Computational investigation on the molecular structure and chemical reactivity of a traditional Chinese medicine extract MK-1 molecule

MK-1 molecule(C_(16)H_(16)O_(2)),the simplest structure of vitamin K(VK)compound family,is an extract from traditional Chinese medicine Cymbopogon distans(Nees ex Steud.)Wats(Chinese name YunXiangCao),which has attracted a great deal of attention in recent years due to its antiasthmatic,antitussives and expectorant effects.To investigate the molecular structure and chemical reactivity of MK-1 molecule,computational investigations on six conformational minima structures were carried out at the MP2/6-311++G(2d,2p)level of theory.Several local reactivity descriptors including condensed Fukui function,average local ionization energy,and molecular electrostatic potential on each individual atom were determined to predict the intrinsic reactivity of MK-1 molecule.

Syndrome differentiation in traditional Chinese medicine and E-cadherin/ICAM-1 gene protein expression in gastric carcinoma

AIM： To explore the syndrome differentiation in traditional Chinese medicine （TCM） and gene protein expression in gastric carcinoma METHODS： Preoperative data of gastric cancer cases were collected from the General Surgery Department and classified according to the criteria for syndrome differentiation in TCM. E-cadherin （E-cad） and ICAM-1 gene protein expressions were detected in postoperative specimens from these cases by the immunohistochemical EnVision two-step method. RESULTS： The E-cad positive expression rate was 90% in 100 cases of gastric carcinoma. The difference in E-cad expression was significant between the different syndrome differentiation types in TCM （P 〈 0.01）. Further group-group comparison showed that there was a significant difference in E-cad expression between the stagnation of phlegm-damp type and the deficiency in both qi and blood and the deficiency-cold of stomach and spleen types, where E-cad expression was high. There was no significant difference between the internal obstruction of stagnant toxin type and the in-coordination between liver and stomach type, where E-cad expression was relatively low. The ICAM-1 positive expression rate was 58%, and there was no statistically significant difference between the two groups （x^2= 8.999, P 〉 0.05）. CONCLUSION： E-cad expression is relatively low in the internal obstruction of stagnant toxin type and the incoordination between liver and stomach type, where tumor development and metastasis may be associated with low E-cad expression, or with low homogeneous adhesiveness between tumor cells.

Rapid bioluminescence assay for monitoring rat CES1 activity and its alteration by traditional Chinese medicines

In traditional Chinese medicine herbs(TCM),including Radix Salviae Miltiorrhizae(Danshen),Radix Puerariae Lobatae(Gegen),Radix Angelicae Sinensis(Danggui),and Rhizoma Chuanxiong(Chuanxiong)are widely used for the prevention and treatment of cardiovascular diseases and also often co-administered with Western drugs as a part of integrative medicine practice.Carboxylesterase 1(CES1)plays a pivotal role in the metabolisms of pro-drugs,Since(S)-2-(2-(6-dimethylamino)-benzothiazole)-4,5-dihydrothiazole-4-carboxylate(NLMe)has recently been identified by us as a selective CES1 bioluminescent sensor,we developed a rapid method using this substrate for the direct measurement of CES1 activity in rats.This bioluminescence assay was applied to determine CES1 activity in rat tissues after a two-week oral administration of each of the four herbs noted above.The results demonstrated the presence of CES1 enzyme in rat blood and all tested tissues with much higher enzyme activity in the blood,liver,kidney and heart than that in the small intestine,spleen,lung,pancreas,brain and stomach.In addition,the four herbs showed tissue-specific effects on rat CES1 expression.Based on the CES1 biodistribution and its changes after treatment in rats,the possibility that Danshen,Gegen and Danggui might alter CES1 activities in human blood and kidney should be considered.In summary,a selective and sensitive bioluminescence assay was developed to rapidly evaluate CES1 activity and the effects of orally administered TCMs in rats.

International Communication of Traditional Chinese Medicine in the Context of COVID-19 Pandemic by Analogy of Directional Solidification

According to the phenomenon-taking of classified analog,directional solidification can be an excellent approach for international communication of traditional Chinese medicine(TCM)in the context of COVTD-19 pandemic.Attitudes toward TCM by Western Medicine(WM)can be represented by various morphologies of the solid/liquid interface.COVID-19 has created an urgent need for the worldwide spread of TCM.To counter any doubts and objections against TCM,COVTD-19 pandemic provides a good opportunity,meanwhile a steady and firm pace forward should be kept.It is also necessary to resolve domestic controversies and to lower cultural shock.The philosophy of TCM can agree fairly well with dialectical materialism;the scientific connotation of pentacy in TCM can be explained through the symptoms of C OVID-19-infected patients.A TCM understanding compatible with WM will accelerate its international acceptance,which could help to better elaborate the significance of humanity in TCM.Holistic medicine under the guidance of TCM principles is an important trend in medical development,whose framework is illustrated in a 4C+T diagram.

Traditional Chinese medicine as monotherapy or combined with oseltamivir in the treatment of H1N1 influenza:a systematic review and meta-analysis

Objective This study aimed to assess the efficacy and safety of traditional Chinese medicine,alone or in combination with oseltamivir,in patients with H1N1 Influenza.Methods In the present study,we searched the Cochrane Central Register of Controlled Trials,PUBMED,EMBASE,Chinese Biomedical Literature Database,China Science and Technology Journal Database,China National Knowledge Infrastructure Database,and WanFang Data for studies published in or before February 8,2022.Data were extracted and checked by two investigators.Review Manager 5.4 and STATA statistical software 16.0 were used for the data analysis.Results We identified 22 individual studies reporting data from 2292 individuals with H1N1 influenza.Compared with oseltamivir,the fever clearance duration[MD=-3.99,95%CI(-6.89,-1.09)]and sore throat relief time[MD=-5.39,95%CI(-10.19,-0.59)]in the intervention group of traditional Chinese medicine monotherapy or combined with oseltamivir were shorter.Maxingshigan was the primary component of Lianhuaqingwen.The subgroup analyses indicated that Maxingshigan shortened fever clearance time[MD=-3.23,95%CI(-5.60,-0.85)],and also had certain advantages in relieving sore throat[RR=-4.55,95%CI(-10.04,0.95)].However,as for the effective rate,fever duration,cough disappearance time,hospital length of stay,clinical symptoms time as well as viral shedding duration,there were no significant differences between the two groups.Besides,no serious adverse effects were reported in the included studies.Conclusion Although we couldn’t get a definitive conclusion due to the small sample sizes and high risk of bias in the included studies,most traditional Chinese medicine showed similar effects to oseltamivir in treating H1N1 influenza.Some were showed to have a statistically significant shorter time of fever clearance and sore throat remission when they were used alone or in combination with oseltamivir and were well-tolerated treatment,such as Maxingshigan.

The clinical efficacy of traditional Chinese medicine in the auxiliary treatment of grade 1 hypertension: A systematic review and metaanalysis

Objective:To systematically evaluate the clinical efficacy of traditional Chinese medicine(TCM)in auxiliary treatment of grade 1 hypertension.Methods:The China National Knowledge Infrastructure,Wan Fang Data,VIP,PubMed were searched to screen the literature of randomized controlled trials of TCM or non-drug therapies assisting conventional medicine to treat grade 1 hypertension.The search time was from the establishment of the database to October 1,2020.Revman5.3 was used for meta-analysis.Results:8 Chinese literatures were included.The results of the study showed that 24h diastolic blood pressure(DBP),24h systolic blood pressure(SBP),DBP lowering effect and TCM syndrome curative efficacy of the experimental group using TCM was better than that of the control group.However,TCM combined conventional medicine did not show an advantage on SBP lowering effect,antihypertensive efficacy rate and total clinical efficacy rate.Conclusion:TCM has a significant effect on lowering blood pressure for adjuvant treatment of grade 1 hypertension and can significantly improve clinical symptoms.

Study on the targets and mechanisms of traditional Chinese medicine in inhibiting platelet aggregation

Platelets aggregation and thrombosis formation are major reasons of cardiovascular and cerebral vascular diseases.To develop novel,effective and safe agents for inhibiting platelet aggregation and preventing above diseases is urgently needed.Some traditional Chinese medicines for“Houxue Huayu”have been shown to inhibit platelet aggregation potently.They are used frequently in China and also in Asian countries.Recently,the major effective components of Pueraria lobata,Salvia miltiorrhiza Bunge,Apium graveolens L.and so on were studied.The mechanisms and the molecular targets of puerarin,salvianolic acid B and the analogue of 3-n-butylphthalide,dl-PHPB were investigated.Four platelet aggregation inducers,ADP,arachidonic acid(AA),collagen(Col)and thrombin,were used in the study.

Pharmacological efficacy of the traditional Chinese medicinal formula Kun-Tai-1A in the treatment of letrozole-induced polycystic ovary syndrome

Background:Polycystic ovary syndrome(PCOS)is an endocrine disorder that occurs in women of child-bearing age.Moreover,PCOS patients have decreased pregnancy rates and clomiphene citrate resistance.The traditional Chinese medicine formula Kun-Tai-1S(KT1S),consisting of the seahorse species hippocampus,has been reported to elicit therapeutic effects in patients with PCOS.However,given the limited resources and global demand for wild hippocampus,whether KT1S with or without hippocampus can elicit similar therapeutic effects has not been confirmed.Methods:KT1S and Kun-Tai-1A(KT1A,KT1S without dry hippocampus)were used to treat a letrozole-induced rat model of PCOS with an established disease.The serum levels of testosterone,luteinizing hormone,anti-Müllerian hormone,and estradiol were determined,the luteinizing hormone/follicle-stimulating hormone ratio was determined,and the ovarian pathology was evaluated.Results:Similar to the therapeutic effects of cyproterone acetate,both the KT1S and KT1A treatments reduced the body weight and ovarian and uterine indices in the rats with PCOS.The serum levels of testosterone,anti-Müllerian hormone,and luteinizing hormone and the luteinizing hormone/follicle-stimulating hormone ratio were significantly lower in the KT1S and KT1A treatment groups compared to the model group(P<0.01 and P<0.05,respectively).Moreover,the histopathological assessment results suggested that both the KT1S and KT1A treatments significantly ameliorated the PCOS pathology in the rats with an established disease,with a reduced number of cystic and atretic follicles and an increased number of corpora lutea being observed in the ovaries.Notably,there was no obvious difference in the disease outcomes between the KT1S and KT1A-treated groups.Network pharmacology analysis revealed that 4’,7-dihydroxyflavanone,sinpemine A,quercetin,8-isopentenyl-kaempferol,and luteolin in KT1A may promote estrogen signaling;furthermore,the nitric oxide regulation pathway is also closely involved.Conclusion:KT1A and KT1S treatments both significantly ameliorated the PCOS-related pathology in rats,suggesting that the hippocampus component is dispensable for KT1S-mediated amelioration.Given the limited resources and global demand for wild hippocampus for use in complementary medicines,our findings may help conserve this species.Together,our results suggest that KT1A is a promising approach for treating PCOS.

探讨基于核心指标集构建中医特色的射血分数保留心力衰竭1+N模式疗效评价体系

核心指标集是就某一特定研究领域达成的所有临床研究都应该测量和报告的最少的临床结局,核心指标集可以提高临床疗效评价的规范性和可比性,是循证医学发展的必然、是中医药临床疗效评价的重要抓手、是推动中医药疗效评价与国际接轨的关键。如何运用核心指标集实现临床疗效国际化、标准化的同时,又能遵循中医诊疗特点体现自身优势是中医临床疗效评价的难点。针对这一难点,项目组创新性地提出了1+N模式的射血分数保留心衰(heart failure with preserved ejection fraction, HFpEF)疗效评价体系,即通用的核心指标集“1”+个性化指标集“N”,以满足循证医学和中医学疗效评价的双重需求。本文初探HFpEF疗效评价构建模式,主张在规范化基础上体现多样化和个性化的研究目的需求。结合HFpEF临床疗效评价的现状,综合业内专家意见,探讨了HFpEF 1+N模式疗效评价构建中核心指标集“1”的取舍以及“N”体系的构建思路,以期最大程度的形成符合中医药特色的临床评价体系新范式,推动中医药国际化进程。

止疼膏1号外敷治疗肺癌癌痛患者的临床观察

目的 观察止疼膏1号外敷痛点及穴位治疗肺癌癌痛患者的临床疗效。方法 选取2022年1月—2022年12月期间山东省昌乐人民医院收治的80例肺癌患者作为研究对象,按随机数字表法分为对照组和观察组,每组各40例。对照组仅采用规范的三阶梯止痛方案,观察组在接受三阶梯止痛方案治疗的基础上,采用止疼膏1号外敷痛点及穴位。治疗2周后,观察比较两组患者临床疗效、不良反应情况,治疗前后疼痛程度[数字疼痛分级法(Numberical rating scale, NRS)]、生活质量[肺癌治疗功能评价系统(Functional Assessment of Cancer Therapy-Lungcancer, FACT-L)]评分。结果 治疗后观察组总有效率87.50%(35/40)高于对照组67.50%(27/40),差异有统计学意义(P<0.05)。治疗后两组患者NRS评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组NRS评分均较对照组同期明显降低,差异有统计学意义(P<0.05)。治疗后两组患者FACT-L评分均较治疗前升高,差异有统计学意义(P<0.05);且观察组FACT-L评分明显高于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 止疼膏1号外敷治疗具有协同止痛作用,能够有效减轻肺癌癌痛患者的疼痛程度,提高肺癌患者的生活质量。

中药调控Nrf2/HO-1信号通路干预心肌缺血再灌注损伤的研究进展

心肌缺血再灌注损伤(MIRI)是心肌梗死患者进行血运重建时的严重并发症。核转录因子红系2相关因子2(Nrf2)/血红素加氧酶1(HO-1)信号通路在MIRI病理进程中具有重要意义。目前研究发现,中药对缺血再灌注引起的心肌损伤具有很好的效果。本文基于Nrf2/HO-1信号通路总结中药复方和单体干预MIRI的作用机制,发现中药复方(益心方、温阳通脉方、定心方Ⅰ号方)以及中药单体萜类(银杏内酯、黄芪甲苷、人参皂苷等)、酚类(巴西苏木素、苏木酮A、白藜芦醇等)、醌类(芦荟素、大黄素)等均可通过激活Nrf2/HO-1信号通路,抑制氧化应激、炎症反应等,从而减轻MIRI。

基于NLRP3/Caspase-1介导细胞焦亡探讨中医药干预肺纤维化的研究进展

细胞焦亡是一种新型细胞程序性死亡,其表现出以NOD样受体蛋白3(NLRP3)为关键靶通路,严重依赖半胱天冬酶(Caspase)家族成员为主要生物学特征,对细胞炎症及免疫调节具有重要意义。肺纤维化是呼吸系统中常见的间质性肺疾病,早期产生不同程度的炎症损伤及修复,后期以肺组织纤维化为主要病理表现。中医药在治疗肺纤维化过程中具有多靶点、多途径等特点。一方面通过阻止细胞炎症介质释放,保护肺组织免受炎症损伤;另一方面,抑制促纤维因子形成,减少细胞外基质及胶原沉积物,阻止肺成纤维细胞向肌成纤维细胞转化。文章就NLRP3/Caspase-1焦亡经典通路机制与PF作用分析,整理、归纳近年来中医药干预细胞焦亡在PF发挥生物活性的研究进展,以期为其深入研究提供参考。

The potential of herbal drugs to treat heart failure:The roles of Sirt1/AMPK

Heart failure(HF)is a highly morbid syndrome that seriously affects the physical and mental health of patients and generates an enormous socio-economic burden.In addition to cardiac myocyte oxidative stress and apoptosis,which are considered mechanisms for the development of HF,alterations in cardiac energy metabolism and pathological autophagy also contribute to cardiac abnormalities and ultimately HF.Silent information regulator 1(Sirt1)and adenosine monophosphate-activated protein kinase(AMPK)are nicotinamide adenine dinucleotide(NAD+)-dependent deacetylases and phosphorylated kinases,respectively.They play similar roles in regulating some pathological processes of the heart through regulating targets such as peroxisome proliferator-activated receptorγcoactivator 1α(PGC-1α),protein 38 mitogen-activated protein kinase(p38 MAPK),peroxisome proliferator-activated receptors(PPARs),and mammalian target of rapamycin(mTOR).We summarized the synergistic effects of Sirt1 and AMPK in the heart,and listed the traditional Chinese medicine(TCM)that exhibit cardioprotective properties by modulating the Sirt1/AMPK pathway,to provide a basis for the development of Sirt1/AMPK activators or inhibitors for the treatment of HF and other cardiovascular diseases(CVDs).

Heyingwuzi formulation alleviates diabetic retinopathy by promoting mitophagy via the HIF-1α/BNIP3/NIX axis

BACKGROUND Diabetic retinopathy(DR)is the primary cause of visual problems in patients with diabetes.The Heyingwuzi formulation(HYWZF)is effective against DR.AIM To determine the HYWZF prevention mechanisms,especially those underlying mitophagy.METHODS Human retinal capillary endothelial cells(HRCECs)were treated with high glucose(hg),HYWZF serum,PX-478,or Mdivi-1 in vitro.Then,cell counting kit-8,transwell,and tube formation assays were used to evaluate HRCEC proliferation,invasion,and tube formation,respectively.Transmission electron microscopy was used to assess mitochondrial morphology,and Western blotting was used to determine the protein levels.Flow cytometry was used to assess cell apoptosis,reactive oxygen species(ROS)production,and mitochondrial membrane potential.Moreover,C57BL/6 mice were established in vivo using streptozotocin and treated with HYWZF for four weeks.Blood glucose levels and body weight were monitored continuously.Changes in retinal characteristics were evaluated using hematoxylin and eosin,tar violet,and periodic acid-Schiff staining.Protein levels in retinal tissues were determined via Western blotting,immunohistochemistry,and immunostaining.RESULTS HYWZF inhibited excessive ROS production,apoptosis,tube formation,and invasion in hg-induced HRCECs via mitochondrial autophagy in vitro.It increased the mRNA expression levels of BCL2-interacting protein 3(BNIP3),FUN14 domain-containing 1,BNIP3-like(BNIP3L,also known as NIX),PARKIN,PTEN-induced kinase 1,and hypoxia-inducible factor(HIF)-1α.Moreover,it downregulated the protein levels of vascular endothelial cell growth factor and increased the light chain 3-II/I ratio.However,PX-478 and Mdivi-1 reversed these effects.Additionally,PX-478 and Mdivi-1 rescued the effects of HYWZF by decreasing oxidative stress and apoptosis and increasing mitophagy.HYWZF intervention improved the symptoms of diabetes,tissue damage,number of acellular capillaries,and oxidative stress in vivo.Furthermore,in vivo experiments confirmed the results of in vitro experiments.CONCLUSION HYWZF alleviated DR and associated damage by promoting mitophagy via the HIF-1α/BNIP3/NIX axis.

基于TRPA1离子通道蛋白的支气管哮喘病理机制及中医药干预现代研究进展

哮喘是一种反复发作的气道阻塞和喘息为特征的气道慢性炎症性疾病,瞬时受体电位锚蛋白1(Transient Receptor Potential Al,TRPA1)离子通道存在于多种组织细胞中,参与调节气道功能和炎症。以往对于TRPA1的研究更多的是在疼痛领域,尚未对相关调控离子蛋白通道表达治疗支气管哮喘的病理机制及中医药治疗进展做系统阐述。查阅国内外相关文献资料发现,在哮喘发生发展过程中,TRPA1离子通道蛋白参与气道炎症、气道高反应等病理过程。因此调控TRPA1离子蛋白通道的表达有利于治疗支气管哮喘。目前西医的治疗手段主要以吸入糖皮质激素与支气管扩张剂联合治疗为主,但部分患者不能达到完全控制,中医药在治疗哮喘方面具有靶点多、作用广、疗效优等特点,具有祛痰平喘、宣肺下气的中药及复方可以通过抗炎等作用有效调控TRPA1在体内的表达。文章总结TRPA1离子通道蛋白及其与支气管哮喘的关系,并就近年来中医药调控TRPA1的表达治疗支气管哮喘的研究进展进行综述,以期为基于TRPA1探讨支气管哮喘新的病理机制奠定实验室基础,为支气管哮喘防治及相关中药新药研发提供新的作用靶点与研究方向。

两组不同中医体质安氏Ⅱ^(1)错(牙合)患者运用PASS技术矫正前后牙颌相关指标及体质的变化

目的:比较平和质与阴虚质安氏Ⅱ1错(牙合)患者运用PASS矫正技术治疗后牙颌及体质相关指标的变化。方法:选择2019年2月-2023年2月来笔者医院口腔科就诊的安氏Ⅱ类1分类患者为研究对象,通过体质分型选择平和质(10例)与阴虚质(10例)错(牙合)患者运用PASS矫正技术进行治疗,比较两组患者矫正时托槽的脱落情况,矫正前后面型、牙颌及体质的改变。结果:平和质组患者托槽的脱落率明显小于阴虚质组(P<0.05);两种体质患者运用PASS矫正技术治疗前后的头影测量结果差异有统计学意义(P<0.05);矫正结束半年后,阴虚质较平和质患者的体质发生了明显改善(P<0.05)。结论:相较于阴虚体质错(牙合)患者,平和质体质错(牙合)患者在托槽脱落情况及矫正结束后体质的转归方面具有明显优势,因此不同体质对于错(牙合)畸形的矫正具有一定的指导意义。

Nrf2/HO-1通路在银屑病中作用的研究进展

银屑病的发病机制复杂,探索其发病机制对于治疗十分重要。核因子E2相关因子2(Nrf2)/血红素加氧酶1(HO-1)通路对细胞具有保护作用,与氧化应激、免疫、血管异常增生、表皮失衡以及细胞死亡等生理病理过程密切相关。目前已有研究证实Nrf2/HO-1通路对银屑病皮损有抑制作用,可能通过多种途径参与银屑病发病。就Nrf2/HO-1通路在银屑病中的作用机制及中医药通过干预该通路治疗银屑病的研究进展进行综述。

Polymorphisms in PPARD,PPARG and APM1 associated with four types of Traditional Chinese Medicine constitutions

Based on the theory of constitution of Traditional Chinese Medicine （TCM）, the human population is divided into nine constitutions including one balanced constitution （Normality） and eight unbalanced constitutions （Yang-deficiency, Yin-deficiency, Phlegm-wetness, Qi-deficiency, Wetness-heat, Blood stasis, Depressed constitution, and Inherited special constitution）. Different constitutions have specific metabolic features and different susceptibility to certain diseases. However, whether a genetic basis accounts for such constitution classification is yet to be determined. Here we performed a genetic study to assess the association between genetic variations of metabolic genes including PPARD, PPARG and APM1 and the constitutions. A total of 233 individuals of the Han population in China were classified into four groups, Normality, Yang-deficiency, Yin-deficiency and Phlegm-wetness with whom 23 single nucleotide polymorphisms （SNPs） in the three genes were genotyped using polymerase chain reaction-restriction fragment length polymorphism （PCR-RFLP） method. Biased distribution of PPARD rs2267669 and rs2076167, APM1 rs7627128 and rs1063539 in Yang-deficiency, PPARG Prol2Ala in Yin-deficiency and PPARD rs2076167, APMI rs266729 and rs7627128 in Phlegm-wetness were observed. The frequencies of Haplotypel3 （Hapl3） of PPARG in Yin-deficiency, Hap25 of APM1 in Yang-deficiency and Hap2 of PPARD and Hapl4 of PPARG in Phlegm-wetness, were significantly different from those in Normality, suggesting those might be group-associated haplotypes. These results suggested that single SNP and haplotypes ofPPARD, PPARG and APM1 may underlie the genetic basis of the constitutions classified in TCM.

Effect of polypeptide 2B1 on condition of dampness pattern in rats in terms of Traditional Chinese Medicine

OBJECTIVE： This study investigated how polypeptide 2B1 is involved in regulating and governing dampness in rat models with dampness pattern defined in terms of Traditional Chinese Medicine. METHODS： We randomly divided 48 SPF 10-week-old male Sprague-Dawley （SD） rats into a normal group, normal ＋ Aristolochic acid I （AA-I） for 5 min group, normal ＋ AA-I for 60 min group, dampness pattern group （DS-Group）, dampness pattern ＋ AA-I for 5 rain tern ＋ AA-I for 60 min group, and dampness pat- group. Groups were then treated accordingly. We took out the lung, stom- ach, liver, spleen, kidney, large intestine, and small intestine tissues to detect gene and protein expres- sion of organic anion transporter polypeptide 2B1 （OATP2B1）. RESULTS= Gene expression of OATP2B1 in spleen, kidney, and small intestine of rats with dampness pattern was lower than that in normal rats （P〈0.05）. The gene expressions of OATP2B1 in liver, stomach, large intestine, and small intestine were lower than that in control rats at different time points after being stimulated by AA-I （P〈0.05）. CONCLUSION There is coordination among multiple viscera in handling the condition of dampness, and the mechanism underlying the action may rely on regulating the expression of OATP2B1.

中药联合PD-1/PD-L1抑制剂治疗恶性肿瘤不良反应的回顾性分析

目的探讨中药联合程序性细胞死亡蛋白-1(PD-1)或程序性死亡蛋白配体-1(PD-L1)抑制剂在临床应用中的免疫相关不良反应发生情况并总结其特征。方法回顾性分析2019年9月至2022年1月在本院接受中药联合PD-1/PD-L1抑制剂治疗各类晚期实体恶性肿瘤的患者,记录患者接受治疗期间发生的所有不良反应信息,并进行严重程度分级和影响因素分析。结果共录入160例患者,其中57例患者发生不良反应,发生率为35.63%,主要有内分泌毒性(22.50%)、皮肤毒性(6.25%)、心脏毒性(6.25%)、胃肠毒性(5.00%)、肺毒性(3.75%)、肝脏毒性(1.88%)、反应性皮肤毛细血管增生症(1.25%)、血液毒性(0.63%)、肾脏毒性(0.63%)等。其中1、2级不良反应58次,3、4级不良反应16次。结论中药联合PD-1/PD-L1抑制剂引起的不良反应发生率较文献报道中单纯PD-1/PD-L1抑制剂低,严重程度较轻,提示中药辩证治疗可减轻免疫检查点抑制剂所致不良反应。