indicate that point application with Angong Niuhuang stickers promotes the expression of Bcl-2, and inhibits the expressions of Bax and p53 in the hippocampal CA1 area of rats after focal cerebral ischemia. Thus, point application of Angong Niuhang stickers protects brain tissues from cerebral ischemia.
文摘Background:Angong Niuhuang Pill(ANP)is a famous Chinese materia medica preparation prescribed for treating ischemic stroke.However,the protective mechanisms of ANP in acute ischemic stroke remain unclear and need to be explored.Objective:Our study aims to investigate the therapeutic effects of ANP on focal cerebral ischemia and explore the molecular mechanisms underlying its heat-clearing and detoxifying effects.Methods:The permanent middle cerebral artery occlusion(pMCAO)model was established in C57BL/6 male mice,which were then treated with ANP(25 mg/kg,100 mg/kg,or 400 mg/kg)or 80 mg/kg butylphthalide.To further verify the involvement of mitophagy in ANP function,mice were also treated with the autophagy inhibitor wortmannin or the mitophagy inhibitor mdivi-1 at ischemic onset.Results:Acute administration with 100 mg/kg,or 400 mg/kg ANP significantly improved neurological behavior and decreased cerebral infarct volume,suggesting that ANP conferred neuroprotective effects dose-dependently.Further,western blot analysis showed that ANP treatment significantly decreased the protein levels of cytoplas-mic cytochrome C and Bax,but elevated levels of mitochondrial cytochrome C and Bcl-2.TUNEL staining also indicated that ANP ameliorated cell apoptosis.ANP did not promote ischemia-induced lipidation of LC3,but significantly reduced the protein level of SQSTM1.Moreover,ANP further reduced mitochondrial contents and enhanced translocation of Parkin and SQSTM1 to the mitochondria.Importantly,the neuroprotective effects of ANP could be abolished by wortmannin and mdivi-1,respectively.Conclusion:Our findings showed that ANP exerted protective effects in response to ischemic injury and enhanced selective mitophagy without increasing autophagic flux.
文摘Persistent vegetative state （PVS） is a clinical condition wherein the cerebral cortex loses its function although brain stem function remains relatively intact. It has high mortality and disability rates. Although treatment for PVS is extensively studied in developed countries, little breakthrough has been made. In China, many PVS patients who were treated with traditional Chinese medicine （TCM） and acupuncture therapy were reported to have regained consciousness. In our department, we have been investigating TCM diagnosis and treatment methods for PVS for many years and have summarized a set of curative programs. Our patient is a male and 5 years and 3 months of age. He had traumatic brain injury and had been unconscious for three months on admission. Considering his condition, we adopted Xingnao Kaiqiao acupuncture, oral Angong Niuhuang Wan, and Xingnaojing intravenous drip. After the 50-day treatment, his health significantly improved and is nearly similar to that of a healthy child, indicating that the treatment is effective for PVS. Therefore, we decided to report the case and treatment methods.
基金Science and Technology Innovation Project of China Academy of Chinese Medical Sciences:Research on Key Technologies of Real-world Clinical Evaluation and Data Governance Analysis Based on Disease Research(No.CI2021A00702-2)Project of National Key Research and Development Program:Development of International Clinical Research Service Standard for Acupuncture and Moxibustion(No.2019YFC1712205)。
文摘OBJECTIVE:To systematically evaluate the efficacy and safety of Angong Niuhuang pill(安宫牛黄丸,ANP)in the treatment of acute stroke.This can provide ideas and basis for the treatment of this disease with integrated Traditional Chinese and Western Medicine.METHODS:Randomized controlled trials(RCTs)of China National Knowledge Infrastructure Database,Wanfang Database,Chinese BioMedical Literature Database,PubMed,Embase,and the Cochrane Library were searched from the establishment to March 2022.Two researchers screened the literature and extracted the data according to inclusion and exclusion criteria.Meta-analysis was performed using RevMan 5.3 software.RESULTS:A total of 28 RCTs were included,including 2745 patients in the acute stage of stroke(1375 in the experimental group and 1370 in the control group).Metaanalysis showed that compared with conventional treatment,combined treatment with ANP could improve the effective rate of acute stroke patients[relative risk(RR)=1.26,95%confidence interval(CI)(1.21,1.31)],Glasgow Coma Scale scores[mean difference(MD)=2.01,95%CI(1.04,2.98)],Mini-mental State Examination scores[MD=4.79,95%CI(2.22,7.37)],Activities of Daily Living scores[MD=15.70,95%CI(14.05,17.36)]and the Barthel index scores[MD=13.89,95%CI(12.12,15.65)],reduce National Institute of Health stroke scale scores[MD=-3.90,95%CI(-4.96,-2.84)]and serum brain natriuretic peptide[MD=-38.50,95%CI(-46.85,-30.15)].In terms of safety,the incidence of adverse reactions showed no statistical differences between the two groups[RR=0.71,95%CI(0.43,1.15),P=0.16],and no serious adverse reactions/events were observed,indicating a good safety.CONCLUSIONS:Existing clinical research evidence shows that ANP has good efficacy and safety in the treatment of acute stroke,which can provide a basis for the treatment of integrated Traditional Chinese and Western Medicine.However,the quality of included research methodology needs to be improved,and the above conclusions need to be verified by more highquality studies.
基金Local Special Projects in Major Health of Hubei Provincial Science and Technology Department,No.2022BCE054Key Scientific Research Projects of Hubei Polytechnic University,No.23xjz08AHubei polytechnic University Huangshi Daye Lake hightech Zone University Science Park joint open fund project,No.23xjz04AK.
文摘BACKGROUND On June 30,2021,China received certification from the World Health Organization for malaria elimination.However,this certification does not signify the absence of malaria within China.Due to the increasing frequency of international exchanges and collaborations,the threat of imported malaria persists in China.Consequently,the prevention and control of imported malaria have become a primary focus for our country to maintain its malaria elimination status.CASE SUMMARY Herein,we present a case report of a 53-year-old Chinese man who worked in Africa for nearly two years.He was diagnosed with malaria in the Democratic Republic of the Congo between November 19 and November 23,2022.After receiving effective treatment with oral antimalarial drugs,his condition improved,allowing him to return to China.He was later admitted to our hospital on January 12,2023,during the coronavirus disease 2019 pandemic in Huangshi,China.Through a thorough evaluation of the patient's symptoms,clinical signs,imaging and laboratory test results,and epidemiological data,he was rapidly diagnosed with severe cerebral malaria.The patient underwent successful treatment through a series of intensive care unit interventions.CONCLUSION The successful treatment of this imported case of severe cerebral malaria provides a valuable reference for managing patients with similar malaria infections and has significant clinical implications.
文摘目的探讨安宫牛黄丸辅助再灌注治疗重症急性缺血性卒中(AIS)的疗效。方法回顾性选取2021年5月至2023年5月绍兴市人民医院收治的60例再灌注治疗时间窗内重症AIS患者为研究对象,采用安宫牛黄丸辅助再灌注治疗30例,为观察组;采用单纯再灌注治疗30例,为对照组。观察并比较两组患者治疗后病情及神经功能指标[包括美国国立卫生研究院卒中量表(NIHSS)、格拉斯哥昏迷量表(GCS)、改良Rankin量表(mRS)评分以及梗死后加重、梗死后出血、脑疝、神经功能恢复、治疗期间2周内死亡比例]、炎症指标[包括C反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、全身免疫炎症指数(SII)]等。结果观察组患者在90 d NIHSS评分,14、30 d GCS评分,90 d mRS评分以及神经功能恢复比例方面均优于对照组(均P<0.05)。两组患者治疗前后CRP、NLR、PLR、SII等炎症指标比较,差异均无统计学意义(均P>0.05)。结论安宫牛黄丸辅助再灌注治疗AIS有助于促进患者早期意识的恢复和远期神经功能缺损的改善,但对炎症指标影响不大。
