Clinical and Experimental Study on Effect of Garlicin in Treating Angina Pectorls

Objective: To observe the effect and mechanism of Garlicin in treating coronary heart disease (CHD) with angina pectoris. Methods: Clinical study: 55 patients were selected and randomized into the Garlicin group and the nitroglycerin group. To Garlicin group, 60 mg of Garlicin was given by adding in 5% glucose solution for intravenous dripping once per day, the therapeutic course

CLINICAL OBSERVATION ABOUT THE EFFECT OF BLOOD-LETTING OF JING-POINTS ON CEREBRAL BLOOD FLOW IN STROKE PATIENTS AT THE EARLY STAGE AND EXPERIMENTAL STUDY ON ITS MECHANISMS IN THE RABBIT

In this paper, the authors sum their research results about the effect of blood-letting of Jing (Well)-point on cerebral blood flow both in stroke patients and in experimental cerebral ischemia, cerebral hematoma and hypertension rabbits. In 30 cases of stroke (cerebral hemorrhage and cerebral infarction) patients, blood flow state of the anterior cerebral artery (ACA), middle cerebral artery (MCA) and the posterior cerebral artery (PCA), and the blood flow velocity of the bilateral vertebral artery (VA) and the basil artery (BA) are determined before and after pricking blood of the Twelve Jing-points. In experimental cerebral ischemia (by occlusion of the common carotid artery) rabbits, cerebral hematoma model rabbits and intravenous injection of noradrenaline induced hypertension rabbits, rheoencephalogram (REC) is detected before and after blood letting of the twelve "Jing"-points. In these 30 stroke patients, ultrasound Doppler examination’s results show that in 22 cases (73.33%) whose blood flow velocity decreases, after blood-letting of the 12 Jing-points, it increases significantly (P<0.01); in the rest 8 cases ( 26.67%) whose blood flow velocity speeds up, after treatment, it decreases evidently (P<0.01), showing a good dual-directional regulative effect of blood-letting therapy. In experimental cerebral ischemia rabbits, cerebral hematoma rabbits and hypertension rabbits whose REG lowers in the amplitude apparently (P<0.01), after blood letting stimulation of the 12 Jing-points, it increases at different degrees. Three patterns of stimulation as blood letting stimulation, pain stimulation and Jing-point stimulation, also the 3 factors of blood-letting therapy, may contribute to their effect on improvement of the cerebral blood flow. Somatic afferent nerve, sympathetic nerve of the vascular wall, central cholinergic nerve (M receptors) and adrenergic nerve (α receptors) participate in the effect of blood letting on cerebral blood flow.

CLINICAL APPLICATION OF NEIGUAN (内关 PC 6) IN THE TREATMENT OF DISORDERS OF THE DIGESTIVE SYSTEM——THE RELATED RESEARCH PROGRESS

In the present paper, the authors review recent situations of clinical application of Neiguan (PC 6内关), etc. in the treatment of disorders of the digestive system and its related research progresses. In clinical practice, Neiguan (PC 6) is usually selected as one of the main acupoints to treat gastrointestinal reactions induced by ① nausea and vomiting, ② hiccup, ③ gastrointestinal dyskinesia, ④ gastritis, and ⑤ intra-gastric examination, cesarean section, etc. Concerning experimental studies, the effects of Neiguan (PC 6), etc. on ① gastric electrical activities, ② gastrointestinal motion, ③ gastrointestinal hormone secretion, and ④ gastric mucosal structure were observed. Results indicated that Neiguan (PC 6) is an important and effective acupoint for treatment of gastrointestinal disorders in clinic. Stimulation of Neiguan (PC 6) induced favorable regulation of both the peripheral nervous system and central nervous system, and changes of the gastrointestinal hormone secretion may contribute to its effects in treating various disorders.

CT examination, clinical situation and experimental characteristics of infants with intracranial hemorrhage induced by delayed vitamin K deficiency

BACKGROUND: Delayed vitamin K deficiency is characterized by acute onset, severe illness and high fatality rate. 33%-50% survivors accompany with other various nervous system sequelas. Therefore, diagnosis and treatment of intracranial hemorrhage in time become a key factor for improving healing rate and reducing fatality rate and incidence of sequela. OBJECTIVE: To investigate the clinical situation, experimental characteristics, CT examination and terminative characteristics of infants with intracranial hemorrhage induced by delayed vitamin K deficiency. DESIGN: Case analysis. SETTING: Department of Pediatrics, Zhongshan Hospital Affiliated to Xiamen University. PARTICIPANTS: A total of 17 infants with intracranial hemorrhage induced by delayed vitamin K deficiency aged 1-3 months including 11 boys and 6 girls were selected from Department of Pediatrics, Zhongshan Hospital Affiliated to Xiamen University from January 1994 to December 2005. All infants had drowsiness, rejective milk, spiting milk, gaze of both eyes, tic, coma, full anterior fontanelle, high muscular tension and cerebral hernia, etc. Experimental examination demonstrated that infants had anemia at various degrees; prothrombin time and partial thromboplastin time were prolonged; platelet count was normal. CT examination indicated that screenages of subarachnoid hemorrhage, subdural hematoma, cerebral parenchyma hemorrhage and intraventricular hemorrage were changed. Hemorrhage was stopped by the application of vitamin K. All patients provided informed consent. METHODS: ① Clinical situation and physical sign of infants were observed after hospitalization and scanned with rapid spiral CT scanning system. The thickness and average space of layers were 8-10 mm and the scanning time was 5 s with window width of 30-80 Hu and window position of 28-35 Hu. ② After hospitalization, four items of blood coagulation was measured with Futura meter and biochemical indexes of blood, such as serum calcium, serum alkaline phosphatase, total bilirubin, direct bilirubin and indirect bilirubin, were detected with Roche Modular PPI automatic biochemistry analyzer. ③ After hospitalization, infants were given 5-10 mg vitamin K1 for 3-5 days, and then, they were transfused with 10-15 mL/kg fresh plasma or whole blood for 1-3 times and received other relative therapies. Therapeutic effects were evaluated based on clinical diagnosis and criteria. MAIN OUTCOME MEASURES: ① Clinical situation, physical sign and CT examination; ② results of experimental examination; ③ treatment and termination. RESULTS: A total of 17 infants with intracranial hemorrhage were involved in the final analysis. ① Clinical situation, physical sign and CT examination: All infants had pale facial expression and full or bossing anterior fontanelle. Among them, 13 infants had drowsiness or dysphoria, 12 rejective milk or emesis, 11 tic, 13 injection site hemorrhage, 2 gastrointestinal hemorrhage, 3 cerebral hernia, 11 high muscular tension and 6 cervical rigidity. CT examination demonstrated that most infants (88%, 15/17) had subarachnoid hemorrhage; 10 (59%, 10/17) had subdural hematoma; 8 (47%, 8/17) had cerebral parenchyma hemorrhage; few had intraventricular hemorrhage. In addition, results of CT examination also indicated that 17 infants had intracranial hemorrhage. Hemorrhage sites of 12 infants were equal to or more than 2, which was accounted for 70% (12/17); meanwhile, partial cases accompanied with a large area of focus of cerebral infarction or cerebral hypoxia-ischemia lesion. ② Results of experimental examination: There were 6 infants with elongation of prothrombin time, 5 with partial elongation of prothrombin time, 4 with decrease of serum calcium (1.69-2.25 mmol/L), 3 with increase of serum alkaline phosphatase, 3 with increase of total bilirubin, 3 with increase of direct bilirubin, and 3 with increase of indirect bilirubin. ③ Treatment and termination: After treatment, 12 infants were cured well, 3 improved, 1 given up and 1 died. Later, ten infants received CT re-examination at 3 months after treatment. The results indicated that 3 infants had simple subarachnoid hemorrhage and 4 had subarachnoid hemorrhage accompanying with subdural hematoma. Their focuses were absorbed well and not show as obvious sequela. One infant had subdural hematoma accompanying with subarachnoid hemorrhage, cerebral parenchyma hemorrhage, intraventricular hemorrage and cerebral hypoxia ischemia, and then, after hematom absorption, obvious cerebral malacia focus, hydrocephalus, brain atrophy and inferior accumulating fluid of dura mater were observed; 2 had subdural hematoma accompanying with subarachnoid hemorrhage and cerebral hypoxia ischemia, and then, after bleeding absorption, brain atrophy was changed remarkably; changes of hydrocephalus were observed in one infant. CONCLUSION: ① Symptoms of pale facial expression, full or bossing anterior fontanelle, drowsiness and dysphoria are observed in infants with delayed vitamin K deficiency . ② Experimental indexes demonstrate that prothrombin time and partial prothrombin time are prolonged, and numbers of infants having decrease of serum calcium are in the third place. ③ Poly-intracranial hemorrhage is a notable characteristic of CT examination. Partial infants who have poly-intracranial hemorrhage always accompany with cerebral hypoxia-ischemia lesion or cerebral infarction. Clinical situation and prognosis of infants who have a large area of intracranial hemorrhage and cerebral hypoxia-ischemia changes are poor; however, those of infants who have simple subarachnoid hemorrhage or combination of subarachnoid hemorrhage with subdural hematoma are well. ④ Effect of vitamin K on this kind of disease is well.

Stem cells:a promising candidate to treat neurological disorders

Neurologic impairments are usually irreversible as a result of limited regeneration in the central nervous system.Therefore,based on the regenerative capacity of stem cells,transplantation therapies of various stem cells have been tested in basic research and preclinical trials,and some have shown great prospects.This manuscript overviews the cellular and molecular characteristics of embryonic stem cells,induced pluripotent stem cells,neural stem cells,retinal stem/progenitor cells,mesenchymal stem/stromal cells,and their derivatives in vivo and in vitro as sources for regenerative therapy.These cells have all been considered as candidates to treat several major neurological disorders and diseases,owing to their self-renewal capacity,multi-directional differentiation,neurotrophic properties,and immune modulation effects.We also review representative basic research and recent clinical trials using stem cells for neurodegenerative diseases,including Parkinson＇s disease,Alzheimer＇s disease,and age-related macular degeneration,as well as traumatic brain injury and glioblastoma.In spite of a few unsuccessful cases,risks of tumorigenicity,and ethical concerns,most results of animal experiments and clinical trials demonstrate efficacious therapeutic effects of stem cells in the treatment of nervous system disease.In summary,these emerging findings in regenerative medicine are likely to contribute to breakthroughs in the treatment of neurological disorders.Thus,stem cells are a promising candidate for the treatment of nervous system diseases.

DEVELOPMENT OF RESEARCHES ON THE TREATMENT OF BRONCHIAL ASTHMA WITH ACUPUNCTURE AND MOXIBUSTION

Acu-moxibustion therapy is one of the commonly-used remedies for the prevention and treatmerit of asthma. In the present article, the authors review development of clinical studies on acu-moxibustion treatment of asthma in recent 5 years from ① changes of pulmonary function as forced expiratory volume in 1 second （FEV1）, forced vital capacity （FVC）, FEV1%, peak expiratory flow （PEF）, maximum mid expiratory flow （MMEF）, etc., ② changes of immune function as serum IgE, IgG, subgroups of T lymphocytes, inflammatory mediators, cytokines, etc, and ③ changes of the nervous system and related receptors including nitric oxide （NO）, vasoactive intestinal peptide （VIP）, substance P （SP）, and cAMP/cGMP. Additionally, the authors also introduce the development of experimental researches from the effects of acu-moxibustion on ① inflammatory cells, ② nervous system and receptors, ③ patho-morphological changes of the lung tissue, and ④serology of acupuncture.

Can cannabinoids be a potential therapeutic tool in amyotrophic lateral sclerosis？

Amyotrophic lateral sclerosis（ALS） is the most common degenerative disease of the motor neuron system. Over the last years, a growing interest was aimed to discovery new innovative and safer therapeutic approaches in the ALS treatment. In this context, the bioactive compounds of Cannabis sativa have shown antioxidant, anti-inflammatory and neuroprotective effects in preclinical models of central nervous system disease. However, most of the studies proving the ability of cannabinoids in delay disease progression and prolong survival in ALS were performed in animal model, whereas the few clinical trials that investigated cannabinoids-based medicines were focused only on the alleviation of ALS-related symptoms, not on the control of disease progression. The aim of this report was to provide a short but important overview of evidences that are useful to better characterize the efficacy as well as the molecular pathways modulated by cannabinoids.

A NEW EXPERIMENTAL AND CLINICAL APPROACH OF COMBINING USAGE OF HIGHLY ACTIVE TUMOR-INFILTRATING LYMPHOCYTES AND HIGHLY SENSITIVE ANTITUMOR DRUGS FOR THE ADVANCED MALIGNANT TUMOR

In recent years, tumor-nfiltrating lymphocytes (TILs) have been reported to be effective for tumors in experimental and clinical research. In order to increase the therapeutical effect, we modified some steps of Rosenberg's approach a. cold digestion with collagenase at 4C for 24 hours; b. sedimentation instead of centrifugation; c. elimination of tumor cells before the cultivation procedure. Compared with the original approach, the proliferation, activity and cytotoxicity of TILs obtained by the modified procedure were much improved. TILs' expansion-old was greater than that with the original approach. Cytotoxicity against rumor cells was more potent. Increased TILs' subsets were CD3 and CD8 cells. Meanwhile, we took tumor cells from tumor tissues to test their in vitro chemosensitivities to different drugs in order to select highly sensitive antitumor drugs for treatment of cases with advanced tumors. According to the design of using highly active TILs and highly sensitive drugs (H & H therapy), preliminary clinical results of 50 cases showed higher response rates than those in treatment with TIL / IL2, LAK / 1L2 and TIL+IL2+CTX. Less toxic side effects were observed in 14 patients.

Clinical experiment of exercise induced asthma and respiratory impedance assessed with impulse oscillometry to measure exercise response of asthmatics

Abstract Objective In order to investigate pathophysiology of exercise induced asthma (EIA), the impedance of the respiratory system was studied using impulse oscillometry (IOS). EIA is a temporary increase in airway resistance, which occurs after several minutes of strenuous exercise. Most asthmatics experience EIA. Patients and methods Respiratory impedance was measured with IOS (MasterScreen, Jaeger, Germany) in 14 healthy volunteers and 14 asthmatics as baseline value at first. The procedure of exercise challenge with an ergometer (Corival 300 Gould Co.) increased heart rate to 90% of predicted maximum values in 3-4 min and maintained for 6 min. After challenge, measurements with IOS were made immediately at 5 min intervals for 5 times. Results The maximal increase of respiratory impedance occurred at 5-10 min after exercise and the increment magnitude of peripheral resistance (99.6%) was more than that of central resistance (13.5%) in asthmatics. After challenge, R5Hz, R5Hz-R20Hz, Zrespir (total impedance), resonance frequency (Fres) and X5Hz from patients changed significantly. The increment value of R5Hz-R20Hz from asthmatics was≥0.032kpa/l·s -1 and the change ratio of X5Hz from 71.4% of asthmatics was ≥41% (2SD beyond the mean response of nonashmatics). Air trapping loop was expressed in V T Zrespir graph in 57.1% patients. All subjects underwent IOS measurement. Conclusion Exercise test can diagnose asthma and evaluate efficacy of treatment for bronchial asthma. Because the patients usually have shortness of breath after exercise challenge, the measurement with spirometry (FEV 1) may not be accurate. IOS is based on measurement of the relationship between an external pressure pulse applied to the respiratory system and the resulting respiratory airflow. The spectral ratio of the amplitude of the pressure wave signal to the resulting flow signal constitutes the impedance of the respiratory system, from which the resistance (R) and the reactance (X, including elastance and inertance) of respiratory system in the frequency range 5Hz to 35Hz can be calculated. Our data showed that the increment value of R5Hz-R20Hz was more sensitive than other indices for detecting exercise induced asthma. The bronchoconstriction took place in peripheral airway mainly after exercise. Because obstruction of small bronchi during expiration and impedance increased abruptly, air trapping loops were expressed in V T Zrespir graph after challenge in asthmatics. Fres is the frequency point where the absolute value of elastance equals to that of inertance. X5Hz reflects the condition of compliance of lungs. Fres shifted right and change ratio of X5Hz increased after exercise were relative to the compliance decrease of lungs. The airway response of exercise challenge may be assessed more accurately and more conveniently with IOS that did not require a maximal inspiration and forced expiration.

Clinical and Experimental Study of Effect on Acute Phase Protein of Multiple Organ Dysfunction Syndrome Treated with Dachengqi Decoction

Objective: To investigate the level of acute phase proteins (APP)-synthesized in hepatocytes in pathogenic process of multiple organ dysfunction syndrome (MODS) and the effect of Dachengqi Decoction (DCQD) on it. Methods: The levels of C-reactive protein (CRP),α1-acid glycoprotein (AAG), α1-antitrypsin total (α1AT), α2-macroglobulin (α2-MG), ceruloplasmine (CP), hepatoglobin (HP) and transferrin (TF) synthesis were determined in 32 cases of MODS patients and rat models of MODS induced by acute infective peritonitis and mesenterial artery ischemia-reperfusion.Results: The serum APP level in MODS patients was increased and higher than that in the control group (P < 0. 01 ). After 3 days of DCQD treatment it reduced significantly (P <0. 05). Serum APP level in MODS model was also increased significantly, and after 3 days of DCQD treatment, it reduced significantly (P < 0. 05). The APP secreting level of rat hepatocytes cultured in vitro raised after stimulated and activated by lipopolysacchride, which was reduced after cultured with rabbits serum containing different concentration of effective ingredients of DCQD. The APP inhibiting effect of DCQD was dose dependent. Conclusion: Purgation therapy with DCQD could reduce the stimulation of pathogenic factors on hepatocytes, protect tissues and organs from damage caused by excessive inflammatory reaction.Original article on CJIM(Chin) 1998; 18(8): 453

Recent Highlights of Chinese Medicine for Advanced Lung Cancer

Owing to its unique superiority in improving quality of life and prolonging survival time among advanced lung cancer patients, Chinese medicine（CM） has, in recent years, received increased attentions worldwide. We utilized a bibliometric statistical method based on MEDLINE/Go Pub Med to conduct a comprehensive analysis of the current application status of CM in lung cancer, by including annual and accumulated publications, origin distribution of countries and journals, and keywords with a higher frequency score. Then the relevant clinical trials and mechanistic studies were systematically summarized within the field according to research types. We have raised potential problems and provided potentially useful reference information that could guide similar studies in the future. The basic experimental results are highly consistent with clinical trials, leading us to conclude that CM can offer better overall therapeutic benefits when used in combination with routine Western medicine for patients with advanced lung cancer.