Clinical Application of Gaofang(Medicated Paste)in Cardiovascular Disease

Gaofang(medicated paste),also known as gaoji in Chinese,is one of the eight dosage forms of traditional Chinese medicine.Originated in the Han and Tang dynasties,it is widely used in Shanghai,Jiangsu,Zhejiang,and Guangdong of China at present.It is generally believed that Gaofang can help reinforce deficiency,delay aging,and regulate the overall health status.Currently,Gaofang has been extensively used in the treatment of cardiovascular disease.Based on the relevant literature and clinical experience,this article reviews the general situation and the clinical application of Gaofang as well as the common Chinese medicines in Gaofang for cardiovascular diseases.

Brain-derived neurotrophic factor and its related enzymes and receptors play important roles after hypoxic-ischemic brain damage

Brain-derived neurotrophic factor(BDNF) regulates many neurological functions and plays a vital role during the recovery from central nervous system injuries. However, the changes in BDNF expression and associated factors following hypoxia-ischemia induced neonatal brain damage, and the significance of these changes are not fully understood. In the present study, a rat model of hypoxic-ischemic brain damage was established through the occlusion of the right common carotid artery, followed by 2 hours in a hypoxic-ischemic environment. Rats with hypoxic-ischemic brain damage presented deficits in both sensory and motor functions, and obvious pathological changes could be detected in brain tissues. The m RNA expression levels of BDNF and its processing enzymes and receptors(Furin, matrix metallopeptidase 9, tissuetype plasminogen activator, tyrosine Kinase receptor B, plasminogen activator inhibitor-1, and Sortilin) were upregulated in the ipsilateral hippocampus and cerebral cortex 6 hours after injury;however, the expression levels of these m RNAs were found to be downregulated in the contralateral hippocampus and cerebral cortex. These findings suggest that BDNF and its processing enzymes and receptors may play important roles in the pathogenesis and recovery from neonatal hypoxic-ischemic brain damage. This study was approved by the Animal Ethics Committee of the University of South Australia(approval No. U12-18) on July 30, 2018.

Single-nucleotide polymorphism screening and RNA sequencing of key messenger RNAs associated with neonatal hypoxic-ischemia brain damage

A single-nucleotide polymorphism(SNP)is an alteration in one nucleotide in a certain position within a genome.SNPs are associated with disease susceptibility.However,the influences of SNPs on the pathogenesis of neonatal hypoxic-ischemic brain damage remain elusive.Seven-day-old rats were used to establish a hypoxic ischemic encephalopathy model.SNPs and expression profiles of mRNAs were analyzed in hypoxic ischemic encephalopathy model rats using RNA sequencing.Genes exhibiting SNPs associated with hypoxic ischemic encephalopathy were identified and studied by gene ontology and pathway analysis to identify their possible involvement in the disease mechanism.We identified 89 up-regulated genes containing SNPs that were mainly located on chromosome 1 and 2.Gene ontology analysis indicated that the up-regulated genes containing SNPs are mainly involved in angiogenesis,wound healing and glutamatergic synapse and biological processing of calcium-activated chloride channels.Signaling pathway analysis indicated that the differentially expressed genes play a role in glutamatergic synapses,long-term depression and oxytocin signaling.Moreover,intersection analysis of high throughput screening following PubMed retrieval and RNA sequencing for SNPs showed that CSRNP1,DUSP5 and LRRC25 were most relevant to hypoxic ischemic encephalopathy.Significant up-regulation of genes was confirmed by quantitative real-time polymerase chain reaction analysis of oxygen-glucose-deprived human fetal cortical neurons.Our results indicate that CSRNP1,DUSP5 and LRRC25,containing SNPs,may be involved in the pathogenesis of hypoxic ischemic encephalopathy.These findings indicate a novel direction for further hypoxic ischemic encephalopathy research.This animal study was approved on February 5,2017 by the Animal Care and Use Committee of Kunming Medical University,Yunnan Province,China(approval No.kmmu2019038).Cerebral tissue collection from a human fetus was approved on September 30,2015 by the Ethics Committee of Kunming Medical University,China(approval No.2015-9).

Identification of Hypertension Subgroups through Topological Analysis of Symptom-Based Patient Similarity

Objective:To obtain the subtypes of the clinical hypertension population based on symptoms and to explore the relationship between hypertension and comorbidities.Methods:The data set was collected from the Chinese medicine(CM)electronic medical records of 33,458 hypertension inpatients in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine between July 2014 and May 2017.Then,a hypertension disease comorbidity network(HDCN)was built to investigate the complicated associations between hypertension and their comorbidities.Moreover,a hypertension patient similarity network(HPSN)was constructed with patients'shared symptoms,and 7 main hypertension patient subgroups were identified from HPSN with a community detection method to exhibit the characteristics of clinical phenotypes and molecular mechanisms.In addition,the significant symptoms,diseases,CM syndromes and pathways of each main patient subgroup were obtained by enrichment analysis.Results:The significant symptoms and diseases of these patient subgroups were associated with different damaged target organs of hypertension.Additionally,the specific phenotypic features(symptoms,diseases,and CM syndromes)were consistent with specific molecular features(pathways)in the same patient subgroup.Conclusion:The utility and comprehensiveness of disease classification based on community detection of patient networks using shared CM symptom phenotypes showed the importance of hypertension patient subgroups.

Effect of point application on chronic obstructive pulmonary disease in stationary phase and effects on pulmonary function:A systematic evaluation of randomized controlled trials

OBJECTIVE:To evaluate clinical efficacy of point application or adjuvant therapy on chronic obstructive pulmonary disease in stationary phase and effects on pulmonary functions.METHODS:Computer retrieved CNKI,VIP,CBM and other databanks and manual operations retrieved correlative literatures to find randomized controlled trials(RCTs) about comparison between point application or adjuvant therapy and no-point-applications for treatment of chronic obstructive pulmonary disease in stationary phase in China.RevMan 5.0 software was used for Meta analysis.RESULTS:Among 3481 cases in the inclusive 32 RCTS,1780 cases were in the test group and 1701 cases in the control group.Meta analysis indicated:1) clinical efficacy:the groups containing point application therapy all were better than the groups of no-point-application;2) force vital capacity(FVC):There was no statistically significant difference between the group of point application plus Western Medicine and the Western Medicine group;3) force expiratory volume 1(FEV1):The groups containing point application therapy were better than the no-point-application;4) FEV1%:the groups of point application plus Western Medicine were better than the Western Medicine groups;5) FEV1/FVC:there was a significant difference between the group of point application plus Chinese drugs and the group of Chinese drug.CONCLUSION:Point application can increase clinical efficacy of chronic obstructive pulmonary disease in stationary phase in varying degrees,and different combinations of point application with Chinese drugs or Western Medicines have incomplete same actions in improvement of pulmonary function and therapeutic effect.

Electroacupuncture Attenuates Ischemic Brain Injury and Cellular Apoptosis via Mitochondrial Translocation of Cofilin

Objective:To investigate the potential mechanisms of electroacupuncture(EA)to prevent ischemic stroke.Methods:The method of middle cerebral artery occlusion(MCAO)was employed to establish a rat model of ischemic stroke.Seventy-eight Sprague-Dawley rats were divided into the sham group,MCAO+EA control(EC)group,and MCAO+EA(EA)group according to a random number table(n=26 per group).EA was applied to the acupoints of Baihui(DU 20)and Shenting(DU 24)5 min and 6 h,respectively after the onset of MCAO for 30 min.Rats in the sham and EC groups received only light isoflurane anesthesia for 30 min after MCAO.The neuroprotective effects of EA were evaluated by rota-rod test,neurological deficit scores and infarct volumes.Additionally,Nissl staining and immunostaining were performed to examine brain damage,rod formation,cellular apoptosis,and neuronal loss induced by ischemia.The activities of caspase-3,and expression levels of cofilin and p-cofilin in mitochondria and cytoplasm after ischemic injury were determined by Western blot.Results:Compared with the EC group,EA significantly improved neuromotor function and cognitive ability after ischemic stroke(P<0.05 or P<0.01).Therapeutic use of EA also resulted in a significant decrease of cofilin rod formation and microtubule-associated protein-2(MAP2)degradation in the cortical penumbra area compared with the EC rats(P<0.01).Furthermore,Western blot analysis showed that EA stimulation significantly inhibited mitochondrial translocation of cofilin and caspase-3 cleavage(P<0.05 or P<0.01).Additionally,brain damage(infarct volume and neuropathy),cellular apoptosis and neuronal loss induced by ischemia were remarkably suppressed by EA in the cortical penumbra of rats(P<0.05 or P<0.01).Conclusion:EA treatment after ischemic stroke may attenuate ischemic brain injury and cellular apoptosis through the regulation of mitochondrial translocation of cofilin,a novel mechanism of EA therapy.

Effect of Jianpi therapy in treatment of chronic obstructive pulmonary disease:a systematic review

OBJECTIVE:To evaluate the efficacy of Jianpi therapy in Traditional Chinese Medicine (TCM) for treatment of chronic obstructive pulmonary disease (COPD) in stable phase by performing a systematic review and meta-analysis. METHODS: The literatures concerning randomized controlled trials (RCTs) and quasi-RCTs comparing TCM treatment plus Western Medicine (WM) treatment with TCM alone, orTCM treatment vs no treatment, placebo for stable phase of COPD were searched in PubMed (1990-December 2010), in English and using Chinese National Knowledge Infrastructure (CNKI, 1990-December 2010), Chinese Biomedical Database (1990-December 2010), Wangfang Database (1990-December 2010), and Weipu (VIP) Database in Chinese. The quality assessment and data extraction for RCTs were conducted by two reviewers independently. Jadad scale and allocation concealment were used to assess the quality of the included studies, and meta-analyses were conducted with the Collaboration's Revman 5.0 software. RESULTS: Seventeen RCTs or quasi-RCTs involving 1269 patients were included. The methodological quality was poor in all trials except one trial (Jadad score=4). In the meta-analysis, TCM-WM treatment was significantly superior to WM treatment in cure rate [OR=3.82, 95%CI (2.45, 5.95)], and the effective rate between TCM treatment and placebo also had significant difference [OR=4.31, 95%CI (2.35, 7.91)]. Moreover, pulmonary function of the patients in TCM-WM group and TCM group was significantly improved [forced vital capacity (FVC), P=0.01, quality of life, P<0.001]. CONCLUSION: The experience in TCM-WM treatment of COPD in stable phase was encouraging. The current evidence shows that TCM-WM treatment might be more efficient in effective rate, quaity of life, and FVC than WM treatment alone. But for forced expiratory volume in one second (FEV1) and FEV1/FVC, no matter TCM-WM treatment compared with WM treatment alone or TCM treatment compared with placebo, there was no significant difference, with no obvious adverse reactions. Due to the low methodological quality of trials included, more RCTs of high quality in large scale are required.

Prevalence of Kaposi's sarcoma-associated herpesvirus in Uygur and Han populations from the Urumqi and Kashgar regions of Xinjiang, China

Kaposi's sarcoma-associated herpesvirus(KSHV) is the infectious etiologic agent associated with Kaposi's sarcoma(KS), primary effusion lymphoma, and multicentric Castleman disease. It has been shown that high KSHV prevalence and high incidence of both classic KS and AIDSassociated KS are found mostly among people of Uygur ethnicity in Xinjiang, while people of Han ethnicity in Xinjiang have a higher KSHV seroprevalence than those of other Han populations in China's Mainland. However, it is still unclear why there is such geographical and population variation in KSHV distribution in China. In this work, we focused on the populations in the Kashgar region and Urumqi area, where a total of 1294 research subjects were randomly selected to investigate the potential correlation between KSHV prevalence and different ethnicities in endemic areas of Xinjiang, and to determine risk factors that may affect KSHV infection rates or KS incidence. We identified a high seroprevalence of KSHV and high peripheral blood DNA infection in the general Uygur and Han populations in both Urumqi and Kashgar regions of Xinjiang, and determined that advancing age, low education level, and stationary population status affect KSHV infection rates. Further, KSHV-positive Uygur participants were shown to have higher prevalence of neutralizing antibodies and neutralizing antibody titers than KSHV-positive Han participants.

Tonifying kidney therapy for stable chronic obstructive pulmonary disease: a systematic review

OBJECTIVE: To evaluate the efficacy and safety of tonifying kidney therapy(Bushen, TK) for stable chronic obstructive pulmonary disease(COPD).METHODS: Randomized controlled trials(RCTs) of TK use for treatment of stable COPD were searched in four databases including Pub Med, the Cochrane Library, Chinese Biomedical Literature Database,and China National Knowledge Infrastructure Database from inception to December 2017. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. Rev Man 5.3 software was used for the Meta-analysis.RESULTS: Eight RCTs involving 809 patients with stable COPD were included. Compared with the conventional Western Medicine(CWM) group, the TK group(TK combined with CWM) showed significant improvements in the effectiveness rates(RR =1.37, 95% CI 1.22 to 1.53, P < 0.000 01) and 6-min walk distance in meters(MD 11.92, 95% CI 3.52 to20.32, P = 0.005), this study also showed that the TK group can decrease The Traditional Chinese Medicine Syndrome Score(MD-8.01, 95% CI-12.89 to-3.13, P = 0.001). The lung function [forced expiratory volume in one second%(FEV1%), FEV1/forced vital capacity] showed no difference between the TK and control groups.CONCLUSION: For patients with stable COPD, TK can improve the clinical effectiveness and exercise capacity but fail to improve the patient's symptoms. Because of the low methodological quality of the included trials, additional high-quality and large-scale RCTs are required.

Correlation between acne and Northwest dryness syndrome in Xinjiang autonomous region of China

OBJECTIVE: To analyze the correlation between acne and Northwest dryness syndrome in the Xinjiang region to provide an epidemiological foundation for the prevention and treatment of acne in the region. METHODS: The correlations among acne, clinical syndromes of Northwest dryness syndrome, and Northwest dryness syndrome were evaluated using the syndrome fitness index and canonical correlation analysis. RESULTS: The acne group had a Northwest dryness syndrome rate of 24.13%, and the control group 10.34%(χ2=7.733, P<0.01). There was no significant difference in the fitness index for acne and for the sub-syndromes of Northwest dryness syndrome(P> 0.05). The first canonical correlation coefficient was 0.5656(P<0.01). The acne-dependent variable group had the largest damp-heat syndrome load(0.8709), and the independent variable had the largest lung-heart-spleen pyretic dryness load(0.6766). CONCLUSION: Northwest dryness syndrome is a risk factor for acne in the Xinjiang region. Exogenous dryness and endogenous damp are frequently seen as subsyndromes in Northwest dryness syndrome in acne patients in the region. Acne was correlated with the damp-heat and lung-heart-spleen pyretic dryness sub-syndromes of Northwest dryness syndrome.

Expression of airway mucus-associated proteins in rats with chronic obstructive pulmonary disease with a cold-dryness symptom pattern

OBJECTIVE: To reveal the effects on expression of airway mucus-associated proteins in rats with chronic obstructive pulmonary disease(COPD) and a cold-dryness symptom pattern induced by elastase and smoking.METHODS: The COPD model was established with an elastase dose into the trachea combined with exposure to smoking; the COPD model cold-dryness symptom pattern was further developed by exposure to a cold, dry environment. After 90 days,pathologic lung sections, inflammatory cytokine levels(measured by enzyme linked immunosorbent assay), m RNA and protein expression of mucus-associated proteins and aquaporins(measured by real-time polymerase chain reaction and western blots) were examined.RESULTS: Cytokines interleukin-6(IL-6), interleukin-8(IL-8), and tumor necrosis factor-α(TNF-α) in the COPD and the cold-dryness symptom pattern COPD groups were all significantly higher than in controls(each P < 0.01). IL-6 and IL-8 levels were higher in the cold-dryness symptom pattern COPD group than in the COPD group(each P < 0.05). The AQP5 m RNA expression in the cold-dryness symptom pattern COPD and COPD groups was lower than in the control group(P < 0.01), and that in the cold-dryness symptom pattern COPD group was lower than the COPD group(P < 0.05). The expression of MUC5 AC and MUC5 B m RNAs in the cold-dryness symptom pattern COPD group and COPD group was higher than in the control group(each P < 0.01), and that in the cold-dryness symptom pattern COPD group was higher than the COPD group(P < 0.01, and P < 0.05, respectively).The ratio of MUC5 AC m RNA/MUC5 B m RNA was COPD group < the cold-dryness symptom pattern COPD group < the control group. AQP4 and AQP5 protein expression in the cold-dryness symptom pattern COPD group was lower than that in the COPD group which was lower again than in the control group. MUC5 AC and MUC5 B expression in the cold-dryness symptom pattern COPD group was higher than in the COPD group and higher again than in the control group.CONCLUSION: Cold-dryness affects the expression of mucus-associated protein m RNA and its corresponding proteins, reducing the secretion of aquaporins and increasing the secretion of mucins. Imbalance in aquaporins and mucins can affect the function of mucus, increasing airway obstruction.

Tonifying Kidney, Lung, and Spleen Combined with Western Medicine for Stable Chronic Obstructive Pulmonary Disease: A Systematic Review

Introduction:This study aimed to evaluate the clinical effectiveness and safety of tonifying kidney,lung,and spleen(TKLS)combined with Western medicine for stable chronic obstructive pulmonary disease(COPD).Materials and Methods:Randomized controlled trials(RCTs)of TKLS for stable COPD were searched from four databases including Pub Med,the Cochrane Library,China Biology Medicine,and China National Knowledge Infrastructure from inception to December 2017.Two reviewers independently screened the literature,extracted the data,and assessed the risk of bias in the included studies.Rev Man5.3 software was used for meta-analysis.Results:Fourteen RCTs involving 1339 patients with stable COPD were included.Five of the included articles described the specific method of randomization,1 of them was double-blind method research,and 1 of them was single-blind method research.Compared with the conventional Western medicine(CWM)group,the use of TKLS,if combined with CWM demonstrated significantly improved effective rate(relative risk=1.25,95%confidence interval[CI]:1.18–1.33,P<0.00001),decreased traditional Chinese medicine syndrome score(mean difference[MD]-5.72,95%CI:-8.31 to-3.14,P<0.0001),Decreased St George's Respiratory Questionnaire total score(MD-7.39,95%CI:-10.46 to-4.31,P<0.00001),increased 6-min walk distance in meters(MD 78.46,95%CI:60.18–96.73,P<0.00001),increased forced expiratory volume 1%(MD 6.49,95%CI:3.64–9.33,P<0.00001),increased CD4(MD 9.84,95%CI:6.73–12.94,P<0.00001),CD8(MD-1.84,95%CI:-3.62 to-0.06,P=0.04)and CD4/CD8(MD 0.26,95%CI:0.20–0.32,P<0.0001),and increased immunoglobulin M(MD 0.15,95%CI:0.10–0.20 P<0.00001)..Conclusions:For stable COPD,TKLS combined with CWM is superior to CWM alone with regard to clinical effectiveness,symptoms,and quality of life.The above conclusion needs to be validated by further well-designed,multicentric,large-scale,double-blinded RCTs.

Effect of cold-dryness on pulmonary and immunologic function in chronic obstructive pulmonary disease model rats

OBJECTIVE: To study the effects of cold-dryness on pulmonary and immunologic function of peripheral T-lymphocytes in chronic obstructive pulmonary disease(COPD) model rats, and to provide references for the prevention and treatment of cold-dryness COPD in the Xinjiang region.METHODS: The COPD model was established with an elastase drip into the trachea combined with smoking. The cold-dryness COPD model was developed by stressing with a cold-dry environment.Success of the model was determined by observation of pathologic lung sections. Rats were sacrificed by exsanguination from the femoral artery and changes of peripheral blood CD4+, CD8+, and CD4+/CD8+were detected by flow cytometry. Data were analyzed with SAS 11.5 statistical software.RESULTS: On the ninetieth day after ending the experiment, Peak expiratory flow in the cold-dryness COPD group was lower than that in the COPD and normal control groups(P<0.01). The time of inspiration in the cold-dryness COPD group was higher than that in the COPD and normal groups(P<0.05).Time of expiration(Te) in the cold-dryness COPD group was higher than that in the COPD and normal groups(P<0.01). 50% tidal volume expiratory flow(EF50) in the cold-dryness COPD group was lower than that in the COPD and normal groups(P<0.01), and EF50 in the COPD group was lower than that in the normal group(P<0.05). CD4+ content of peripheral blood in the cold-dryness COPD group was lower than that in the COPD and the normal groups(P<0.05). CD8+ content in the cold-dryness COPD and COPD groups was higher than that in the normal control group(P<0.01), and CD8+ content in the cold-dryness COPD group was higher than that in the COPD group(P<0.01). CD4+/CD8+in the cold-dryness COPD group and the COPD group was lower than that in the normal control group(P<0.01), and CD4+/CD8+ in the cold-dryness COPD group was lower than that in the COPD group(P<0.05).CONCLUSION: In the cold-dryness COPD model,CD8+ increased and CD4+/CD8+ decreased. Moreover, cold-dryness may aggravate this state. The effects of cold-dryness on pulmonary function mainly manifested as prolongation of Te and decrease of EF50, which could be one of causes of cold-dryness environment in the northwest of China leading to COPD with region characteristics.

Can Ashi Points Stimulation Have Specific Effects on Shoulder Pain? A Systematic Review of Randomized Controlled Trials

Objective： To provide an evidence-based overview regarding the efficacy of Ashi points stimulation for the treatment of shoulder pain. Methods： A comprehensive search [PubMed, Chinese Biomedical Literature Database, China National Knowledge Infrastructure （CNKI）, Chongqing Weipu Database for Chinese Technical Periodicals （VIP） and Wanfang Database] was conducted to identify randomized or quasi-randomized controlled trials that evaluated the effectiveness of Ashi points stimulation for shoulder pain compared with conventional treatment. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool. RevMan 5.0 was used for data synthesis. Results： Nine trials were included. Seven studies assessed the effectiveness of Ashi points stimulation on response rate compared with conventional acupuncture. Their results suggested significant effect in favour of Ashi points stimulation [odds ratio （OR）： 5.89, 95% confidence interval （CI）： 2.97 to 11.67, P〈0.01, heterogeneity： x 2=3.81, P=0.70, 12=0% ]. One trial compared Ashi points stimulation with drug therapy. The result showed there was a significantly greater recovery rate in group of Ashi points stimulation （OR： 9.58, 95% CI： 2.69 to 34.12）. One trial compared comprehensive treatment on the myofascial trigger points （MTrPs） with no treatment and the result was in favor of MTrPs. Conclusions： Ashi points stimulation might be superior to conventional acupuncture, drug therapy and no treatment for shoulder pain. However, due to the low methodological quality of included studies, a firm conclusion could not be reached until further studies of high quality are available.