The basic core traditional C hinese medicine for the prevention and treatment of COVID-19 and its active mechanisms

Background:COVID-19 has had a dramatic impact on human health,economies,societies,and livelihoods around the world.Traditional Chinese medicine(TCM)formulae have played an important role in the prevention and treatment of COVID-19.WHO evaluated the role of TCM in treating of COVID-19 and encouraged other countries to promote the use of TCM formulae.However,the key is to find the basic core traditional Chinese medicine(BC-TCM)among those formulae.Methods:For the first time,we mined the data of TCM formulae in CNIPA and analyzed herb characteristics and association rules.We then determined the BC-TCM and screened main compounds and therapeutic targets.Finally,the potential molecular mechanisms were explored by using enrichment analyses and molecular docking.Results:This study screened 123 patented TCM formulae,including 312 herbs.According to frequency statistics and association rules,nine herbs(Gan Cao,Jin Yinhua,Guang Huoxiang,Fu Ling,Huang Qi,Jie Geng,Lian Qiao,Cang Zhu,Ku Xingren)were selected as the BC-TCM.The BC-TCM involved 166 main compounds and 48 therapeutic targets.The active compounds Hederagenin,Spinasterol,Beta-sitosterol,and Liquiritin had high binding activity to the COVID-19 targets 3CL,ACE2,and core targets RELA,HSP90AA1,STAT3,MAPK3,and TP53 according to molecular docking results.Interestingly,Hederagenin might be a potential compound for the prevention and treatment of COVID-19.Conclusion:Our research predicted and confirmed the preventive therapeutic effect of BC-TCM on COVID-19.This has the potential to broaden the scope of TCM,guide people in using clinical formulae,and provide valuable insights for future TCM discovery research.

甲状腺相关性眼病临床试验受试者脱落原因分析及预测模型构建

目的 回顾性分析甲状腺相关性眼病(thyroid-associated ophthalmopathy,TAO)临床研究中受试者脱落发生的原因,并建立受试者脱落预测模型,为TAO临床试验受试者管理提供依据。方法 收集2017年11月至2021年4月于上海交通大学医学院附属第九人民医院眼科参加TAO临床试验的384例受试者资料,通过Lasso回归进行变量筛选,构建Logistic回归预测模型,绘制受试者操作特征(receiver operator characteristic, ROC)曲线和校准曲线验证模型的区分度和校准度。结果 384例受试者的平均年龄为(44.55±13.25)岁,其中男性173例(45.1%)、女性211例(54.9%),有53例受试者脱落,脱落率为13.8%。受试者脱落的原因主要有入组后未治疗、未追踪到原因、拒绝随访、新冠疫情影响及电话无人接听。训练集多因素Logistic回归分析结果显示,治疗方式[OR=0.16,95%CI(0.06,0.40),P <0.001]、吸烟情况[OR=0.19,95%CI(0.03,0.78),P=0.04]、复视评分[OR=0.36,95%CI(0.19,0.61),P <0.001]、来源[OR=12.09,95%CI(3.41,48.76),P <0.001]为受试者脱落的独立预测因子。验证集中ROC曲线下面积(area under curve, AUC)为0.786,表明训练集所建模型具备较好的预测能力,同时校准曲线在验证集中表现出良好的一致性。结论 应用建立的预测模型对即将开展的TAO临床研究受试者脱落情况进行预测,重点关注脱落发生概率高的受试者,对可能导致脱落发生的问题进行预警,同时加强研究者临床研究管理培训,有助于降低受试者脱落率,提高临床研究质量。

Study on the mechanism of Wuzi Yanzong pill in treating osteoporosis based on network pharmacology and molecular docking

Background:Based on network pharmacology and molecular docking,our study discussed the mechanism of Wuzi Yanzong pill in treating Osteoporosis(OP),which lays the foundation for drug development of OP.Methods:The chemical compounds and potential targets of Wuzi Yanzong pill were explored through TCMSP,PubChem,Swiss ADME and other databases.GeneCards,OMIM and Drugbank databases were used to obtain OP related targets.The intersection between the targets of Wuzi Yanzong pill and the related targets of OP was found by drawing a Venn diagram.PPI network was constructed with the STRING database and core targets were screened.The TCM-compound-action target-disease network was drawn using the Cytoscape software.The Metascape platform was used to find the pathways and functions for core target enrichment.Molecular docking validation of action compounds and core targets is completed by software such as Auto Dock Vina.Results:59 compounds and 707 action targets of Wuzi Yanzong pill were found.603 disease targets were selected,106 intersection targets were found using a Venn diagram,and 37 core targets were screened.By enrichment analysis,143 KEGG pathways,1026 GO biological processes,23 GO cell compositions and 60 GO molecular functions were obtained.The results of molecular docking showed that the effective compounds of Wuzi Yanzong pill,such as stigmasterol,quercetin,kaempferol andβ-sitosterol,had high binding activity with STAT3,TNF and IL6 core target proteins.Conclusion:Wuzi Yanzong Pill may play a role in treating OP by regulating STAT3,TNF,IL-6,TP53,VEGFA,JUN,AKT1,IL-1B,SRC,MMP9 and other pathways,as well as cancer-correlation,rheumatoid arthritis-correlation,MAPK,Th17 cell differentiation,IL-17,TNF signaling pathway and so on,to interpret Wuzi Yanzong pill’s clinic.

“Astragali Radix−Salviae Miltiorrhizae Radix Et Rhizoma”herb pair in the treatment of liver cirrhosis and its pharmacological mechanisms

Objective:Liver cirrhosis is a disease that seriously damages human health.Traditional Chinese Medicine(TCM)formulae have a good therapeutic effect on cirrhosis,and the herb pair is the smallest unit in formula compatibility,which is important for improving the therapeutic effect.Therefore,identifying core herb pairs among TCM formulae is key.Methods:We mined the data of TCM formulae for the treatment of cirrhosis in the China National Intellectual Property Administration for the first time and analyzed their herb characteristics and association rules.We screened 405 patented TCM formulae,including 953 herbs.Based on frequency statistics and association rules,we determined“Astragali Radix-Salviae Miltiorrhizae Radix Et Rhizoma”as the core herb pair.Results:Six active compounds,Isorhamnetin,Formononetin,Calycosin,Cryptotanshinone,Dihydrotanshinone I,and Tanshinone II A,were screened out based on previous studies and network pharmacology.We found that SRC,TP53,HSP90AA1,MAPK3,MAPK1,and STAT3 played pivotal roles in treating cirrhosis.Interestingly,molecular docking indicated that MAPK3 might be a potential pharmacological target for cirrhosis.Conclusion:We preliminarily predicted and verified the pharmacological and molecular mechanism of“Astragali Radix-Salviae Miltiorrhizae Radix Et Rhizoma”in treating cirrhosis.This can expand the scope of TCM in the treatment of cirrhosis,guide people to use clinical formulae,and provide valuable insights for further drug discovery studies.

Efficacy and safety of Banxia Xiexin Decoction in the treatment of gastric ulcer:a systematic review and meta-analysis of twenty-seven randomized controlled trials

Background:Banxia XieXin Decoction(BXD)is a traditional Chinese medicine decoction commonly used in the Chinese clinical treatment of gastric ulcer(GU).Although some people believe that it may have some advantages in this regard,There is no reliable evidence-based study demonstrating its effectiveness.This study aims to systematically evaluate the healing effect and security of BXD in the treatment of GU.Methods:PubMed,Cochrane Library,EMBASE,ScienceNet,China National Knowledge Infrastructure(CNKI),Wanfang database,Weipu database,and China biomedical literature service(CBM)database were systematically searched to obtain all randomized controlled trials(RCTs)evaluating the treatment GU of BXD published as of April 2022.Two researchers independently screened and extracted all research data,finally evaluated the bias risk of inclusion in the study using revman 5.4.Results:This meta-analysis included 27 randomized controlled trials and 1411 patients.The clinical effective rate,recurrence rate,HP eradication rate,adverse reaction rate,and visual analog score(VAS)of BXD combined treatment and standard treatment alone were compared.The results of the meta-analysis showed that BXD combined treatment improve the symptoms related to the gastric ulcers and reduce drug-related adverse reactions.Due to the low quality of the research included in this analysis,in-depth high-quality research is crucial for verifying these results.

Epidemiologic characteristics and outcomes of open globe injury in Shanghai

AIM： To investigate the epidemiologic characteristics and outcomes of open globe injury in Shanghai. METHODS： A retrospective study was conducted for 148 unilateral open globe injury cases presenting to a tertiary referral hospital of Shanghai. Electronic medical records were reviewed and phone surveys were conducted to collect and analyze 1） background of patient; 2） setting of injury and clinical signs at presentation; 3） treatment procedure and outcome; 4） quality of life after injury. RESULTS： There were more male patients （77.03%） than females （22.97%）, more temporary habitants （79.05%） than residents （20.95%）. The subjects in this study presented a significantly lower constitutional status of education than that of the whole Shanghai population （P〈0.001）. Occupational injury was the first cause of injuries （39.86%）, followed by home accident （20.27%）, road accident （16.80%）, violent behavior （16.89%） and outdoor injury （6,08%）. The 143 subjects （96.62%） were not wearing spectacles at the time of injury. Of all patients, 77 subjects （52.03%） had the outcome of no vision （including enucleation）. The classification and regression tree （CART） prognosis presents 59.58% sensitivity to predict visual survival correctly and 80.19% specificity to predict no vision correctly. The patients whose injured eye had no vision reported more reduction of life quality. CONCLUSION： We found that male subject, temporary habitants, low educational status and no eyewear are risk factors of open globe injury in Shanghai. Occupational injury is the leading cause. CART analysis presents a certain agreement to the actual visual outcome. The injury imposes negative impact on quality of life especially in no vision cases. The education of eye protection may help to avoid the injury.

Ocular surface changes in Graves’ophthalmopathy

Many patients with Graves’ophthalmopathy(GO)suffer from dry eye syndrome(DES),and this is one of the most common reasons of eye discomfort in patients with GO.The prevalence of DES in patients with GO is significantly higher than normal subjects.The ocular surface changes involving changes in tears,cornea,conjunctiva and glands occur in GO patients.However,the mechanism of how DES occurs in GO still remains unclear.In this review,the ocular surface changes were illustrated and analyzed the reasons for high prevalence of DES in GO patients.

Treatment of Kangxian Pills to Chronic Liver Injury in Mice Induced with Carbon Tetrachloride

Objective Kangxian Pills, containing Angelicae Sinensis, Chuanxiong Rhizoma, radix paeoniae rubra, and 12 other kinds of Chinese materia medica, have the functions of softening and dispersing blood stasis. It has been used for liver injury and liver fibrosis. The current study was designed to evaluate the anti-hepatic injury activity and the mechanism of Kangxian Pills on a CCl4-induced animal model. Methods To induce chronic liver injury, mice were treated with CCl4 twice a week for four weeks. Kangxian Pills（6 or 12 g/kg） and Compound Biejia Ruangan Tablet（0.901 g/kg） were ig given to mice once daily for four weeks after CCl4 was withdrawal. The anti-hepatic injury activities and mechanisms of Kangxian Pills were assessed by hepatic histology and by measuring the levels of aspartate aminotransferase（AST）, alanine aminotransferase（ALT）, albumin（ALB）, and total protein（TP） of serum as well as superoxide dismutase（SOD） and glycogen（Gn） of the liver. Results Kangxian Pills significantly decreased the levels of liver index, ALT, and AST in mice liver injury models in treatment group. Moreover, Kangxian Pills and Compound Biejia Ruangan Tablet inhibited the CCl4-induced reduction of SOD and Gn levels in the liver. The histological study showed that Kangxian Pills could reduce cellular swelling and infiltration of inflammatory cells in liver injury. Conclusion Kangxian Pills possess the potent abilities to alleviate chronic liver injury, suggesting that Kangxian Pills exert this effect by enhancing the anti-oxidant ability and metabolism of the liver.