Compatibility mechanism of Chinese medicine formula:state of the art and perspectives

Traditional Chinese medicine(TCM)has been practiced in China and surrounding countries for thousands of years and has gradually attracted the attention of Western countries.After reasonable compatibility,TCMs could play the key role of enhancing efficacy and reducing toxicity,which has significant therapeutic advantages in the treatment of complex diseases in clinical practice.While the TCM compatibility is not the simple addition of drugs.Under the appropriate dosage ratio,multiple TCMs can play a synergistic role to realize the overall regulation of TCM treatment.Therefore,it is of critical essential to study the compatibility of TCM formula to promote TCM modernization,new drug development and clinical application.Recently,under the guidance of TCM theory,many researches on the composition,pharmacodynamic activity and pharmacokinetic properties of TCM formula have emerged by integrating new technologies and new methods,revealing the scientific connotation of the compatibility of TCM formula from different perspectives and levels.This paper introduces the research progress of compatibility rules from different levels of compatibility,compatibility for synergistic enhancement and detoxification,and application of cutting-edge technology,with representative cases,in order to provide ideas and references for further study on TCM compatibility.

彩色多普勒超声技术对糖尿病视网膜病变患者视网膜血流动力学的分析研究

目的:通过彩色多普勒超声技术观察糖尿病性视网膜病变(diabeticretinitis,DR)患者血流动力学的变化。方法:选取2014-06/2017-05于我院就诊的糖尿病(diabetes mellitus,DM)患者96例96眼,根据眼底检查结果分为A、B、C三组,A组为单纯DM患者32例32眼;B组为糖尿病合并单纯性视网膜病变(NPDR)患者32例32眼;C组为糖尿病合并增殖性视网膜病变(PDR)患者32例32眼。同时选取健康志愿者30例30眼作为对照组。采用彩色多普勒超声技术检测患者眼部CRA(视网膜中央动脉)、PCA(睫状后动脉)、OA(眼动脉)血流动力学改变情况,并探讨糖尿病患者视网膜病变程度与糖化血红蛋白(HbA1c)、空腹血糖(FBG)、糖尿病病程的关系。结果:各组CRA、PCA、OA血流动力学指标差异均有统计学意义(P<0.05)。A组与对照组CRA、PCA、OA的PSV比较,差异均无统计学意(P>0.05);C组CRA、PCA、OA的PSV与EDV最低、RI最高,与A、B组比较差异均有统计学意义(P<0.05)。各组HbA1c、FBG比较,差异均有统计学意义(P<0.05)。病程仅A组与C组间比较,差异有统计学意义(P<0.05)。结论:彩色多普勒超声监测DM患者CRA、PCA、OA血流动力学改变,可了解患者视网膜的血流变化。

Can Yin-Chai-Xiao-Du decoction be useful of COVID-19?the mechanism research based on network pharmacology

Background:In this study,we preliminarily investigated the mechanism of Yin-Chai-Xiao-Du decoction for the treatment of COVID-19 by the method of network pharmacology.Methods:The potential targets and pathways of Yin-Chai-Xiao-Du decoction for the treatment of COVID-19 were examined using network pharmacology;the ingredient and active targets of Yin-Chai-Xiao-Du decoction were collected from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and PharmMapper databases;the COVID-19-related targets were obtained from the online Mendelian inheritance in man,GeneCards,and GeneMANIA databases;the STRING database and Cytoscape were used to build a protein-protein interaction network,and a Network Analyzer tool was used to perform topology analysis to screen for the key ingredients and targets;the ClueGO and KOBAS 3.0 databases were for the enrichment analysis of gene function(Gene Oncology)and gene pathway(Kyoto Encyclopedia of Genes and Genomes);the herb-ingredient-target-pathway network diagram was constructed by Cytoscape.Results:The core herbs screened by the network pharmacological analysis were Jinyinhua(Lonicerae japonicae flos),Lianqiao(Forsythia suspensa),Chaihu(Bupleuri radix),Huangqin(Scutellariae radix),Yinchen(Herba Artemisiae Scopariae),Guanghuoxiang(Pogostemonis herba),Roudoukou(Semen myristicae)and Qinghao(Artemisiae annuae herba).A total of 293 active ingredients were screened by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,and the key ingredients were quercetin,kaempferol,isorhamnetin,stigmasterol,beta-sitosterol,and luteolin.Yin-Chai-Xiao-Du decoction has 138 COVID-19-related targets,and the key targets were mitogen-activated protein kinase 3,interleukin-6,tumor necrosis factor,vascular endothelial growth factor A,and CC motif ligand 2.Kyoto Encyclopedia of Genes and Genomes analysis revealed 120 enriched gene pathways,and the key pathways were signaling by interleukins,immune system,cytokine signaling in the immune system,and the signaling pathways of interleukin-17,tumor necrosis factor,and relaxin.Conclusion:The core herbs of Yin-Chai-Xiao-Du decoction are Jinyinhua(Lonicerae japonicae flos),Lianqiao(Forsythia suspensa),Chaihu(Bupleuri radix),Huangqin(Scutellariae radix),Yinchen(Herba Artemisiae Scopariae),Guanghuoxiang(Pogostemonis herba),Roudoukou(Semen myristicae)and Qinghao(Artemisiae annuae herba).The key ingredients are quercetin,kaempferol,isorhamnetin,stigmasterol,and beta-sitosterol;the critical targets are luteolin,interleukin-6,mitogen-activated protein kinase 3,tumor necrosis factor,and CC motif ligand 2;and the core signaling pathways are those mediated by interleukin-17,tumor necrosis factor,and relaxin.

Correlation between circulating myeloid-derived suppressor cells and Th17 cells in esophageal cancer

AIM: To perform a comprehensive investigation into the potential correlation between circulating myeloidderived suppressor cells (MDSCs) and Th17 cells in esophageal cancer (ECA). METHODS: A total of 31 patients newly diagnosed with ECA and 26 healthy subjects were included in the current study. The frequencies of MDSCs and Th17 cells in peripheral blood were determined by flow cytometry. The mRNA expression of cytokines, arginase 1 (Arg1) and inducible NO synthase (iNOS) in peripheral blood mononuclear cells (PBMCs) and plasma Arg1 were assessed by real-time polymerase chain reaction and enzyme-linked immunosorbent assay, respectively. RESULTS: There was an increased prevalence of MDSCs in the peripheral blood from ECA patients (15.21% ± 2.25%) when compared with healthy control (HC) (1.10% ± 0.12%, P < 0.0001). The plasma levels of Arg1 in ECA patients were significantly higher than those in HC (28.28 ± 4.10 ng/mL vs 9.57 ± 1.51 ng/ mL, P=0.0003). iNOS mRNA levels in the peripheral blood of ECA patients also showed a threefold increase compared with HC (P=0.0162). The frequencies of Th17 cells (CD4 + IL-17A + ) were significantly elevated in ECA patients versus HC (3.50% ± 0.33% vs 1.82% ± 0.19%, P=0.0001). Increased mRNA expression of IL-17 and ROR-γt was also observed in ECA patients compared with HC (P=0.0041 and P=0.0004, respectively), while the mRNA expression of IL-6 and tumor necrosis factor-α (TNF-α) showed significant decreases (P=0.0049 and P < 0.0001, respectively). No obvious correlations were found between the frequencies of MDSCs and Th17 cells in the peripheral blood from ECA patients(r=-0.1725, P=0.3534). Arg1 mRNA levels were positively correlated with levels of IL-6 (r=0.6404, P=0.0031) and TNF-α (r=0.7646, P=0.0001). Similarly, iNOS mRNA levels were also positively correlated with levels of IL-6 (r=0.6782, P=0.0007) and TNF-α (r=0.7633, P < 0.0001). CONCLUSION: This study reveals the relationship between circulating MDSCs and Th17 cells, which may lead to new immunotherapy approaches for ECA based on the associated metabolites and cytokines.

Electrical stimulation promotes regeneration of injured oculomotor nerves in dogs

Functional recovery after oculomotor nerve injury is very poor. Electrical stimulation has been shown to promote regeneration of injured nerves. We hypothesized that electrical stimulation would improve the functional recovery of injured oculomotor nerves. Oculomotor nerve injury models were created by crushing the right oculomotor nerves of adult dogs. Stimulating electrodes were positioned in both proximal and distal locations of the lesion, and non-continuous rectangular, biphasic current pulses （0.7 V, 5 Hz） were administered 1 hour daily for 2 consecutive weeks. Analysis of the results showed that electrophysiological and morphological recovery of the injured oc- ulomotor nerve was enhanced, indicating that electrical stimulation improved neural regeneration. Thus, this therapy has the potential to promote the recovery of oculomotor nerve dysfunction.

Satisfaction about Patient-centeredness and Healthcare System among Patients with Chronic Multimorbidity

The aim of the present study was to measure the prevalence of multimorbidity in Bangladesh,India and China,and to assess the relationship between multimorbidity and patient's opinion regarding their involvement in healthcare decision-making and overall satisfaction of healthcare system.Cross-sectional data on 18696 men and women aged 18 and above were collected from the World Health Survey of World Health Organization(WHO).Outcome variables were subjective rating of(1)healthcare system's ability to involve patients in decision-making,and(2)satisfaction with the way healthcare system runs in the country.Self-reported chronic conditions were used to measure the prevalence of multimorbidity.Out of 9 chronic conditions,back pain,arthritis,and chronic cough appeared to be the most prevalent ones among majority of the participants.About one-third of the participants in China(30.7%)and two-thirds in Bangladesh(66.1%)and India(66.6%)reported having at least one chronic illness.Prevalence of multimorbidity was highest in India(34.3%)followed by Bangladesh(28.8%)and China(14.3%).In Bangladesh,India and China,respectively 70.5%,41.7%,61.3%women and 54.5%,42.8%and 58.8%men expressed dissatisfaction regarding the way healthcare system runs in their country.In Bangladesh and India,men who were living with multimorbidity were more likely to rate the patient-centeredness as"bad"than those who had no disease illness.This study suggests that the prevalence of multimorbidity was remarkably high especially in Bangladesh and India.Higher likelihood of dissatisfaction about healthcare system among multimorbid patients might be indicative of inadequacy in the provision of care in qualitative and quantitative terms.