Systematic Evaluation of Biyuan Tongqiao Granule in the Treatment of Chronic Sinusitis in Children Based on Meta-analysis

[Objectives]To make an evaluation of the efficacy and safety of Biyuan Tongqiao Granule in the treatment of chronic sinusitis in children,and provide evidence-based medical reference for clinical use.[Methods]Databases such as Chinese Biomedical Literature Service System(SinoMed),China Knowledge Infrastructure(CNKI),Wanfang Digital Journal Full-text Database(WF),VIP Database(VIP),EmBase,PubMed,Science Direct,and Cochrane Library were used to collect the clinical randomized controlled trials of Biyuan Tongqiao Granule in children with chronic sinusitis published since the creation of databases.The quality of the included literature was evaluated and the data were extracted.The data was analyzed using Review Manager 5.3 software for meta-analysis,and descriptive analysis was performed for studies that could not be combined.The GRADE method was applied to evaluate the quality of evidence.[Results]A total of 12 studies were included,including 1645 cases of patients.The analysis results show that compared with the control group,Biyuan Tongqiao Granule has an excellent curative effect on children with chronic sinusitis and has a lower incidence of adverse reactions.The GRADE evidence level indicated that the sinus CT scan lesion score was intermediate evidence,and the visual analog score,endoscopic mucosal morphology score,and total effective rate were low-level evidence.[Conclusions]Biyuan Tongqiao Granule has a significant effect in treating chronic sinusitis in children and does not increase the incidence of adverse reactions,but its efficacy and safety need support of more high-quality studies.

Acute Toxicity and Toxicokinetics of Tongguan Powder in Rats

[Objectives]To evaluate the acute toxicity and toxicokinetics of Tongguan Powder in rats,and provide references for clinical safe medication.[Methods]The classical acute toxicity test method was used,rats were given different doses of Tongguan Powder through the mouth and nasal cavity to observe the symptoms of toxicity,and make a record of the food intake,weight changes,and death.After the medication,blood was taken from each group of rats at different time points,and the plasma levels of benzoyl aconitine(BA),benzoyl hypaconine(BH)and benzoyl mesaconine(BM)were determined by the liquid chromatography tandem-mass spectrometry(LC-MS/MS),and the toxicokinetic parameters were fitted with the aid of DAS software.[Results]Rats were given Tongguan Powder 3.75 g/kg(equivalent to 54 times the human daily dose)in the nasal cavity of rats.Rats were observed with reactions such as scratching and sneezing;rats were given Tongguan Powder LD50 and 95%confidence limit of 4.15(3.53-4.71)g/kg through the oral administration,which is equivalent to 60 times the human daily dose,rats showed slow weight gain,decreased food intake,decreased voluntary activities,prone,black stools,etc.One hour after nasal administration of Tongguan Powder,the plasma concentration of benzoyl aconitine and benzoyl hypaconine was below the lower limit of detection,and benzoyl mesaconine could not be detected at any time point;one hour after the oral administration of Tongguan Powder,the plasma concentration of the three components reached the maximum,the exposure level of benzoyl hypaconine was higher than that of benzoyl aconitine and benzoyl mesaconine;there was no gender difference in the kinetic parameters.[Conclusions]The toxicity of Tongguan Powder in nasal administration is much lower than that of intragastric administration.The target organs and mechanism of toxicity need to be further studied.

Optimization of the Ethanol Extraction Method of Monoester Alkaloids from Radix Aconiti Preparata Based on HPLC-MS and Orthogonal Test

[Objectives] This study was conducted to optimize the ethanol extraction technology of monoester alkaloids from Radix Aconiti Preparata. [Methods]On the basis of defined extraction times,ethanol concentration,ethanol times and extraction time were investigated by HPLC-MS combined with orthogonal test to optimize extraction process using the content of monoester alkaloids( the sum of benzoyl neoaconitine,benzoyl hypoaconitine and benzoyl aconitine) as an index.[Results]The optimum ethanol extraction technology was as follows: 75% ethanol,ethanol amount 25 times of the medicinal material,and each extraction for 1. 5 h.[Conclusions] The optimal extraction technology is simple,feasible,stable and reliable. It can provide reference for the industrial production and quality control of monoester alkaloids from Radix Aconiti Preparata.