Hepatic sinusoidal endothelial cells(HSEC)are the most important cells that constitute the microcirculation barrier of liver.Clinically,W-P bodies have been detected in the HSEC cells of most patients with liver fibro...Hepatic sinusoidal endothelial cells(HSEC)are the most important cells that constitute the microcirculation barrier of liver.Clinically,W-P bodies have been detected in the HSEC cells of most patients with liver fibrosis,and these bodies have become the synthesis and storage sites of vW factor,ET-1 and other factors of liver fibrosis;during pathological stimulation,W-P bodies will excrete the above factors into the cytoplasm,which can make the structure and function of HSEC maladjusted,cause the disturbance of liver microcirculation,and aggravate the process of liver fibrosis.However,previous studies have found that Plumbagin,the active ingredient of Guangxi specialty ethnic medicine,has the definite function of promoting blood circulation and removing blood stasis and anti-liver fibrosis,but its mechanism is not clear.In this study,the research progress of the above problems was reviewed,and further research ideas were derived from it as follows:the role of Plumbagin in promoting blood circulation and removing blood stasis and anti-liver fibrosis is produced by affecting the formation quantity of W-P bodies,affecting the synthesis and storage of the contents of W-P bodies,and interfering with their exocytosis ability.展开更多
Hepatic fibrosis is a reversible pathological phenomenon in the early and middle stages,but but no satisfactory intervention drugs have been available so far.Recent studies have suggested that microcirculation disturb...Hepatic fibrosis is a reversible pathological phenomenon in the early and middle stages,but but no satisfactory intervention drugs have been available so far.Recent studies have suggested that microcirculation disturbance of liver is one of the important pathogenesis of chronic liver disease,the improvement of microcirculation is beneficial to the recovery of liver function and the delay of liver fibrosis.Hepatic stellate cells are the core cells of hepatic fibrosis,and also the most critical cells that affect the microcirculation of the liver.While TLR4/MyD88/NF-κB and TLR4/MyD88/MAPKs which are based on the action of hepatic stellate cells are two pathways that have very important influence on the inflammatory response of liver,the proliferation and apoptosis of hepatic stellate cells,and the secretion of fibrogenic cytokines.It was found that Plumbapin,the active ingredient of Guangxi specialty ethnic medicine,has the definite effect of promoting blood circulation and removing blood stasis and anti-hepatic fibrosis,but its mechanism is not clear.In this study,the research progress of the above problems was reviewed,and further research ideas were derived as follows:the pharmacological effect of Plumbapin on anti-hepatic fibrosis,promoting blood circulation and removing stasis was based on the influence of TLR4/MyD88/NF-κB and MAPKs signal pathway.展开更多
[ Objectives ] This study was conducted to evaluate the action of the aqueous extract of a medicinal plant Plumbago zeylanica L. in the reversal of dime- thylnitrosamine （DMN） -induced hepatic fibrosis in rats, and ...[ Objectives ] This study was conducted to evaluate the action of the aqueous extract of a medicinal plant Plumbago zeylanica L. in the reversal of dime- thylnitrosamine （DMN） -induced hepatic fibrosis in rats, and to provide a scientific basis for the utilization of P. zeylanica in treatment of hepatic fibrosis. [Meth- ods ] Hepatic fibrosis in rats was induced by intraperitoneal injection of DMN. The rats were then given the aqueous extract of P. zeylanica at high, medium or low concentration by garage for five weeks. Serum level of alanine aminotransferase （ALT） was determined by lactate dehydrogenase （LDH）-release assay, and serum level of aspartate transaminase （AST） was measured by UV-malate dehydrogenase （MDH） assay. Serum levels of total bilirubin （TBIL）, direct bilirubin （DBIL） and indirect bilirubin （1BIL） were measured by vanadate oxidation assay. Four indices of hepatic fibrosis （hyaluronic acid, laminin, procollagen type III and colla- gen type IV） were determined by radioimmunoassay （RIA） assay. Morphological damage of liver tissue was observed by hematoxylin-eosin staining （H＆E stai- ning）. Immunohistochemical staining was performed to determine the location and area of deposited collagen type I, collagen type III and ct-smeoth muscle actin （a-SMA） in liver tissue. [ Results] Compared with the negative control （rats with diseased fiver and untreated with P. zeylanica aqueous extract）, the serum lev- els of ALT, AST, TBIL, DBIL and IBIL were significantly decreased by P. zeylanica aqueous extract; the levels of the four serum indices of hepatic fibrosis were also obviously reduced. H＆E staining showed that hepatic fibrosis in rats was obviously inhibited or even reversed by P. zeylanica aqueous extract. Immunohisto- chemical staining proved that the aqueous extract of P. zeylanica significantly reduced the area and coloration of collagen type I, collagen type III and ct-SMA in rat liver. [ Conclusions] The aqueous extract of P. zeylanica has a definite effect in reversal of DMN-indueed hepatic fibrosis in rat by promoting the recovery of liver function, reversal of histopathological changes and reducing fibrotic collagen.展开更多
目的系统评估乙型肝炎病毒核心抗体(hepatitis B virus core antibody,HBcAb)水平与慢性乙型肝炎(chronic hepatitis B,CHB)患者肝脏炎症及纤维化程度的相关性,以及HBcAb能否作为CHB患者抗病毒疗效的预测指标。方法检索PubMed、Embase、...目的系统评估乙型肝炎病毒核心抗体(hepatitis B virus core antibody,HBcAb)水平与慢性乙型肝炎(chronic hepatitis B,CHB)患者肝脏炎症及纤维化程度的相关性,以及HBcAb能否作为CHB患者抗病毒疗效的预测指标。方法检索PubMed、Embase、Web of Science、The Cochrane Library、中国知网、万方、维普数据库建库至2022年10月发表的有关HBcAb的文献。使用R4.2.1软件进行Meta分析,横断面研究文献质量评价参照美国卫生保健质量和研究机构(the Agency for Healthcare Research and Quality,AHRQ)提出的文献质量评价标准,队列研究质量评价参照纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)。采用剔除异质性最大或权重最大的文献进行敏感性分析。采用漏斗图和Egger检验进行发表偏倚评估。结果纳入30篇文献进行系统评价,其中21篇文献纳入Meta分析。结果表明HBcAb水平越高,CHB患者肝脏炎症程度(Summary r=0.39,95%CI:0.30~0.48,P<0.05)和肝脏纤维化程度(Summary r=0.33,95%CI:0.22~0.43,P<0.05)均越高。ALT基本正常的CHB患者中HBcAb较低的患者发生肝脏炎症(G2~G4)的风险较高(OR=2.02,95%CI:0.64~6.38,P<0.05)。干扰素(interferon,IFN)治疗的CHB患者基线HBcAb水平越高,HBsAg阴转率越高(MD=0.34,95%CI:-0.12~0.80,P<0.05)。核苷(酸)类似物[nucleos(t)ide analogues,NAs]和IFN治疗的CHB患者基线HBcAb水平越高,HBeAg血清学转换率(MD=0.37,95%CI:0.26~0.49,P<0.05)和HBV DNA病毒学应答率(MD=0.30,95%CI:0.16~0.44,P<0.05)均越高。IFN治疗的CHB患者停药时HBcAb水平越高,临床治愈后复发率越低(MD=-0.74,95%CI:-1.00~-0.48,P<0.05)。结论HBcAb水平越高,CHB患者肝脏炎症程度及纤维化程度越高。较高的HBcAb水平可作为预测NAs或IFN抗病毒疗效的指标之一。展开更多
目的观察保肺康治疗气阴两虚、痰瘀阻络型慢性阻塞性肺疾病合并肺间质纤维化(chronic obstructive pulmonary disease with pulmonary interstitial fibrosis,COPD-PIF)患者的临床疗效。方法将符合纳入标准的COPD-PIF患者按照随机数字...目的观察保肺康治疗气阴两虚、痰瘀阻络型慢性阻塞性肺疾病合并肺间质纤维化(chronic obstructive pulmonary disease with pulmonary interstitial fibrosis,COPD-PIF)患者的临床疗效。方法将符合纳入标准的COPD-PIF患者按照随机数字表法分为2组,治疗组予以中药保肺康联合西医综合治疗,对照组予以中药安慰剂联合西医综合治疗,疗程共3个月。观察并比较2组患者治疗有效率,以及治疗前后中医证候积分、肺功能、动脉血氧分压(partial pressure of oxygen in arterial blood,PaO_(2))、慢阻肺患者自我评估测试(COPD assessment test,CAT)评分、改良英国医学研究学会(modified British medical research council,mMRC)呼吸困难指数评分、急性加重次数等指标的变化。结果治疗组患者中医证候总积分、主要症状积分、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)占预计值百分比(FEV1%pred)、PaO_(2)、CAT评分、mMRC评分、急性加重次数较治疗前均有改善(P<0.05),且疗效优于对照组。相关性分析显示中医证候积分的改善与CAT评分、mMRC评分呈显著正相关,与FEV1%pred、肺一氧化碳弥散量(diffusing capacity of the lung for carbon monoxide,DLCO)占预计值百分比(DLCO%pred)呈显著负相关。结论中药保肺康不仅可以显著改善COPD-PIF患者的主要症状(喘息、胸闷、气短、咳嗽、咯痰、乏力),且能降低CAT评分、mMRC评分,改善患者氧合与肺功能,减少急性加重次数,临床疗效显著,且未见明显不良反应,值得临床推广应用。展开更多
OBJECTIVE:To evaluate the efficacy and safety of activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine(TCM) for managing renal fibrosis(RF) in patients with chronic kidney dis...OBJECTIVE:To evaluate the efficacy and safety of activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine(TCM) for managing renal fibrosis(RF) in patients with chronic kidney disease(CKD).METHODS:We searched randomized controlled trials(RCTs) from eight databases.RESULTS:Sixteen eligible studies with 1,356 participants were included in this study.Compared to treatment with Western Medicine(WM) alone,the combined treatment with activating blood circulation and removing blood stasis in terms of TCM(ARTCM) and WM to manage RF in patients with CKD significantly ameliorated type Ⅳ collagen(C-Ⅳ)(SMD:-2.17,95% CI:3.01 to-1.34),type Ⅲ procollagen(PC-Ⅲ)(SMD:-1.08,95% CI:-1.64 to-0.53),laminin(LN)(SMD:-1.28,95% CI:-1.65 to-0.90),transforming growth factor β 1(TGF-β1)(SMD:-0.65,95% CI:-1.18 to-0.12),serum creatinine(Scr)(SMD:-1.36,95% CI:-1.85 to-0.87),blood urea nitrogen(BUN)(MD:-1.51,95% CI:-2.59 to-0.43),and 24 h urine protein(24h Upro)(SMD:-1.23;95% CI:-1.96 to-0.50).The level of hyaluronic acid(HA) was similar in both types of treatment(SMD:-0.74,95% CI:-1.91 to 0.44).The subgroup analysis showed that the duration of 8 weeks might affect the concentration of C-Ⅳ,PC-Ⅲ,and LN(P < 0.05).The effectiveness of the longer duration to C-Ⅳ,PC-Ⅲ,and LN was not certain.However,the result should be interpreted in care.The safety of the treatment using ARTCM and WM could not be evaluated because a few studies had reported adverse effects.The results of the Meta-analysis were not stable enough.There was publication bias for the reports on Scr(P = 0.001),C-Ⅳ(P = 0.001),PC-Ⅲ(P = 0.026),and LN(P = 0.030) and no publication bias for the reports on BUN(P = 0.293).The quality of evidence varied from low to very low.CONCLUSIONS:The combined treatment using ARTCM and WM to manage RF in patients with CKD has some advantages over treatment with WM alone.High-quality RCTs need to be conducted for the strong support.展开更多
基金Supported by the Research Project of National Natural Science Foundation of China(No.81960761,81960751,81680705)Basic Ability Improvement Project for Young and Middle-aged Teachers in Colleges and Universities of Guangxi(No.2018KY1149)。
文摘Hepatic sinusoidal endothelial cells(HSEC)are the most important cells that constitute the microcirculation barrier of liver.Clinically,W-P bodies have been detected in the HSEC cells of most patients with liver fibrosis,and these bodies have become the synthesis and storage sites of vW factor,ET-1 and other factors of liver fibrosis;during pathological stimulation,W-P bodies will excrete the above factors into the cytoplasm,which can make the structure and function of HSEC maladjusted,cause the disturbance of liver microcirculation,and aggravate the process of liver fibrosis.However,previous studies have found that Plumbagin,the active ingredient of Guangxi specialty ethnic medicine,has the definite function of promoting blood circulation and removing blood stasis and anti-liver fibrosis,but its mechanism is not clear.In this study,the research progress of the above problems was reviewed,and further research ideas were derived from it as follows:the role of Plumbagin in promoting blood circulation and removing blood stasis and anti-liver fibrosis is produced by affecting the formation quantity of W-P bodies,affecting the synthesis and storage of the contents of W-P bodies,and interfering with their exocytosis ability.
基金the Research Project of National Natural Science Foundation of China(81960761,81960751,81680705)Basic Ability Improvement Project for Young and Middle-aged Teachers in Colleges and Universities of Guangxi(2018KY1149)Natural Science Foundation of Guangxi Province(2020JJA140257).
文摘Hepatic fibrosis is a reversible pathological phenomenon in the early and middle stages,but but no satisfactory intervention drugs have been available so far.Recent studies have suggested that microcirculation disturbance of liver is one of the important pathogenesis of chronic liver disease,the improvement of microcirculation is beneficial to the recovery of liver function and the delay of liver fibrosis.Hepatic stellate cells are the core cells of hepatic fibrosis,and also the most critical cells that affect the microcirculation of the liver.While TLR4/MyD88/NF-κB and TLR4/MyD88/MAPKs which are based on the action of hepatic stellate cells are two pathways that have very important influence on the inflammatory response of liver,the proliferation and apoptosis of hepatic stellate cells,and the secretion of fibrogenic cytokines.It was found that Plumbapin,the active ingredient of Guangxi specialty ethnic medicine,has the definite effect of promoting blood circulation and removing blood stasis and anti-hepatic fibrosis,but its mechanism is not clear.In this study,the research progress of the above problems was reviewed,and further research ideas were derived as follows:the pharmacological effect of Plumbapin on anti-hepatic fibrosis,promoting blood circulation and removing stasis was based on the influence of TLR4/MyD88/NF-κB and MAPKs signal pathway.
基金Supported by National Natural Science Foundation of China(81403189,81460628,81660705,81560690)Scientific Research Project for Higher Education of Guangxi Zhuang Autonomous Region Education Department(YB2014182)
文摘[ Objectives ] This study was conducted to evaluate the action of the aqueous extract of a medicinal plant Plumbago zeylanica L. in the reversal of dime- thylnitrosamine （DMN） -induced hepatic fibrosis in rats, and to provide a scientific basis for the utilization of P. zeylanica in treatment of hepatic fibrosis. [Meth- ods ] Hepatic fibrosis in rats was induced by intraperitoneal injection of DMN. The rats were then given the aqueous extract of P. zeylanica at high, medium or low concentration by garage for five weeks. Serum level of alanine aminotransferase （ALT） was determined by lactate dehydrogenase （LDH）-release assay, and serum level of aspartate transaminase （AST） was measured by UV-malate dehydrogenase （MDH） assay. Serum levels of total bilirubin （TBIL）, direct bilirubin （DBIL） and indirect bilirubin （1BIL） were measured by vanadate oxidation assay. Four indices of hepatic fibrosis （hyaluronic acid, laminin, procollagen type III and colla- gen type IV） were determined by radioimmunoassay （RIA） assay. Morphological damage of liver tissue was observed by hematoxylin-eosin staining （H＆E stai- ning）. Immunohistochemical staining was performed to determine the location and area of deposited collagen type I, collagen type III and ct-smeoth muscle actin （a-SMA） in liver tissue. [ Results] Compared with the negative control （rats with diseased fiver and untreated with P. zeylanica aqueous extract）, the serum lev- els of ALT, AST, TBIL, DBIL and IBIL were significantly decreased by P. zeylanica aqueous extract; the levels of the four serum indices of hepatic fibrosis were also obviously reduced. H＆E staining showed that hepatic fibrosis in rats was obviously inhibited or even reversed by P. zeylanica aqueous extract. Immunohisto- chemical staining proved that the aqueous extract of P. zeylanica significantly reduced the area and coloration of collagen type I, collagen type III and ct-SMA in rat liver. [ Conclusions] The aqueous extract of P. zeylanica has a definite effect in reversal of DMN-indueed hepatic fibrosis in rat by promoting the recovery of liver function, reversal of histopathological changes and reducing fibrotic collagen.
文摘目的系统评估乙型肝炎病毒核心抗体(hepatitis B virus core antibody,HBcAb)水平与慢性乙型肝炎(chronic hepatitis B,CHB)患者肝脏炎症及纤维化程度的相关性,以及HBcAb能否作为CHB患者抗病毒疗效的预测指标。方法检索PubMed、Embase、Web of Science、The Cochrane Library、中国知网、万方、维普数据库建库至2022年10月发表的有关HBcAb的文献。使用R4.2.1软件进行Meta分析,横断面研究文献质量评价参照美国卫生保健质量和研究机构(the Agency for Healthcare Research and Quality,AHRQ)提出的文献质量评价标准,队列研究质量评价参照纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)。采用剔除异质性最大或权重最大的文献进行敏感性分析。采用漏斗图和Egger检验进行发表偏倚评估。结果纳入30篇文献进行系统评价,其中21篇文献纳入Meta分析。结果表明HBcAb水平越高,CHB患者肝脏炎症程度(Summary r=0.39,95%CI:0.30~0.48,P<0.05)和肝脏纤维化程度(Summary r=0.33,95%CI:0.22~0.43,P<0.05)均越高。ALT基本正常的CHB患者中HBcAb较低的患者发生肝脏炎症(G2~G4)的风险较高(OR=2.02,95%CI:0.64~6.38,P<0.05)。干扰素(interferon,IFN)治疗的CHB患者基线HBcAb水平越高,HBsAg阴转率越高(MD=0.34,95%CI:-0.12~0.80,P<0.05)。核苷(酸)类似物[nucleos(t)ide analogues,NAs]和IFN治疗的CHB患者基线HBcAb水平越高,HBeAg血清学转换率(MD=0.37,95%CI:0.26~0.49,P<0.05)和HBV DNA病毒学应答率(MD=0.30,95%CI:0.16~0.44,P<0.05)均越高。IFN治疗的CHB患者停药时HBcAb水平越高,临床治愈后复发率越低(MD=-0.74,95%CI:-1.00~-0.48,P<0.05)。结论HBcAb水平越高,CHB患者肝脏炎症程度及纤维化程度越高。较高的HBcAb水平可作为预测NAs或IFN抗病毒疗效的指标之一。
文摘目的观察保肺康治疗气阴两虚、痰瘀阻络型慢性阻塞性肺疾病合并肺间质纤维化(chronic obstructive pulmonary disease with pulmonary interstitial fibrosis,COPD-PIF)患者的临床疗效。方法将符合纳入标准的COPD-PIF患者按照随机数字表法分为2组,治疗组予以中药保肺康联合西医综合治疗,对照组予以中药安慰剂联合西医综合治疗,疗程共3个月。观察并比较2组患者治疗有效率,以及治疗前后中医证候积分、肺功能、动脉血氧分压(partial pressure of oxygen in arterial blood,PaO_(2))、慢阻肺患者自我评估测试(COPD assessment test,CAT)评分、改良英国医学研究学会(modified British medical research council,mMRC)呼吸困难指数评分、急性加重次数等指标的变化。结果治疗组患者中医证候总积分、主要症状积分、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)占预计值百分比(FEV1%pred)、PaO_(2)、CAT评分、mMRC评分、急性加重次数较治疗前均有改善(P<0.05),且疗效优于对照组。相关性分析显示中医证候积分的改善与CAT评分、mMRC评分呈显著正相关,与FEV1%pred、肺一氧化碳弥散量(diffusing capacity of the lung for carbon monoxide,DLCO)占预计值百分比(DLCO%pred)呈显著负相关。结论中药保肺康不仅可以显著改善COPD-PIF患者的主要症状(喘息、胸闷、气短、咳嗽、咯痰、乏力),且能降低CAT评分、mMRC评分,改善患者氧合与肺功能,减少急性加重次数,临床疗效显著,且未见明显不良反应,值得临床推广应用。
基金Supported by the Fund of Science and Technology Sichuan Province:Optimization and Evaluation of Clinical Scheme of Traditional Chinese Medicine for Delaying the Progression of Chronic Kidney Disease by Fuzhenghuayu Jiangzhuo tongluo Principle(No.2021YFS0034)the National Natural Science Foundation of China:Studies on Mechanism of Bupiyishen Tongfu Xiezhuo Principle in Delaying the Progression of Chronic Kidney Disease in Rats by Adjusting Host Metabonomics and Gut Microbiota with Multi-omics Technology(No.81973673)。
文摘OBJECTIVE:To evaluate the efficacy and safety of activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine(TCM) for managing renal fibrosis(RF) in patients with chronic kidney disease(CKD).METHODS:We searched randomized controlled trials(RCTs) from eight databases.RESULTS:Sixteen eligible studies with 1,356 participants were included in this study.Compared to treatment with Western Medicine(WM) alone,the combined treatment with activating blood circulation and removing blood stasis in terms of TCM(ARTCM) and WM to manage RF in patients with CKD significantly ameliorated type Ⅳ collagen(C-Ⅳ)(SMD:-2.17,95% CI:3.01 to-1.34),type Ⅲ procollagen(PC-Ⅲ)(SMD:-1.08,95% CI:-1.64 to-0.53),laminin(LN)(SMD:-1.28,95% CI:-1.65 to-0.90),transforming growth factor β 1(TGF-β1)(SMD:-0.65,95% CI:-1.18 to-0.12),serum creatinine(Scr)(SMD:-1.36,95% CI:-1.85 to-0.87),blood urea nitrogen(BUN)(MD:-1.51,95% CI:-2.59 to-0.43),and 24 h urine protein(24h Upro)(SMD:-1.23;95% CI:-1.96 to-0.50).The level of hyaluronic acid(HA) was similar in both types of treatment(SMD:-0.74,95% CI:-1.91 to 0.44).The subgroup analysis showed that the duration of 8 weeks might affect the concentration of C-Ⅳ,PC-Ⅲ,and LN(P < 0.05).The effectiveness of the longer duration to C-Ⅳ,PC-Ⅲ,and LN was not certain.However,the result should be interpreted in care.The safety of the treatment using ARTCM and WM could not be evaluated because a few studies had reported adverse effects.The results of the Meta-analysis were not stable enough.There was publication bias for the reports on Scr(P = 0.001),C-Ⅳ(P = 0.001),PC-Ⅲ(P = 0.026),and LN(P = 0.030) and no publication bias for the reports on BUN(P = 0.293).The quality of evidence varied from low to very low.CONCLUSIONS:The combined treatment using ARTCM and WM to manage RF in patients with CKD has some advantages over treatment with WM alone.High-quality RCTs need to be conducted for the strong support.
