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
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
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.
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。
