Multidisciplinary strategies to enhance therapeutic effects of flavonoids from Epimedii Folium:Integration of herbal medicine,enzyme engineering,and nanotechnology

Flavonoids such as baohuoside I and icaritin are the major active compounds in Epimedii Folium(EF)and possess excellent therapeutic effects on various diseases.Encouragingly,in 2022,icaritin soft capsules were approved to reach the market for the treatment of hepatocellular carcinoma(HCC)by National Medical Products Administration(NMPA)of China.Moreover,recent studies demonstrate that icaritin can serve as immune-modulating agent to exert anti-tumor effects.Nonetheless,both production efficiency and clinical applications of epimedium flavonoids have been restrained because of their low content,poor bioavailability,and unfavorable in vivo delivery efficiency.Recently,various strategies,including enzyme engineering and nanotechnology,have been developed to increase productivity and activity,improve delivery efficiency,and enhance therapeutic effects of epimedium flavonoids.In this review,the structure-activity relationship of epimedium flavonoids is described.Then,enzymatic engineering strategies for increasing the productivity of highly active baohuoside I and icaritin are discussed.The nanomedicines for overcoming in vivo delivery barriers and improving therapeutic effects of various diseases are summarized.Finally,the challenges and an outlook on clinical translation of epimedium flavonoids are proposed.

Application effect of phloroglucinol injection in elderly patients with spastic abdominal pain in emergency department

BACKGROUND Although norepinephrine injection is commonly used in emergency situations,it is associated with risks for elderly patients with spasmodic liver pain.This study explores the safety and effectiveness of mebendazole injection,an alternative treatment option,for the emergency management of spasmodic abdominal pain,while minimizing adverse reactions,in elderly patients.AIM To explore the development of norepinephrine injection and the adverse reactions of this drug in emergency elderly patients with spasmodic liver pain.METHODS The control group consisted of 56 elderly patients visiting our hospital from January 2021 to December 2021.After hospital admission,the control group was intravenously administered tolopin.The experimental group consisted of 56 emergency patients with spasmodic abdominal pain who visited our hospital until June 2022.After hospital admission,the experimental group was intravenously administered toloxazole.The two groups were treated for 3 d.The disappearance of clinical symptoms was observed before and after the treatment,and the difference in adverse reactions between the two groups was compared.RESULTS The pain of the wife,fire,diarrhea,drowning,and surrounding time disappeared in the experimental group.No statistical difference was observed between the experimental and control groups in visual pain analog scale(VAS)scores before and after the treatment(P>0.05).The VAS scores of abdominal pain severity after 0.5 h,1.0 h,and after 6.0 h of treatment were significantly lower for the experimental group than for the control group.After the treatment,the therapeutic effect in the experimental group was higher and statistically significant than that in the control group(P<0.05).The probability of adverse reactions before the treatment was lower in the experimental group than in the control group.CONCLUSION During emergency,mebendazole injection exhibited a good therapeutic value when used for the clinical treatment of elderly patients with spasmodic stomach pain.It accelerated the disappearance of clinical symptoms such as stomach pain,reduced the stomach weight,and improved clinical activity.Reducing and promoting the frequency of high treatment safety with mebendazole injection is worthwhile.

Effectiveness and safety of traditional Chinese medicine for diabetic retinopathy:A systematic review and network meta-analysis of randomized clinical trials

BACKGROUND Diabetic retinopathy(DR)is currently recognized as one of the most serious diabetic microangiopathies and a major cause of adult blindness.Commonly used clinical approaches include etiological control,microvascular improvement,and surgical intervention,but they are ineffective and have many side effects.Oral Chinese medicine(OCM)has been used for thousands of years to treat DR and is still widely used today,but it is unclear which OCM is more effective for DR.AIM To estimate relative effectiveness and safety profiles for different classes of OCMs for DR,and provide rankings of the available OCMs.METHODS The search time frame was from the creation of the database to January 2023.RevMan 5.3 and Stata 14.0 software were used to perform the systematic review and Network meta-analyses(NMA).RESULTS A total of 107 studies and 9710 patients were included,including 4767 cases in the test group and 4973 cases in the control group.Based on previous studies and clinical reports,and combined with the recommendations of Chinese guidelines for the prevention and treatment of DR,9 OCMs were finally included in this study,namely Compound Xueshuantong Capsules,Qiming Granules,Compound Danshen Dripping Pills,Hexue Mingmu Tablets(HXMM),Qiju Dihuang Pills(QJDH),Shuangdan Mingmu Capsules(SDMM),Danggui Buxue Decoction(DGBX),Xuefu Zhuyu Decoction and Buyang Huanwu Decoction.When these nine OCMs were analyzed in combination with conventional western medicine treatment(CT)compared with CT alone,the NMA results showed that HXMM+CT has better intervention effect on the overall efficacy of DR patients,HXMM+CT has better effect on improving patients'visual acuity,SDMM+CT has better effect on inhibiting vascular endothelial growth factor,DGBX+CT has better effect on reducing fundus hemorrhage area,HXMM+CT has better effect on reducing fasting blood glucose,and QJDH+CT has better effect on reducing glycated hemoglobin.When there are not enough clinical indicators for reference,SDMM+CT or HXMM+CT treatments can be chosen because they are effective for more indicators and demonstrate multidimensional efficacy.CONCLUSION This study provides evidence that combining OCMs with CT leads to better outcomes in all aspects of DR compared to using CT alone.Based on the findings,we highly recommend the use of SDMM or HXMM for the treatment of DR.These two OCMs have demonstrated outstanding efficacy across multiple indicators.

Preventive and Therapeutic Effects of New Fungicides on Rice Blast

[Objectives]The paper was to identify the characteristics and the potency of new fungicides to rice blast disease,and study their preventive and therapeutic effects on the disease.[Methods]Six new and conventional fungicides with different mechanisms of action were selected to compare their preventive and therapeutic effects on rice seedling blast in greenhouse.[Results]The agents which showed to be highly efficacious in blast prevention(greater than 90%)were 25%pyraclostrobin EC,20%fenoxanil SC,75%tricyclazole WP and 50%prochloraz-manganese WP sprayed at the dosages of 112.5-150,180-360,270-450 and 450-600 g/ha,respectively.The therapeutic effect of new fungicides 25%pyraclostrobin EC and 50%prochloraz-manganese WP on rice blast were above 90%when the dosages were 90-150 and 360-600 g/ha,respectively.The therapeutic effect of the conventional fungicide 40%isoprothiolane EC on rice blast was 69.04%when the dosage was 480 g/ha,while those of other fungicides were worse.[Conclusions]Both 25%pyraclostrobin EC and 50%prochloraz-manganese WP have good preventive and therapeutic effects on rice blast,which will provide a reference for the use of these fungicides in the field.

Mechanism of Action and Therapeutic Effect of Modified Qiwei Baishu Powder in Diabetes

Objective:To study the mechanism of action and therapeutic effect of modified Qiwei Baishu powder in diabetic patients.Methods:From January 2021 to January 2022,80 diabetic patients were recruited in our study and divided into two groups by the random number table method.Group A was treated with modified Qiwei Baishu powder,whereas group B was treated with western medicine.The therapeutic effect,traditional Chinese medicine(TCM)syndrome score,blood sugar level,and incidence of adverse reaction were compared between the two groups.Result:The therapeutic effect in group A was significantly higher than that in group B(P<0.05);the TCM syndrome scores of group A were significantly lower than those of group B(P<0.05);the fasting blood glucose(FBG),2 hour-postprandial blood glucose(PBG),and glycosylated hemoglobin(HbA1c)levels of group A were significantly lower than those of group B(P<0.05);the incidence of adverse reaction in group A was significantly lower than that in group B(P<0.05).Conclusion:On the basis of western medicine,the addition of modified Qiwei Baishu powder can maintain stable blood sugar levels in patients and alleviate diabetic symptoms;thus,it is not only effective,but also safe for clinical use in diabetes.

Study on the Effect of Bifidobacterium Quadruple Viable Tablets in the Treatment of Ulcerative Colitis

Objective:To study the therapeutic efficacy of patients with ulcerative colitis receiving Bifidobacterium quadruple viable tablets.Methods:49 cases were selected from ulcerative colitis patients who attended the clinic from February 2021 to November 2022,and were randomly grouped into group A for addition of Bifidobacterium quadruple viable tablets treatment,and group B for conventional medication.The efficacy,inflammatory factors,nutritional indexes,and adverse reactions were compared between the groups.Results:The efficacy of UC patients in group A was higher than that in group B(P<0.05);the inflammatory factors in group A were lower than that in group B(P<0.05);nutritional indicators in group A were higher than that in group B(P<0.05);and the adverse reactions of medication in UC patients in group A were lower than that in group B(P<0.05).Conclusion:The treatment of UC patients with the addition of Bifidobacterium quadruple viable tablets can improve the nutritional status of the organism,inhibit the progression of inflammation,and is safe and efficient in treating ulcerative colitis.

Recombinant adeno-associated virus 8-mediated inhibition of microRNA let-7a ameliorates sclerosing cholangitis in a clinically relevant mouse model

BACKGROUND Primary sclerosing cholangitis(PSC)is characterized by chronic inflammation and it predisposes to cholangiocarcinoma due to lack of effective treatment options.Recombinant adeno-associated virus(rAAV)provides a promising platform for gene therapy on such kinds of diseases.A microRNA(miRNA)let-7a has been reported to be associated with the progress of PSC but the potential therapeutic implication of inhibition of let-7a on PSC has not been evaluated.AIM To investigate the therapeutic effects of inhibition of a miRNA let-7a transferred by recombinant adeno-associated virus 8(rAAV8)on a xenobiotic-induced mouse model of sclerosing cholangitis.METHODS A xenobiotic-induced mouse model of sclerosing cholangitis was induced by 0.1% 3,5-Diethoxycarbonyl-1,4-Dihydrocollidine(DDC)feeding for 2 wk or 6 wk.A single dose of rAAV8-mediated anti-let-7a-5p sponges or scramble control was injected in vivo into mice onset of DDC feeding.Upon sacrifice,the liver and the serum were collected from each mouse.The hepatobiliary injuries,hepatic inflammation and fibrosis were evaluated.The targets of let-7a-5p and downstream molecule NF-κB were detected using Western blot.RESULTS rAAV8-mediated anti-let-7a-5p sponges can depress the expression of let-7a-5p in mice after DDC feeding for 2 wk or 6 wk.The reduced expression of let-7a-5p can alleviate hepato-biliary injuries indicated by serum markers,and prevent the proliferation of cholangiocytes and biliary fibrosis.Furthermore,inhibition of let-7a mediated by rAAV8 can increase the expression of potential target molecules such as suppressor of cytokine signaling 1 and Dectin1,which consequently inhibit of NF-κB-mediated hepatic inflammation.CONCLUSION Our study demonstrates that a rAAV8 vector designed for liver-specific inhibition of let-7a-5p can potently ameliorate symptoms in a xenobiotic-induced mouse model of sclerosing cholangitis,which provides a possible clinical translation of PSC of human.

Clinical Application and Prospect of New Radiotherapy Technology in Cancer Treatment

Objective: Carbon ion therapy, a new radiotherapy technology, has shown its remarkable efficacy and potential in cancer treatment, especially in the treatment of refractory tumors. Methods: This paper clarifies the physical basis, technological change, and clinical practice effect of carbon ion therapy, comprehensively discusses the future prospects, and evaluates the clinical application effect. Results: The technology has significantly improved the treatment effectiveness and received a positive response from patients. Conclusion: Carbon ion therapy technology has become a major innovation in the field of cancer treatment. It not only has a profound impact on many current cancer therapy methods but also indicates the application blueprint for a wider range of cancer types in the future, showing a new chapter of medical technology advancement.

Clinical Study on Respiratory Medicine Treatment of Chronic Obstructive Pulmonary Disease Combined with Respiratory Failure

Objective:To explore the respiratory medicine treatment methods for treating chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:70 cases of COPD patients with combined respiratory failure admitted to our hospital from January 2021 to January 2023 were selected as the study subjects,and randomly divided into the control group and the experimental group,each with 35 cases.The control group received only conventional treatment,and the experimental group received non-invasive positive pressure ventilation,and the treatment effects and changes in the levels of IL-18,hs-CRP,and CES2 inflammatory factors were observed and evaluated in the two groups.Results:There was no significant difference between the general data of the two groups(P>0.05);after treatment,the total effective rate of clinical efficacy of the observation group(91.43%)was significantly higher than that of the control group(71.43%),and the difference showed a significant correlation(P<0.05);after treatment,the level of inflammatory factor of the observation group was significantly reduced compared with that of the control group,and the difference showed a highly significant correlation(P<0.001).Conclusion:The non-invasive positive pressure ventilation treatment program significantly improves the therapeutic effect,effectively controls the level of inflammatory factors,and improves the health status of patients when dealing with patients with chronic obstructive pulmonary disease accompanied by respiratory failure,showing a good clinical application prospect.

Comparative study on the anti-tuberculous effect and mechanism of the traditional Chinese medicines NiuBeiXiao He extract and JieHeWan

Background:The traditional Chinese medicine NiuBeiXiaoHe(NBXH)extract and Chinese medicine preparation JieHeWan(JHW)exhibit anti-tuberculosis(TB)effects.The anti-TB effect of NBXH was compared with that of JHW to elucidate the mechanism of action of NBXH.Methods:BALB/c mice aged 6-8 weeks were randomly divided into a normal control group,TB model group,JHW treatment group,and NBXH treatment group.After 3 and 13 weeks of treatment,the therapeutic effect in each group was evaluated by comparing lung histopathology,lung and liver colony counts,the number of spots representing effector T cells secreting IFN-γin an enzyme-linked immunospot assay(ELISPOT),and the levels of Th1,Th2,and Th17 cytokines,which were measured by a cytometric bead array(CBA).Mouse RNA samples were subjected to transcriptome sequencing.Results:After 13 weeks of treatment,the mean histopathological lesion area of the NBXH group was significantly smaller than that of the TB model group(P<0.05).Compared with those in the TB model group,the lung colony counts in the JHW and NBXH groups were significantly decreased(P<0.05),and the IL-2 and IL-4 levels in the NBXH group were significantly increased(P<0.05).NBXH partly restored significant changes in gene expression caused by Mycobacterium tuberculosis(M.tuberculosis)infection.According to GO and KEGG analyses,the changes in biological process(BP),cell composition(CC)and molecular function(MF)terms and in signaling pathways caused by NBXH and JHW treatment were not completely consistent,but they were mainly related to the immune response and inflammatory response in the mouse TB model.Conclusions:NBXH had therapeutic effects similar to those of JHW in improving lung histopathology,reducing lung colony counts,and regulating the levels of cytokines.NBXH restored significant changes in gene expression and repaired cell damage caused by M.tuberculosis infection by regulating immune-related pathways,which clarified the mechanism of action of NBXH.

Observation on the Therapeutic Effects of Acupuncture for 60 Cases of Simple Obesity

Simple obesity refers to a disease characterized by body overweight due to excessive calorie intake and over accumulation of adipose tissue in the body. With the improvement of life conditions, obesity has become a factor that impairs the health of the people. From 1997 to 1998, the author had treated 60 cases of simple obesity with acupuncture and obtained satisfactory results. The results of treatment are reported as follows.

Therapeutic Effect of Shenfu Injection (参附注射液) on Secondary Aplastic Anemia of Tumor Patients after Chemotherapy

Objective: To explore the effect of Shenfu Injection (参府注射液, SFI) on the secondary aplastic anemia (AA) of tumor patients after chemotherapy (CT). Methods: The 15 cases of SFI treated group, 10 cases of control group, 25 cases of SFI + granulocyte-macrophage colony stimulating factor (GM-CSF) treated group and the group of 23 GM-CSF-treated tumor cases of secondary AA after CT were compared, with their increasing rate and the rebound speed of neutrophil, platelet, bone marrow nucleated RBC, granulocyte, and megakaryocyte all being investigated. Results: The increasing rate and rebound speed of granulocyte, platelet, and the increasing rate of bone marrow nucleated RBC, granulocyte, megakaryocyte were obviously higher than those of the control, and the clinical manifestations were also obviously improved. The increasing rate of platelet, bone marrow nucleated RBC, megakaryocyte of the SFI + GM-CSF group were higher than those of the group which used GM-CSF alone, while the increasing rate of granulocyte in blood and bone marrow in both groups was similar. Conclusion: Significant efficacy was shown in SFI for the treatment of secondary AA of tumor patients after CT.

Effect of Epalrestat combined with Huoxue Huayu preparation on early diabetic retinopathy and its effect on serum oxidative stress and inflammatory factors

Objective:To investigate the effect of Epalrestat combined with Huoxue Huayu preparation on early diabetic retinopathy and its effect on serum oxidative stress and inflammatory factors.Methods:132 patients with early diabetic retinopathy from June 2017 to July 2019 in our hospital were randomly divided into the control group(66 cases)and the observation group(66 cases);The control group was treated with epalrestat,and the observation group was treated with epalrestat combined with ginkgo damo injection;The treatment effect,blood rheology indexes,serum oxidative stress indexes and inflammatory factor indexes of the two groups were compared.Results:The treatment efficiency of the observation group(96.96%)was significantly higher than that of the control group(84.84%)(P<0.05).After 3 months of treatment,the high-cut whole blood viscosity(3.62±0.45 mPa/s),low-cut whole blood viscosity(1.54±0.26 mPa/s),erythrocyte sedimentation rate(15.63±2.97 mm/s)of the observation group compared with the control group(4.57±0.52 mPa/s,2.91±0.30 mPa/s,22.36±3.38 mm/s)were significantly lower(P<0.05).After 3 months of treatment,the SOD(93.41±10.17 nmol/mL)and TAC(20.57±3.76 u/mL)of the observation group compared with the control group(82.26±9.45 nmol/mL,18.26±3.63 u/mL)were significantly higher(P<0.05),and the MDA of the observation group(9.22±1.98 u/mL)was significantly lower than that of the control group(12.13±1.06 u/mL)(P<0.05).After 3 months of treatment,the CRP(9.74±1.12 mg/L),IL-2(70.37±12.13 ng/L),TNF-a(11.36±2.08 ng/L)of the observation group compared with the control group(15.28±1.73 mg/L L,82.46±10.58 ng/L,16.28±2.43 ng/L)were significantly lower(P<0.05).Conclusion:Epalrestat combined with Huoxue Huayu preparation is more effective in the treatment of early diabetic retinopathy,and can significantly improve the blood rheology indexes,serum oxidative stress indexes and inflammatory factor indexes of patients.

Therapeutic effect of mesenchymal stem cells from different sources in the treatment of liver diseases

Hepatitis B Virus(HBV)is still one of the important problems threatening the health and safety of human life.If the virus can not be effectively controlled,it will gradually evolve into chronic hepatitis.Chronic hepatitis will not be treated for a long time,and will gradually develop into liver fibrosis,cirrhosis,liver cancer or even liver failure and other diseases with poor prognosis.However,there is no specific western medicine treatment for liver fibrosis,cirrhosis and other liver diseases.The main treatment methods are symptomatic treatment,internal medicine comprehensive treatment and prevention of complications.In recent years,the medical technology has been continuously developed and improved,scholars at home and abroad have focused on the effective ways to prevent and treat liver diseases.More and more studies have confirmed the mesenchymal stem cells Cell(MSC)plays an important role in the treatment of liver diseases.The author will describe the therapeutic effect of MSC from different sources on liver diseases.

Effects of Pak Ning Powder and Oral Liquid Treating Chicken Infectious Laryngotracheitis

[ Objective] To investigate the therapeutic effects of Chinese herbal medicine compound preparation ＂Pak Ning＂ on chicken infectious la- ryngotracheitis. E Methodl ＂Pak Ning＂ with different dosage forms and dosage time were used to carry out clinical observation of artificial infectious and natural infectious ILT of chickens. [ Result] The therapeutic efficacy of ＂Pak Ning＂ oral liquid water was better than powder with high cure rate, the difference was significant （P〈0.05）. compared with Ribavirin, the difference was significant （P 〈0.01 ）, and the preventive effects of feeding in advance were very well. I Conctusionl ＂Pak Ning＂ plays an important role in the treatment and prevention of ILl- with strong infectiosity and high mortality.

Potential therapeutic effects of thymoquinone on treatment of amphetamine abuse

Dear Editor,The prevalence of drug abuse has diverted from traditional drugs such as opioid and cannabis to modern,synthetic and psychoactive drugs such as amphetamine groups,the amphetamine(AT)and methamphetamine[1].Amphetamine is used medically to treat several disorders such as attention deficit hyperactivity disorder,narcolepsy,depression and minor obesity[2].However,AT has also gained

Therapeutic Effects of Tongxinluo Capsule(通心络胶囊) on Patients with Acute Small Oerebral Infarction and Its Influence on SPECT Brain Periusion Image

Objective: To investigate the influence of Tongxinluo capsule (TXL,通心络胶囊) on regional cerebral blood flow (rCBF) with 99mTc-ECD single photon emission computed tomography (SPECT) brain perfusion imaging, and to observe the therapeutic effects of TXL on acute small cerebral infarction (ASCI). Methods: Thirty-four patients with ASCI were enrolled and randomly divided into two groups: the control group (n = 17) was treated with the conventional treatment, i.e. 1. Og of Citicoline added into 300 ml normal saline for intravenous dripping daily for 2 weeks and 0. 8 g of Piracetam taken three times a day orally for 4 weeks, and the treatment group (n = 17) was treated additionally with 4 TXL capsules three times a day for 4 weeks besides the conventional treatment. The 99mTc-ECD SPECT brain perfusion imaging was performed before and after treatment to observe the change of rCBF, and the neurological deficit was evaluated by Edinburgh-Scandinavia stroke scale (SSS) scores and Barthel index (Bl) at the same time. Results: After treatment, the rCBF in the treatment group was significantly improved (P<0. 01), while that in the control group remained unchanged, with the comparison of the rCBF in the two groups after treatment showing significant difference (P<0.01). In addition, the SSS score was significantly lower and Bl significantly higher in the treatment group than those in the control group respectively after treatment. Conclusion: TXL could effectively improve rCBF and lessen the neurological deficit symptoms in patients with ASCI.

Neuregulin 1 isoforms could be an effective therapeutic candidate to promote peripheral nerve regeneration

Traumatic injuries of peripheral nerves represent common casualties and their social impact is considerably high. Although peripheral nerves retain a good regeneration potential, the clinical outcome after nerve lesion is far from being satisfactory and functional recovery is almost never complete, especially in the case of large nerve defects, that result in loss or diminished sensitivity and/or motor activity of the innervated target organs. Therefore, to improve the outcome after nerve damage, or in peripheral neuropathies, there is a need for further research in nerve repair and regeneration to identify factors that promote axonal regrowth, remvelination and target reinnervation.

Therapeutic effect of a dualchamber pacemaker with the optimized program-control mode on long-qt syndrome

Objectives To explore the optimized program-control mode of a dual-chamber pacemaker combined withβ-blocker to treat congenital long QT syndrome(LQTS). Methods 12 LQTS patients in our hospital that still have symptoms despite use of regular drug therapies or that can not endure the therapies were implanted with DDD cardiac pacemaker.The QT/QTc intervals of those patients were measured at different pacing rates respectively.Their cardiac pacemakers were all programmed to selectively turn on and turn off some related functions at the pacing rate of 80 beats/min.The dosage ofβ-blockers was adjusted according to the patients’ PR intervals and blood pressures.The MACE and the cardiac function of the patients were recorded after operation.Results The measured QT / QTc interval decreased with the pacing rate increasing.The pacing rate of 80 beats/min can make QT/QTc interval basically normal. The MACE of the patients were statistically declined(P = 0.003) and no negative effect on cardiac function was found during the follow-up.Conclusions The optimized program-control mode of a dual-chamber pacemaker combined withβ-blocker to treat congenital LQTS are:to pace at the rate of 80 beats/min and program to turn off lag,sleep,automatic preventing PMT and automatic threshold-capture feature and turn on the PVC,rate adaptation and atrioventricular node priority function.