Efficacy and safety of Yangxue Qingnao Granules in treatment of migraine:A systematic review and meta-analysis

BACKGROUND Yangxue Qingnao Granules(YXQN)is a Chinese patent medicine that has been commonly used in the clinical treatment of migraine.AIM To assess the efficacy and safety of YXQN alone for the treatment of migraine.METHODS We searched 10 databases to identify relevant randomized controlled trials(RCTs)published before September 2022.Two review authors independently searched and screened the literature,extracted the data,and assessed the methodological quality of the studies using criteria from ROB 2.0,and analyzed the data using Review Manager 5.4 software.RESULTS A total of 12 RCTs including 767 participants with migraine met the selection criteria.We divided these studies into comparisons of YXQN with placebo,routine treatment drugs,and other Chinese patent medicines.The meta-analysis showed the following:(1)Efficacy:The YXQN group outperformed the placebo group[relative risk(RR)=0.29,95%confidence interval(95%CI):0.15–0.43,P<0.00001],routine treatment group(RR=0.18,95%CI:0.09–0.27,P<0.0001),and Chinese patent medicine group(RR=0.27,95%CI:0.13–0.41,P<0.001);(2)frequency of headache:There was a significant difference between YXQN vs placebo[mean difference(MD)=-1.25,95%CI:-1.60 to-0.90,P<0.00001],routine treatment drugs(MD=-0.85,95%CI:-1.15 to-0.56,P<0.00001),and Chinese patent medicine(MD=-0.91,95%CI:-1.35 to-0.46,P<0.0001);(3)headache duration:We found great heterogeneity between studies,with no differences between YXQN and placebo(MD=-0.61,95%CI:-1.53 to-0.31,P=0.19)and routine treatment drugs(MD=-0.22,95%CI:-0.89 to 0.46,P<0.53).YXQN was more effective than other Chinese patent medicines in reducing headache duration(MD=-1.24,95%CI:-1.70 to-0.77,P<0.00001);and(4)headache severity:There was no significant difference between YXQN vs placebo(MD=-1.67,95%CI:-3.52 to 0.19,P=0.08),routine treatment drugs(MD=-0.53,95%CI:-2.02 to 0.96,P=0.68),and other Chinese patent medicines(MD=-0.49,95%CI:-2.83 to 1.85,P=0.68).Mild gastrointestinal adverse reactions were reported in three cases.CONCLUSION This study revealed that YXQN is effective and safe for treatment of migraine.

Interview with Dr. Liu Qingquan: Traditional Chinese Medicine for COVID-19 Diagnosis and Treatment

To many of us,2020 was a remarkably difficult and challenging year.The whole world experienced a sudden,unexpected outbreak of COVID-19.According to the Zhong Guo Yi Bing Shi Jian(《中国疫病史鉴》History of Epidemics in China),there have been a total of 321 pandemics throughout the history of China ever since the Western Han dynasty(202 BCE–8 CE).

Influence of Acupuncture on Autonomic Balance in Adult Tinnitus Patients:An Exploratory Study

Acupuncture is an alternative therapy for tinnitus in clinical practice.The mechanism by which acupuncture can alleviate tinnitus is still unknown.Autonomic nervous system was reported to be responsible for tinnitus.The aim of this study was to explore the effect of acupuncture on autonomic balance in adult tinnitus patients.Thirty patients were randomly assigned into either the deep acupuncture(DA)group or the shallow acupuncture(SA)group.Each patient received 6 acupuncture sessions(a-f phase)over three weeks.Measures of heart rate variability and Tinnitus Handicap Inventory(THI)were obtained at baseline and after the sixth acupuncture session in all patients.The results showed that the low frequency/high frequency(LF/HF)pattern was increased at b-f phase until the sixth acupuncture session when compared with that at the first acupuncture session in DA group.However,it continuously increased at b-f phase in SA group even at the sixth acupuncture session,which was not significantly different from that at the first acupuncture session.The decrease in THI in DA group was greater than that in SA group after 3-week treatment(P=0.043).Our preliminary study suggests three-week deep acupuncture can improve tinnitus symptoms in adult tinnitus patients,which may be related to the regulation of autonomic nervous system balance.

Immediate analgesia effect of contralateral needling at Tiaokou (ST38) in patients with chronic shoulder pain: A randomized controlled exploratory trial

Objective:To compare the immediate effect of acupuncture at the contralateral versus ipsilateral Tiaokou (ST38) in patients with Chronic shoulder pain (CSP).Method:Altogether,38 patients with unilateral CSP were randomly assigned to a contralateral ST38 group (Contra group) or ipsilateral ST38 group (Ipsi group).Each underwent 20 min of manual acupuncture:Contra group at the contralateral ST38,Ipsi group at the ipsilateral ST38.Primary outcome measure was the visual analog scale (VAS) score.Secondary outcome measure for assessing shoulder mobility was the Constant-Murley (CM) score,which included pain level,activities of daily living (ADL),and shoulder range of motion (RONM).These factors were assessed before and immediately after acupuncture.A value of P <.05 indicated significance.Results:VAS scores decreased immediately after treatment in both groups,but the effect was significantly greater in the Contra group (P =.043).CM scores also improved in both groups,but the Contra group improved significantly more (P =.002).The CM's pain and ADL scores were similar in the two groups (P =.055 and P =.193,respectively),but ROM and strength scores were better in the Contra group than in the Ipsi group (P =.003 and P =.037,respectively).No adverse effects were reported.Conclusion:The immediate effect of acupuncture at the contralateral ST38 may be superior to that at the ipsilateral ST38 in CSP patients.

Acupuncture and regulation of gastrointestinal function

In China, acupuncture has been considered an effective method for treating gastrointestinal(GI) dysfunction diseases for thousands of years. In fact, acupuncture has gained progressive acceptance from both practitioners and patients worldwide. However, the therapeutic effects and underlying mechanisms in treating GI dysfunction have not yet been established due to a lack of systematic and comprehensive review articles. Therefore, the aim of this review is to discuss the efficacy of acupuncture as a treatment for GI dysfunction and the associated underlying mechanisms. A search of Pub Med was conducted for articles that were published over the past 10 years using the terms "acupuncture", "gastrointestine", and other relevant keywords. In the following review, we describe the effect and underlying mechanisms of acupuncture on GI function from the perspectives of GI motility, visceral sensitivity, the GI barrier, and the brain-gut axis. The dual regulatory effects of acupuncture may manifest by promoting gastric peristalsis in subjects with low initial gastric motility, and suppressing peristalsis in subjects with active initial motility. In addition, the regulation of acupuncture on gastric motility may be intensitydependent. Our findings suggest that further studies are needed to investigate the effects and more systematic mechanisms in treating GI dysfunction, and to promote the application of acupuncture for the treatment of GI diseases.

Effects of Hemp seed soft capsule on colonic ion transport in rats

AIM To investigate the effect of Hemp seed soft capsule(HSCC) on colonic ion transport and its related mechanisms in constipation rats.METHODS Sprague-Dawley male rats were randomly divided into three groups: normal group, constipation group and HSSC group. Rats in the constipation and HSSC groups were administrated loperamide 3 mg/kg per day orally for 12 d to induce the constipation model. Then, the HSSC group was given HSSC 0.126 g/kg per day by gavage for 7 d. The normal and constipation groups were treated with distilled water. After the treatment, the fecal wet weight and water content were measured. The basal short-circuit current(Isc) and resistance were measured by an Ussing Chamber. Besides the in vivo drug delivery experiment above, an in vitro drug application experiment was also conducted. The accumulative concentrations of HSSC(0.1 mg/m L, 0.5 mg/m L, 1.0 mg/m L, 2.5 mg/m L, 5.0 mg/m L, 10.0 mg/m L and 25.0 mg/m L) were added to the normal isolatedcolonic mucosa and the Isc was recorded. Further, after the application of either ion(Cl^-or HCO_3^-) substitution, ion channel-related inhibitor(N-phenylanthranilic acid, glybenclamide, 4,4-diisothiocyano-2,2-stilbenedisulfonic acid or bumetanide) or neural pathway inhibitor [tetrodotoxin(TTX), atropine, or hexamethonium], the Isc induced by HSSC was also measured. RESULTS In the constipation group, the fecal wet weight and the water content were decreased in comparison with the normal group(P < 0.01). After the treatment with HSSC, the fecal wet weight and the water content in the HSSC group were increased, compared with the constipation group(P < 0.01). In the constipation group, the basal Isc was decreased and resistance was increased, in comparison with the normal group(P < 0.01). After the treatment with HSSC, the basal Isc was increased(P < 0.05) and resistance was decreased(P < 0.01) in the HSSC group compared with the constipation group. In the in vitro experiment, beginning with the concentration of 1.0 mg/m L, differences in Isc were found between the experimental mucosa(with HSSC added) and control mucosa. The Isc of experimental mucosa was higher than that of control mucosa under the same concentration(1.0 mg/m L, P < 0.05; 2.5-25 mg/m L, P < 0.01). After the Cl^-or HCO_3^-removal and pretreated with different inhibitors(c AMPdependent and Ca^(2+)-dependent Cl^-channels, Na^+-K^+-2 Cl^-cotransporter(NKCC), Na^+-HCO_3^-cotransporter or Cl^-/HCO_3^-exchanger inhibitor), there were differences between experimental mucosa and control mucosa; the Isc of experimental mucosa was lower than that of control mucosa under the same concentration(P < 0.05). Meanwhile, after pretreatment with neural pathway inhibitor(TTX, atropine, or hexamethonium), there were no differences between experimental mucosa and control mucosa under the same concentration(P > 0.05).CONCLUSION HSSC ameliorates constipation by increasing colonic secretion, which is mediated via the coaction of c AMPdependent and Ca^(2+)-dependent Cl^-channels, NKCC, Na^+-HCO_3^-cotransporter or Cl^-/HCO_3^-exchanger.

Randomized controlled study of a diagnosis and treatment plan for moderate coronavirus disease 2019 that integrates Traditional Chinese and Western Medicine

OBJECTIVE:To investigate the clinical efficacy and safety of a diagnosis and treatment plan for moderate coronavirus disease 2019(COVID-19)that integrates traditional Chinese(TCM)and western medicine.METHODS:One hundred twenty patients with moderate COVID-19 were randomized 1∶2 to the control group(n=40)and experimental group(n=80).Both groups received conventional western medicine treatment,and the experimental group also received TCM decoction.Over a 2-week period from diagnosis,we observed the time to clinical recovery(TTCR),rate of improvement on lung computed tomography(CT)imaging,time to defervescence,cough remission time,hospital discharge rate,average hospitalization stay,modified Medical Research Council(m MRC)scale score,clinical cure rate,laboratory findings,incidence of progression to severe or critical disease,and adverse events.RESULTS:Among 120 enrolled patients,108 completed the study.The baseline data did not differ between the experimental and control groups(all P>0.05).After treatment,the TTCR,rate of lung CT imaging improvement,time to defervescence,cough remission time,hospital discharge rate,average hospitalization stay(among discharged patients),m MRC scale score,clinical cure rate,and rates of normal values for laboratory findings were better in the experimental group than in the control group(P<0.05 or<0.01).The incidence of progression to severe or critical disease and the incidence of adverse events did not differ between the two groups(P>0.05).CONCLUSION:The diagnosis and treatment plan integrating Chinese and western medicine showed improved clinical efficacy compared with western medicine alone for patients with moderate COVID-19 and is worthy of clinical promotion and application.

Applying latent tree analysis to classify Traditional Chinese Medicine syndromes(Zheng)in patients with psoriasis vulgaris

OBJECTIVE:To treat patients with psoriasis vulgaris using Traditional Chinese Medicine(TCM),one must stratify patients into subtypes(known as TCM syndromes or Zheng)and apply appropriate TCM treatments to different subtypes.However,no unified symptom-based classification scheme of subtypes(Zheng)exists for psoriasis vulgaris.The present paper aims to classify patients with psoriasis vulgaris into different subtypes via the analysis of clinical TCM symptom and sign data.METHODS:A cross-sectional survey was carried out in Beijing from 2005-2008,collecting clinical TCM symptom and sign data from 2764 patients with psoriasis vulgaris.Roughly 108 symptoms and signs were initially analyzed using latent tree analysis,with a selection of the resulting latent variables then used as features to cluster patients into subtypes.RESULTS:The initial latent tree analysis yielded a model with 43 latent variables.The second phase of the analysis divided patients into three subtype groups with clear TCM Zheng connotations:'blood deficiency and wind dryness';'blood heat';and'blood stasis'.CONCLUSIONS:Via two-phase analysis of clinic symptom and sign data,three different Zheng subtypes were identified for psoriasis vulgaris.Statistical characteristics of the three subtypes are presented.This constitutes an evidence-based solution to the syndromedifferentiation problem that exists with psoriasis vulgaris.

Spatholobus suberectus column extract inhibit estrogen receptor positive breast cancer

OBJECTIVE To investigate the inhibitory effects of Spatholobus Suberectus Column Extract(SSCE)on estrogen receptor positive(ER+)breast cancer cel MCF-7and its possible molecular mechanism.METHODS MCF-7cells were cultured without estrogen and with 17-β-estrogen(10-8mol·L-1),respectively,then treated with SSCE(0,40,80,160,320μg·m L-1).MTT assay was employed to evaluate cell viability.Flow cytometry assays were performed to underlying apoptosis and detecting cel cycle of MCF-7 cells treated with SSCE(0,80,160,320μg·mL-1).Wound healing assays was conducted to detect the migration ability.Dual luciferase reporter system was used to detect the activity of p-ERα,p-ERβpresented in intra-nuclear estrogen response element(ERE).Western blotting assay was employed to identify the expression of protein such as Bax,Bcl-2,p-ERα,p-ERβ,ERK1/2,p-ERK1/2,AKT,p-AKT,m TOR,p-m TOR,PI3K,p-PI3K.RESULTS It showed that SSCE(80,160and 320μg·mL-1)significantly decreased the viability of MCF-7.SSCE also triggered apoptosis,arrested cell cycle at G0/G1phase,inhibited migration.Dual luciferase reporter system showed that SSCE suppressed intra-nuclear p-ER activity,Western blotting analysis confirmed that SSCE did repress the expression of phosphorylated-ER alpha(p-ERα),ERK1/2,p-ERK1/2,AKT,p-AKT,pmT OR,PI3K,p-PI3K,which indicate that SSCE suppress MAPK PI3K/AKT signal pathway.CONCLUSION Our result showed that SSCE cause ER+MCF-7 cells apoptosis,G0/G1phase arresting,migration decreasing,via hypo-active of ER,suppress MAPK PI3K/AKT pathway.

Action mechanism of Yiqi Hexue Formula in the treatment of liver cirrhosis based on network pharmacology and experimental verification

Objective:To study the mechanism of Yiqi Hexue Formula in the treatment of liver cirrhosis based on network pharmacology and experimental verification.Methods:Firstly,the effective components and action targets of various traditional Chinese medicines in Yiqi Hexue Formula were searched from TCMSP and BATMAN-TCM databases.The disease target genes were obtained by using GeneCard,PharmGkb,OMIM,DrugBank and TTD databases.The potential target genes of drugs and disease target genes were intersected,and the Venn diagram was drawn.The"active ingredient-core target"network was constructed by Cytoscape software,and the KEGG pathway of the intersection genes was analyzed by R software.Animal experiments were conducted to observe the effect of Yiqi Hexue Formula on histopathology of CCl4-induced liver cirrhosis model rats,determine the expression levels of JAK2 and STAT3 mRNA in liver tissue,and preliminarily explore the mechanism of Yiqi Hexue Formula in the treatment of liver cirrhosis.Results:A total of 43 active components and 648 targets of Yiqi Hexue Formula for the treatment of liver cirrhosis were screened through the database.KEGG pathway analysis showed that Yiqi Hexue Formula mainly affected PI3K/Akt,MAPK,IL-17 and JAK/STAT signaling pathway.Animal experimental research showed that compared with the model group,the degree of inflammation and fibrosis in liver tissue of rats treated with Yiqi Hexue Formula was significantly improved;The expression of JAK2 and STAT3 mRNA decreased significantly in the treatment group of Yiqi Hexue Formula(P<0.05).Conclusion:Yiqi Hexue Formula can treat liver cirrhosis through multiple components,multiple targets and multiple pathways.JAK2/STAT3 signaling pathway is involved in the formation of liver cirrhosis.Yiqi Hexue Formula can improve the pathological manifestations of cirrhotic rats.Its mechanism may be related to inhibiting the transmission of JAK2/STAT3 signaling pathway.

Professor Xudong Tang's experience in the treatment of gastroesophageal reflux

Professor Xudong Tang believes that definite diagnosis is the key to gastroesophageal reflux disease treatment,and the treatment of refluxesophagitis should be combined with PH monitoring and clinical symptoms differentiation.Generally,according to the degree of acid regurgitation,it can be divided into different traditional Chinese medical syndromes:the liver-stomach depressionheat syndrome differentiation is the main type of acid regurgitation,while the liver-qi stagnation is the main type of acid regurgitation.In addition,attention should be paid to the step-down therapy of combination of traditional Chinese and Western medicine in the process of discontinuation.The lower efficacy of Western medicine should be used successively,together with traditional Chinese medicine Decoction,which can often achieve the effect of stopping recurrence.In addition,the traditional Chinese medicine prescription imitates Jianhua Dong's well-known old Chinese medicine thought,believing that the pathogenesis of gastroesophageal reflux disease is mainly Qi stagnation,the location of the disease is in the stomach,involving the liver and spleen.On the basis of Dr Dong Ganwei Baihe Decoction,the experience of treating gastroesophageal reflux disease with Lianzhu Liuyi Pill combined with Huagan Decoction was summarized.

Antispasmodic effect of Bupi Yichang pill on colonic contraction of rats in vitro

Objective:To investigate the pharmacological effect of Bupi Yichang (BPYX) pill on colonic contraction of rats and explore its underlying mechanism.Methods:The experiments were performed on colonic longitudinal smooth muscle strips (CLSMs) under isometric conditions.CLSMs suspended in tissue chambers were stimulated by KCl (80 mM) or acetylcholine (ACh,0.1 mM),or exhausting intracellular Ca2+ and internal flow of extracellular Ca2+ to induce muscle contraction and their responses to different doses of BPYX pill were observed.After that,incubation with different inhibitors was conducted to verify its underlying mechanism.Results:Bupi Yichang pill dose-dependently and reversibly inhibited colonic contraction.The antispasmodic effect of BPYC pill was partially blocked by 3,4,5-trimethoxybenzoic acid 8-(diethylamino)octyl ester hydrochloride (TMB-8,an intracellular Ca2+ antagonist,500 μM),thapsigargin (a non-competitive inhibitor of the sarco/endoplasmic reticulum Ca2+ ATPase,1 μM),and nifedipine (a voltage-dependent Ca2+ channel blocker,10 μM) (P <.05).However,there were no significant difference after incubation with ethylene glycol tetraacetic acid (EGTA,a calcium chelating agent,1 mM),4-aminopyridine (4-AP,a potassium channel blocker,50 μM),NG-nitro-L-arginine methyl ester (L-NAME,an inhibitor of nitric oxide synthase,10 mM),methylene blue (an inhibitor of cyclic guanosine monophosphate,10 μM) and apamin (a selectire blocker of Ca2+-activated K+ channel,0.1 μM) (P >.05).Conclusion:Bupi Yichang pill could inhibit colonic contraction of rats in vitro and its antispasmodic effect might be partially mediated by calcium channels.

Medicine in Future and Advantages of Integrated Chinese and Western Medicine

The history of medical development shows that oriental medicine, or traditional medicine, was born through medical practice during the times when science and technology were immature and underdeveloped, whereas with the development of science and technology, Western medicine, or modern medicine, was born through experimental analysis and research. With the development of medicine, the pros and cons of both medical systems become increasingly evident. How to integrate them and learn from each other will be the direction of future development of medicine. The formation and development of integrated medicine will, inevitably, usher in a new era for medicine.

Effects of Acupuncture on Chinese Medicine Syndromes of Vascular Dementia

Objective： To study the effects of acupuncture on Chinese medicine syndromes of vascular dementia （VaD）. Methods： Sixty-three VaD patients were divided into three groups. Those willing to be randomized were randomly assigned to receive either acupuncture （random acupuncture group, 24 cases） or rehabilitation training （guided rehabilitation group, 24 cases） for 6 weeks. Those unwilling to be randomized also received acupuncture for 6 weeks （non-random acupuncture group, 19 cases）. Patient syndromes and their severity were evaluated before treatment （baseline）, at the end of treatment, and at 4-week follow-up after the completion of treatment using a CM scoring system （scale of differentiation of syndromes of vascular dementia, SDSVD）. The SDSVD scores of the random and non-random acupuncture groups, and of all patients who received acupuncture （combined acupuncture group, 43 cases）, were compared with those in the guided rehabilitation group. Results： In the random, non-random, and combined acupuncture groups, SDSVD scores were significantly reduced at the end of treatment and at follow- up than at baseline. In the guided rehabilitation group, SDSVD scores were similar to baseline scores at the end of treatment and at follow-up. However, there were no significant differences in SDSVD scores among the three groups or between the combined acupuncture group and the guided rehabilitation group at any time points. In the non-random and combined acupuncture groups, SDSVD scores were significantly reduced at the end of treatment than at baseline in patients with hyperactivity of Liver （Gan）-yang or phlegm obstruction of the orifices. Conclusions： Acupuncture reduced the severity of VaD. The improvement was the greatest in patients undergoing their treatment of choice. Treatments in this study were more effective for excess syndromes, such as Liver-yang hyperactivity or phlegm obstruction of the orifices than deficiency syndromes, such as Kidney （Shen）-essence deficiency.

Mixture prepared with Chinese medicines in terms of releasing exterior cold and clearing interior heat: its efficacy and safety in patients with seasonal influenza-a randomized controlled trial

OBJECTIVE: To assess the efficacy and safety in 105 patients with seasonal Influenza in Beijing, the mixture prepared with Chinese medicines follows the treatment regimen of releasing exterior cold andclearing interior heat.METHODS: Total 330 patients with seasonal influenza were enrolled and randomly and averagely divided into the Chinese herbal medicine, the western medicine and the Chinese patent medicine group. They were treated with Chinese medicine Oseltamivir Phosphate Capsules and the Scattering Wind and Resolving Toxins Capsules. The main efficacy indicators were the antifebrile onset time and recovery time of body temperature. The efficacy and safety of the mixture was scientifically evaluated. Comparisons of several variables were analyzed.RESULTS: Median antifebrile onset time of the Chinese herbal medicine group was significantly shorter than the western medicine group(P < 0.05) and the Chinese patent medicine group(P < 0.05). The median antifebrile recovery time of the Chinese herbal medicine group was significantly shorter than the Chinese patent medicine group(P <0.05). The groups evaluated by TCM symptom pattern effect, both the Chinese herbal medicine group and Western Medicine group were better than the Chinese patent medicine group(P <0.05). The disappearance rate of main symptoms and some minor symptom patterns of the Chinese herbal medicine group were higher than the other 2 groups.CONCLUSION: The mixture of releasing exterior cold and clearing interior heat could significantly shorten the fever time with safety.

Chinese Medicine Yishen Jiangu Granules(益肾健骨颗粒)on Aromatase Inhibitor-Associated Musculoskeletal Symptoms

Objective： To assess the effectiveness of Yishen Jiangu Granules（益肾健骨颗粒, YSJGG） on aromatase inhibitor-associated musculoskeletal symptoms（AIMSS）. Methods： A single-arm, open-label study was conducted in 34 postmenopausal women with breast cancer who experienced AIMSS. Patients were treated with YSJGG for 12 weeks（12.4 g orally twice daily）. The primary outcome was a change in the mean worst pain score of Brief Pain Inventory-Short Form（BPI-SF） over 12 weeks, and the second outcomes included changes in pain severity and pain-related interference of BPI-SF and Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）, Modified Score for the Assessment of Chronic Rheumatoid Affections of the Hands（M-SACRAH）, the Functional Assessment of Cancer Therapy-Breast（FACT-B）, bone mineral density（BMD） and blood indices such as calcium（Ca）, phosphate（P）, and alkaline phosphatase（ALP）. Results： Of 37 women recruited, 30 initiated the therapy and 24 were evaluable at 12 weeks. The primary outcome（BPI-SF worst pain scores） achieved a 2.17-point reduction compared with baseline（5.75±1.87 vs 3.58±2.15, P〈0.01）. There were reductions in pain severity（decreased 1.65, P〈0.01） and pain-related interference（decreased 2.55, P〈0.01）. The changes in WOMAC and M-SACRAH scores were similar to BPI-SF（P〈0.05）. In the FACT-B, only physical wel-being and functional wel-being were improved compared with baseline（P〈0.05）. No clinical differences were found in BMD, Ca, P and ALP. Conclusion： YSJGG is an effective and wel-tolerated agent to reduce AIMSS.

Impact of inhaled corticosteroid use on elderly chronic pulmonary disease patients with community acquired pneumonia

To the Editor:With an aging global population,the incidences of community-acquired pneumonia(CAP)and chronic obstructive pulmonary disease(COPD)have signicantly increased.[1]Previous studies have conrmed that COPD and asthma are independently associated with the prevalence of CAP.The use of inhaled corticosteroid(ICS),the cornerstone of treatment for asthma,COPD with frequent acute exacerbations,and asthma-COPD overlap(ACO)may induce changes in the local lung microbiome and abnormal lung immunity,ultimately,causing a signicantly increased risk of pneumonia.However,in cases of pneumonia,the effect of the use of ICS on CAP mortality remains controversial.While data from one study favored the prior use of ICS,which was associated with a signicantly lower short-term mortality rate,[2]other studies have identied no impact on mortality.To date,data on the impact of the use of ICS on mortality,prehospitalization or during hospitalization,are scarce,particularly in the older population.Therefore,this multicenter,retrospective study explored the association between the use of ICS during hospitalization and short-term mortality in older patients with CAP and those with chronic pulmonary disease(CPD).

Efficacy and safety of Xinglouchengqi decoction for acute ischemic stroke with constipation:study protocol for a randomized con-trolled trial

OBJECTIVE: To investigate the efficacy and safety of Xinglouchengqi(XLCQ) decoction in treatment of acute ischemic stroke with constipation.METHODS: In this prospective, multicenter, assessor-blinded, randomized controlled trial, 360 eligible participants will be randomized to the XLCQ group or the control group. Participants in the XLCQ group will receive XLCQ decoction, while those in the control group will undergo clysis therapy using glycerin enemas or oral administration of lactulose solution. Both groups will undergo a treatment period of(5 ± 2) d and a 1-month follow-up.The primary outcome measure will be the Constipation Scale score. The secondary outcome measures will include scores on the National Institutes of Health Stroke Scale, the Traditional Chinese Medicine(TCM) Stroke Scale, the Diagnostic Scale for TCM Syndromes of Ischemic Stroke and TCM Scale for Syndrome of Phlegm-heat and Fu-organ Excess.Therapeutic mechanism outcomes and safety outcomes will also be assessed. Assessments will be conducted at baseline, at the end of the treatment period, and at the follow-up. Moreover, daily visits will be scheduled to grade the status of constipation during the treatment period.DISCUSSION: The results of this study will provide scientific and objective data with which to assess the efficacy and safety of XLCQ decoction for patients with acute ischemic stroke and constipation.

Efficacy of Gastrosis No.1 Compound on Functional Dyspepsia of Spleen and Stomach Deficiency-Cold Syndrome:A Multi-Center,Double-Blind,Placebo-Controlled Clinical Trial

To assess the efficacy and safety of Gastrosis No.1 compound in the treatment of functional dyspepsia with Spleen （Pi） and Stomach （Wei） deficiency-cold syndrome. Methods： A randomized, double-blind, placebo-controlled trial was performed in 5 centers. Patients with functional dyspepsia （FD） of Spleen-deficiency and qi-stagnation syndrome （162 cases） were randomly assigned to groups given Chinese herbal medicine （CHM） Gastrosis No.1 compound or placebo in a 2：1 ratio. This trial included a 4-week treatment period and a 4-week follow-up period. The outcomes were the dyspepsia symptom scores （measured by total dyspepsia symptom scale and single dyspepsia symptom scale） and syndromes of traditional Chinese medicine score （measured by traditional Chinese medicine syndrome scale）. The outcomes were noted at weeks 0, 4 and 8. Results： Compared with patients in the placebo group, patients in the CHM group showed significant improvement in the dyspepsia symptom scores as rated by patients and investigators （P〈0.01）, and also showed improvement in syndromes of traditional Chinese medicine score （P〈0.01）. No serious adverse event was reported. Safety tests obtained after 4 weeks of treatment showed no abnormal values. Conclusion： CHM Gastrosis No.1 compound was effective and safe in the treatment of functional dyspepsia with Spleen and Stomach deficiency-cold syndrome.

Angiogenesis and Hepatic Fibrosis： Western and Chinese Medicine Therapies on the Road

Hepatic fibrosis is a common feature of almost all chronic liver diseases. Formation of new vessels （angiogenesis） is a process strictly related to the progressive fibrogenesis which leads to cirrhosis and liver cancer. This review mainly concerns the relationship between angiogenesis and hepatic fibrosis, by considering the mechanism of angiogenesis, cells in angiogenesis, anti-angiogenic and Chinese medicine therapies.