Chlorogenic acid ameliorates heart failure by attenuating cardiomyocyte ferroptosis Author links open overlay panel

Objective To elucidate the effects of chlorogenic acid(CGA),a bioactive polyphenol compound prevalent in traditional Chinese medicine and various foods,including Lonicera japonica Thunb.(Jin Yin Hua),Eucommia ulmoides Oliv.(Du Zhong Ye),tea,and coffee,on cardiomyocyte ferroptosis and heart failure.Methods We assessed the effect of CGA on cardiac function using a mouse model of heart failure induced by transverse aortic constriction(TAC).These indicators included the left ventricular ejection fraction(LVEF),fractional shortening(LVFS),end-systolic volume(LVESV),end-diastolic volume(LVEDV),end-systolic diameter(LVESD),and end-diastolic diameter(LVEDD).An isoprenaline hydrochloride(ISO)-induced H9c2 cardiomyocyte cell model was also established,and the cells were treated with various concentrations of CGA.To assess the effect of CGA on ferroptosis in cardiomyocytes,we measured cell viability and evaluated the levels of intracellular reactive oxygen species(ROS),ferrous ions(Fe^(2+)),and lipid peroxidation using fluorescent staining.To clarify the ferroptosis signaling pathway regulated by CGA,western blotting was used to examine the expression of ferroptosis biomarkers,specifically solute carrier family 7 member 11(SLC7A11)and glutathione peroxidase 4(GPX4),in H9c2 cardiomyocytes and mouse myocardial tissues.Results CGA significantly enhanced cardiac performance indices such as LVEF,LVFS,LVESV,LVEDV,LVESD,and LVEDD.H9c2 cardiomyocytes exposed to ISO showed decreased cell viability and increased ROS levels,Fe^(2+)content,and lipid peroxidation levels.However,CGA treatment significantly ameliorated these changes.Additionally,in both H9c2 cardiomyocytes and myocardial tissue obtained from mice with TAC,CGA increased the expression of ferroptosis-related proteins,including SLC7A11 and GPX4.Conclusion CGA has the potential to enhance cardiac function and diminish lipid peroxidation and ROS levels in cardiomyocytes via the SLC7A11/GPX4 signaling pathway.This process alleviates ferroptosis in cardiomyocytes.These results provide new insights into the clinical use of CGA and the management of heart failure.

The Psychosomatic Traits of“People with the Five Elements in Traditional Chinese Medicine”:A Qualitative Study

Objective To identify the representative attributes of the five elements of a person with a qualitative methodology and provide the basis for the clinical diagnosis and treatment of“people with the five elements in traditional Chinese medicine(TCM).”Methods Data collected from the literature review,two sessions of brainstorming of experts with related experience in“people with the five elements in TCM”from October 2020 to December 2020,and six rounds of in-depth interviews with 30 participants who had various attributes of the five elements from March 2021 to October 2021 were analyzed.Triangulation was used in this study,and theming and synthesizing were used to analyze the data.Results A total of 31 experts and 30 interviewees participated in this study.The median age of the experts and interviewees were 48.0 and 38.5 years,respectively;51.66%and 54.8%of experts and interviewees,respectively,were men.The descriptors of facial diagrams of“people with the five elements in TCM”were complexion,shape,distribution state of facial bones,convergence trend of facial muscles,and facial expression.A theoretical model of“people with the five elements in TCM”was shaped based on these findings.Conclusion The study suggests a possibility for bridging the gap between personality and bodily state,identifying an avenue for personality research from the perspective of TCM.

Tong xie yao fang relieves irritable bowel syndrome in rats via mechanisms involving regulation of 5-hydroxytryptamine and substance P

AIM: To investigate whether the Chinese medicine Tong Xie Yao Fang(TXYF) improves dysfunction in an irritable bowel syndrome(IBS) rat model. METHODS: Thirty baby rats for IBS modeling were separated from mother rats(1 h per day) from days 8 to 21, and the rectum was expanded by angioplasty from days 8 to 12. Ten normal rats were used as normal controls. We examined the effects of TXYF on defection frequency, colonic transit function and smooth muscle contraction, and the expression of 5-hydroxytryptamine(5-HT) and substance P(SP) in colonic and hypothalamus tissues by Western blot and RT-PCT techniques in both normal rats and IBS model rats with characterized visceral hypersensitivity.in normal rats and 4.5 ± 1.58 in IBS model rats(P < 0.001). However, the defecation frequency was significantly decreased(3.0 ± 1.25 vs 4.5 ± 1.58, P < 0.05), while the time(in seconds) of colon transit function was significantly increased(256.88 ± 20.32 vs 93.36 ± 17.28, P < 0.001) in IBS + TXYF group rats than in IBS group rats. Increased colonic smooth muscle tension and contract frequency in IBS model rats were significantly decreased by administration of TXYF. Exogenous agonist stimulants increased spontaneous activity and elicited contractions of colon smooth muscle in IBS model rats, and all of these actions were significantly reduced by TXYF involving 5-HT and SP down-regulation. CONCLUSION: TXYF can modulate the activity of the enteric nervous system and alter 5-HT and SP activities, which may contribute to the symptoms of IBS.

Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders

Herbal traditional Chinese medicine(TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providinge ffective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in Pub Med and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn's disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmaticmodern medicine by bridging the gap between the two medicinal cultures.

Protective effect of Radix Astragali injection on immune organs of rats with obstructive jaundice and its mechanism

AIM: To observe the protective effect of Radix Astragali injection on immune organs (lymph nodes, spleen and thymus) of rats with obstructive jaundice (OJ) and its mechanism. METHODS: SD rats were randomly divided into sham-operation group, model control group and Radix Astragali treatment group. On days 7, 14, 21 and 28 after operation, mortality rate of rats, pathological changes in immune organs, expression levels of Bax and nuclear factor (NF)-κB p65 proteins, apoptosis indexes and serum tumor necrosis factor (TNF)-α level in spleen and thymus were observed, respectively.RESULTS: Compared to model control group, the number of dead OJ rats in Radix Astragali treatment group decreased (P > 0.05). The TNF-α level (27.62 ± 12.61 vs 29.55 ± 18.02, 24.61 ± 9.09 vs 31.52 ± 10.95) on days 7 and 21, the pathological severity score for spleen [0.0 (0.0) vs 0.0 (2.0) on days 7 and 14 and for lymph nodes [0.0 (1.0) vs 1.0 (2.0), 1.0 (0.0) vs 2.0 (1.0)] on days 21 and 28, the product staining intensity and positive rate of Bax protein in spleen [0.0 (0.0) vs 1.0 (2.0), 0.0 (1.0) vs 2.0 (1.5) and thymus [0.0 (0.0) vs 1.0 (2.0), 0.0 (1.0) vs 2.0 (1.5)] on days 14 and 28, the apoptotic indexes [0.0 (0.0) vs 0.0 (0.01)] in spleen and thymus [0.0 (0.0) vs 0.0 (0.01) on days 14 and 21 were significantly lower in Radix Astragali treatment group than in model control group (P < 0.05). CONCLUSION: Radix Astragali has protective effects on immune organs of OJ rats by relieving the pathological changes in immune organs, reducing TNF-α level and inhibiting Bax expression and apoptosis in spleen and thymus.

Traditional Chinese medicine for prevention and treatment of hepatocarcinoma: From bench to bedside

Traditional Chinese medicine(TCM) has played a positive role in the management of hepatocarcinoma. Hepatocarcinoma patients may present Qi-stagnation, damp-heat, blood stasis, Qi-deficiency, Yin-deficiency and other TCM syndromes(Zheng). Modern treatments such as surgery, transarterial chemoembolization(TACE) and high intensity focus ultrasound treatment would influence the manifestation of TCM syndromes. Herbs with traditional efficacy of tonifying Qi, blood and Yin, soothing liver-Qi stagnation, clearing heat and detoxifying and dissolving stasis, have been demonstrated to be potent to prevent hepatocarcinogenesis. TCM has been widely used in all aspects of integrative therapy in hepatocarcinoma, including surgical resection, liver transplantation, TACE, local ablative therapies and even as monotherapy for middle-advanced stage hepatocarcinoma. Clinical practices have confirmed that TCM is effective to alleviate clinical symptoms, improve quality of life and immune function, prevent recurrence and metastasis, delay tumor progression, and prolong survival time in hepatocarcinoma patients. The effective mechanism of TCM against hepatocarcinoma is related to inducing apoptosis, autophagy, anoikis and cell senescence, arresting cell cycle, regulating immune function, inhibiting metastasis and angiogenesis, reversing drug resistance and enhancing effects of chemotherapy. Along with the progress of research in this field, TCM will contribute more to the prevention and treatment of hepatocarcinoma.

Simultaneous quantification of five major active components in capsules of the traditional Chinese medicine 'Shu-Jin-Zhi-Tong' by high performance liquid chromatography

A simple and reliable high performance liquid chromatography （HPLC） method has been developed for the simultaneous quantification of five major bioactive components in ＇Shu-Jin- Zhi-Tong＇ capsules （SJZTC）, for the purposes of quality control of this commonly prescribed traditional Chinese medicine. Under the optimum conditions, excellent separation was achieved, and the assay was fully validated in terms of linearity, precision, repeatability, stability and accuracy. The validated method was applied successfully to the determination of the five compounds in SJZTC samples from different production batches. The HPLC method can be used as a valid analytical method to evaluate the intrinsic quality of SJZTC.

Research progress in the treatment of colorectal cancer in classical prescriptions

Shanghan Zabing Lun,an acient book of Chinese medicine that published in Han dynasty(219 C.E.),is the first monograph in China that has the principles of prescription and treatment.Modern physicians flexibly applied many classical prescriptions recorded on this acientd book,such as Banxia Xiexin decoction,Da Chengqi decoction,Yiyi Fuzi Bijiang decoction and Wumei pill for the treatment of colorectal cancer and its complications,and made some progress in clinical and experimental research.Studies have shown that classical prescriptions alone or in combination with other therapies can improve immunity,prevent cancer from recurrence and metastasis,reduce the side effects of anticancer drugs,improve quality of life,and prolong the survival of cancer patients.However,the current clinical and mechanistic studies on the treatment of classical prescriptions still need to explore in depth.This study aims to summarize the clinical and research progress in the treatment of colorectal cancer with classical prescriptions in recent years.

Combination of Chinese and Western medicine in the treatment of aggressive angiomyxoma:a case report

Aggressive angiomyxoma(AAM)is a rare soft tissue tumor.Invasiveness and recurrence are important clinical features of AAM.A patient with recurrent AAM was admitted to the hospital.At present,the treatment for AAM is still based on surgery because it does not have lymph nodes and distant metastasis.Moreover,chemotherapy is of little significance.Traditional Chinese medicine believes the formation of tumor is related to blood stasis,so after surgery,a Chinese medicine called Xue-Shuan-Tong was used to improve blood circulation and disperses stasis.The drainage tube was removed on the 5th day after the operation and achieved a good wound healing.This article analyzes and demonstrates the pathogenesis of female vulvar invasive angiomyxoma from the perspective of modern medicine and traditional medicine,in order to provide a better understanding of the disease.

Analysis on patents of health care products with substances of medicine food homology in China

Objective:The concept of substances of medicine food homology(SMFH)has garnered significant attention in recent years.This study conducts a systematic analysis of patent literature related to SMFH,and elucidates the development trends,technical hotspots,and the overall patent protection landscape of SMFH in China over the past two decades.Methods:The patent search focused on the SMFH varieties as the objects of inquiry,with retrieval conducted in patent databases.Subsequently,the acquired data underwent processing,analysis,and visualization.Results:While the technical threshold for pharmaceutical applications surpasses that of the food service sector,the former may assume a prominent role in the future.Research and development(R&D)activities in the southeast of China demonstrate robust activity than other regions.Colleges and scientific research institutions exhibit substantial advantages in patent applications compared with individuals and hold greater potential for future development.Conclusion:The findings of this patent analysis indicate that China’s SMFH industry are presently undergoing a transition from an extensive model to a high-quality model.The quality and technical standards of SMFH products are consistently improving.Consequently,there is a need for more stringent patent application requirements to align with the evolving development needs.

Rapid Antidepressant-Like Potential of Chaihu Shugan San Depends on Suppressing Glutamate Neurotransmission and Activating Synaptic Proteins in Hippocampus of Female Mice

Objective To explore the rapid antidepressant potential and the underlying mechanism of Chaihu Shugan San(CSS)in female mice.Methods Liquid chromatography mass spectrometry(LC-MS)/MS was used to determine the content of main components in CSS to determine its stability.Female C57BL/6J mice were randomly divided into 4 groups,including control(saline),vehicle(saline),CSS(4 g/kg)and ketamine(30 mg/kg)groups.Mice were subjected to irregular stress stimulation for 4 weeks to establish the chronic mild stress(CMS)model,then received a single administration of drugs.Two hours later,the behavioral tests were performed,including open field test,tail suspension test(TST),forced swimming test(FST),novelty suppression feeding test(NSF),and sucrose preference test(SPT).Western blot analysis was used to detect the expression levels of N-methyl-D-aspartate receptor(NMDA)subtypes[N-methyl-D-aspartate receptor 1(NR1),NR2A,NR2B],synaptic proteins[synapsin1 and post synaptic density protein 95(PSD95)],and brain-derived neurotrophic factor(BDNF).Moreover,the rapid antidepressant effect of CSS was tested by pharmacological technologies and optogenetic interventions that activated glutamate receptors,NMDA.Results Compared with the vehicle group,a single administration of CSS(4 g/kg)reversed all behavioral defects in TST,FST,SPT and NSF caused by CMS(P<0.05 or P<0.01).CSS also significantly decreased the expressions of NMDA subtypes(NR1,NR2A,NR2B)at 2 h in hippocampus of mice(all P<0.01).In addition,similar to ketamine,CSS increased levels of synaptic proteins and BDNF(P<0.05 or P<0.01).Furthermore,the rapid antidepressant effects of CSS were blocked by transient activation of NMDA receptors in the hippocampus(all P<0.01).Conclusion Rapid antidepressant effects of CSS by improving behavioral deficits in female CMS mice depended on rapid suppression of NMDA receptors and activation of synaptic proteins.

Chemical Constituents and Pharmacological Properties of Frankincense:Implications for Anticancer Therapy

The discovery of novel antitumor agents derived from natural plants is a principal objective of anticancer drug research.Frankincense,a widely recognized natural antitumor medicine,has undergone a systematic review encompassing its species,chemical constituents,and diverse pharmacological activities and mechanisms.The different species of frankincense include Boswellia serrata,Somali frankincense,Boswellia frereana,and Boswellia arabica.Various frankincense extracts and compounds exhibit antitumor,anti-inflammatory,and hepatoprotective properties and antioxidation,memory enhancement,and immunological regulation capabilities.They also have comprehensive effects on regulating flora.Frankincense and its principal chemical constituents have demonstrated promising chemoprophylactic and therapeutic abilities against tumors.This review provides a systematic summary of the mechanism of action underlying the antitumor effects of frankincense and its major constituents,thus laying the foundations for developing effective tumor-combating targets.

Treatment of Irritable Bowel Syndrome by Chinese Medicine:A Review

Irritable bowel syndrome(IBS)is a common refractory disease.Chinese medicine(CM)has remarkable efficacy and advantages on the treatment of IBS.This review summarized the articles focusing on the treatment of IBS with CM to sum up the latest treatment methods for IBS and the underlying mechanisms.Literature analysis showed that prescriptions,acupuncture,and moxibustion are the primary methods of CM treatment for IBS.The potential mechanisms center on the regulation of the enteric nervous system,the alleviation of visceral hypersensitivity,the stability of intestinal flora,and the regulation of the immune system.

Understanding health literacy from a traditional Chinese medicine perspective

Health literacy is critical to improving individual and public health.However,indigenous perceptions of health are largely absent from Western-derived measurements,contributing to disparities in health outcomes between indigenous and non-indigenous populations.China is the country with the world's largest population and only officially introduced the term"health literacy"in 2008.Current measures of health literacy in China are primarily based on Western-derived constructs,which have been shown to have poor comparability to the unique dual medical system in China.Given its significant importance to health management globally,understanding health perceptions from a traditional Chinese medicine perspective is essential.This review explores the concept and core elements of indigenous health literacy,evaluates the existing definitions and measurement tools as applied to the concept,and proposes a new model of traditional Chinese medicine health literacy.

Traditional Chinese medicine diagnosis and treatment based on systematics

Background:Traditional Chinese Medicine(TCM)is a well-established medical system with a long history.However,the overall concept and systematic thinking in TCM are not comprehensively understood and applied in its inheritance and development.Objective This study aims to provide a basic theory for TCM diagnosis using systematics as the guiding principle.Using modern scientific and technological achievements,we aim to explore a new TCM diagnosis method.Methods:We analyzed previous studies on TCM diagnosis and treatment,and reviewed clinical research on TCM diagnosis and treatment from the viewpoint of systematics.We propose a new process model based on systematics for TCM diagnosis and treatment.This is a generalized model that summarizes the process of“establishing an image to express meaning”.Results:The proposed model was implemented in the clinical practice of TCM.We monitored the detailed treatment process of patients in the Department of Liver Diseases at Beijing Hospital.One patient underwent a treatment program that lasted 1 year and 45 days,consisting of 12 iterative cycles,each guided by the proposed diagnostic model and tailored to the patient's evolving condition.This case study validates the effectiveness of the proposed model in the diagnosis and treatment of liver disease in TCM.The therapeutic efficacy has been validated through the examination of both TCM indicators and Western medical auxiliary parameters.Among these,the TCM indicators consist of 2 components:tongue diagnosis and pulse diagnosis.Meanwhile,the Western medical auxiliary indicators encompass a range of assessments,including whole blood cell analysis,professional liver function examination,a series of liver function assessments,a high-sensitivity hepatitis B pentathlete test,as well as color Doppler ultrasound evaluations of the liver,bile duct,pancreas,spleen,and assessments of liver elasticity,among other related examination parameters.In conclusion,it is evident that the syndrome of liver depression and spleen deficiency has significantly diminished,and the viral load has decreased to levels below the detectable threshold,thereby confirming the restoration of normal liver function.These findings indicate that the disease is now under control.Conclusions:In this study,we applied the guiding principle of systematics to the study of TCM diagnosis and treatment,and combined it with modern medical technology.We proposed a TCM diagnosis and treatment process model,and a TCM model to establish an image,which can effectively support the diagnosis and treatment of TCM diseases.We illustrated the effectiveness of these models by applying them to TCM liver disease.

Human Gut Microbiota and Gastrointestinal Cancer

Human gut microbiota play an essential role in both healthy and diseased states of humans. In the past decade, the interactions between microorganisms and tumors have attracted much attention in the efforts to understand various features of the complex microbial communities, as well as the possible mechanisms through which the microbiota are involved in cancer prevention, carcinogenesis, and anti-cancer therapy. A large number of studies have indicated that microbial dysbiosis contributes to cancer susceptibility via multiple pathways. Further studies have suggested that the microbiota and their associated metabolites are not only closely related to carcinogenesis by inducing inflammation and immune dysregulation, which lead to genetic instability, but also inter- fere with the pharmacodynamics of anticancer agents. In this article, we mainly reviewed the influ- ence of gut microbiota on cancers in the gastrointestinal （GI） tract （including esophageal, gastric, colorectal, liver, and pancreatic cancers） and the regulation of microbiota by diet, prebiotics, pro- biotics, synbiotics, antibiotics, or the Traditional Chinese Medicine. We also proposed some new strategies in the prevention and treatment of GI cancers that could be explored in the future. We hope that this review could provide a comprehensive overview of the studies on the interactions between the gut microbiota and GI cancers, which are likely to yield translational opportunities to reduce cancer morbidity and mortality by improving prevention, diagnosis, and treatment.

Progress in research on the effects of traditional Chinese medicine on the tumor microenvironment

Tumor microenvironment （TME） has received more and more attention as modern medical research has begun to understand its importance in tumorigenesis. The occurrence, development, metastasis and drug resistance of tumors are closely related to TME. TME is a complicated system, including nontumor cells, their secreted cytokines, extracellular matrix, among other components. The concepts of wholism and multitarget regulation in traditional Chinese medicine （TCM） make it well suited to the regulation of TME. in this paper, the authors reviewed the progress of TME research and the effect of TCM on TME, providing some views of Chinese medicine in antitumor research.

Qiangzhi Decoction(羌跖汤) Protects Mice from Influenza A Pneumonia through Inhibition of Inflammatory Cytokine Storm

Objective： To investigate the preventive effects of Qiangzhi Decoction （羌跖汤, QZD） on influenza A pneumonia through inhibition of inflammatory cytokine storm in vivo and in vitro. Methods： One hundred ICR mice were randomly divided into the virus control, the Tamiflu control and the QZD high-, medium-, and low-dose groups. Mice were infected intranasally with influenza virus （H1N1） at 10 median lethal dose （LDso）. QZD and Tamiflu were administered intragastrically twice daily from day 0 to day 7 after infection. The virus control group was treated with distilled water alone under the same condition. The number of surviving mice was recorded daily for 14 days after viral infection. The histological damage and viral replication and the expression of inflammatory cytokines were monitored. Additionally, the suppression capacity on the secretion of regulated on activation normal T cells expressed and secreted （RANTES） and tumor necrosis factor-α （TNF-α ） in epithelial and macrophage cell-lines were evaluated. Results： Compared with the virus control group, the survival rate of the QZD groups significantly improved in a dose-dependent manner （P〈0.05）, the viral titers in lung tissue was inhibited （P〈0.05）, and the production of inflammatory cytokines interferon-γ （IFN- α ）, interleukin-6 （IL-6）, TNF-α, and intercellular adhesion molecule-1 （ICAM-1） were suppressed （P〈0.05）. Meanwhile, the secretion of RANTETS and TNF-α by epithelial and macrophage cell-lines was inhibited with the treatment of QZD respectively in vitro （P〈0.05）. Conclusions： The preventive effects of QZD on influenza virus infection might be due to its unique cytokine inhibition mechanism. QZD may have significant therapeutic potential in combination with antiviral drugs.

Xuebijing Injection(血必净注射液)Increases Early Survival Rate by Alleviating Pulmonary Vasopermeability in Rats Subjected to Severe Burns

Objective： To investigate the effects of Xuebijing Injection（血必净注射液, XBJ） on survival rate and pulmonary vasopermeability in a rat model of severe scald injury. Methods： Rats were divided into two experiments： experiment 1 was monitored for 12 h post-injury for survival analysis after severe burns; in experiment 2, rats were killed for determination of pulmonary vascular permeability and pro-inflammatory mediators. In both experiments, rats were subject to third-degree 50% total body surface area（TBSA） burns or sham injury followed by XBJ or normal saline（NS） treatment. In addition, rat pulmonary microvascular endothelium cells（PMECs） were pretreated with either XBJ or phosphate buffer saline（PBS）, and then subjected to sham serum or scald serum stimulation for 2 or 6 h, followed by transwell examination for the permeability of PMECs. Meanwhile, pro-inflammatory mediators in PMECs culture supernatant were also investigated. Results： The average survival time in the scald＋XBJ group was 582.1±21.2 min, which was significantly longer than that in the scald ＋ NS group（345.8±25.4 min, P〈0.01）. Plasma levels of tumor necrosis factor-alpha（TNF-α）, E-selectin, interleukin-6（IL-6）, vascular permeability and water content of lung tissues were significantly increased in animals after severe burns（P〈0.01）. However, administration of XBJ significantly decreased these levels in plasma and lung tissue. In in vitro cell experiments, XBJ markedly attenuated permeability in PMECs monolayer and reduced the levels of TNF-α, IL-6 and soluble E-selectin after stimulation with scald serum（P〈0.01）. Conclusions： XBJ increases early survival rate by alleviating pulmonary vasopermeability and inhibiting pro-inflammatory mediators in rats subjected to lethal scald injury. XBJ may be a potent drug in treatment of severe burns.

Association between Skin Reactions and Efficacy of Summer Acupoint Application Treatment on Chronic Pulmonary Disease:A Prospective Study

Objective： To examine the variations in the prevalence of skin reactions and the association between skin reactions and efficacy of summer acupoint application treatment （SAAT） on chronic pulmonary disease （CPD）. Methods： A total of 2,038 patients with CPD were enrolled at 3 independent hospitals （defined as Groups A, B and C, respectively） in China. All patients were treated by SAAT, as applying a herbal paste onto the acupoints of Fengmen （BL 12） and Feishu （BL 13） on the dog days of summer, according to the lunar calendar, in 2008. Ten days after treatment, skin reaction data （no reaction, itching, stinging, blistering, and infection） were obtained via face-to-face interviews. Patients were retreated in the same hospital one year later, thereby allowing doctors to assess treatment efficacy based on the patients＇ symptoms, the severity of the spirometric abnormalities, and the concomitant medications used. Results： A large number of patients （85.3%） displayed reactive symptoms; however, the marked associations between reactive symptoms and age or gender were not observed. An increased number of patients from Group B （99.3%） and Group C （76.5%） displayed reactive symptoms due to the increased mass of crude Semen Sinapis Albae. The effective rate of SPAT was as high as 90.4% for patients of Group B, which was followed by Group A （70.9%） and Group C （42.2%）. Using stratified analyses, a convincing association between reactive symptoms and therapeutic efficacy was observed for patients with asthma [itching： odds ratio （OR）=2,17, 95% confidence interval （CI）： 1.49 to 3.14; blistering： OR=0.43, 95% Ch 0.25 to 0.73; and no reaction： OR=0.56, 95% CI： 0.35 to 0.90]. However, the same tendency was not observed for patients with chronic bronchitis and chronic obstructive pulmonary disease. Conclusions： SAAT can induce very mild skin reactions for patients with CPD, among which patients with asthma displayed a strong association between skin reactions and therapeutic efficacy. The skin reactions may be induced by the crude Semen Sinapis Albae.