Traditional Chinese medicine for treatment of coronavirus disease 2019:a review

prevalence.A number of clinical workers and researchers have made great efforts to understand the pathogenesis and clinical characteristics and develop effective drugs for treatment.However,no effective drugs with antiviral effects on severe acute respiratory syndrome coronavirus 2 have been discovered currently.Traditional Chinese medicine(TCM)has gained abundant experience in the treatment of infectious diseases for thousands of years.In this review,the authors summarized the clinical outcome,pathogensis and current application of TCM on coronavirus disease 2019.Further,we discussed the potential mechanisms and the future research directions of TCM against severe acute respiratory syndrome coronavirus 2.

NLRP3/1-mediated pyroptosis:beneficial clues for the development of novel therapies for Alzheimer’s disease

The inflammasome is a multiprotein complex involved in innate immunity that mediates the inflammatory response leading to pyroptosis,which is a lytic,inflammatory form of cell death.There is accumulating evidence that nucleotide-binding domain and leucine-rich repeat pyrin domain containing 3(NLRP3)inflammasome-mediated microglial pyroptosis and NLRP1 inflammasome-mediated neuronal pyroptosis in the brain are closely associated with the pathogenesis of Alzheimer’s disease.In this review,we summarize the possible pathogenic mechanisms of Alzheimer’s disease,focusing on neuroinflammation.We also describe the structures of NLRP3 and NLRP1 and the role their activation plays in Alzheimer’s disease.Finally,we examine the neuroprotective activity of small-molecule inhibitors,endogenous inhibitor proteins,microRNAs,and natural bioactive molecules that target NLRP3 and NLRP1,based on the rationale that inhibiting NLRP3 and NLRP1 inflammasome-mediated pyroptosis can be an effective therapeutic strategy for Alzheimer’s disease.

Advances in traditional Chinese medicine for liver disease therapy in 2020

Liver diseases are gradually becoming a serious threat to human health worldwide.Although a number of medications have been introduced for the prophylaxis,diagnosis,and treatment of liver diseases,several limitations and challenges remain.Traditional Chinese medicine is frequently used to treat liver diseases and well known to protect hepatocytes and inhibit inflammation,oxidative stress,and fibrosis.However,given the complex composition of traditional Chinese medicine,clarifying the mechanisms behind its curative and protective effects is difficult.In this review,research progress on traditional Chinese medicine for the treatment of liver diseases in 2020 is summarized on the basis of the literature available in the PubMed database.Herbal extracts derived from traditional Chinese medicine,including flavonoids,polysaccharides,saponins,and alkaloids,and Chinese medicinal formulas,such as the classic decoctions Chaihu Shugan powder,Linggui Zhugan decoction,and Huanglian Jiedu decoction,have shown promising therapeutic efficacy in liver disease treatment.We summarized the findings of several studies on the active ingredients of traditional Chinese herbs used for liver disease treatment in 2020,focusing mainly on their ability to confer antiviral effects to treat hepatitis,regulate antioxidant levels and apoptosis to treat liver injury,inhibit inflammation and improve dysfunctions in amino acids and energy metabolism to treat alcoholic liver disease,reduce hepatic lipid deposition to treat nonalcoholic fatty liver disease,promote activated hepatic stellate cells to treat liver fibrosis,inhibit the proliferation or promote the apoptosis of liver cancer cells to treat hepatocellular carcinoma,and improve bile acid metabolism to treat cholestasis.

Advances in traditional Chinese medicine for liver disease therapy in 2021

Liver diseases and their co-morbidities represent a major public health problem.Owing to its progressive pathogenesis and lack of effective treatment,liver disease has become one of the most important causes of death worldwide.Traditional Chinese medicine(TCM)has potential advantages in the prevention and treatment of liver diseases,including high safety,remarkable curative effects,and low toxicity and side effects.In 2021,TCM extracts and their derivatives,TCM compounds,and ethnic medicines showed good efficacy in the treatment of liver diseases.The main mechanisms and representative drugs of TCM can be summarized by the use of amygdalin,dicoumarol,quercetin,and ancient ephedrine decoction to treat hepatitis by inhibiting viral replication,as well as the use of Gentianae Radix,lupeol,Zornia diphylla(L.)Pers.,and Chinese patent medicine Liuwei Wuling tablet to alleviate acute liver injury by improving oxidative stress and inflammatory responses in the body.In the treatment of alcoholic liver disease and metabolic-associated fatty liver disease,the mechanism of TCM is the inhibition of oxidative stress,improving metabolism,regulating intestinal microflora,and enhancing intestinal barrier function.The representative TCM for alcoholic liver disease includes astragaloside,puerarin,patchouli alcohol,and Mori Fructus polysaccharide,while those for metabolic-associated fatty liver disease include saikosaponin,dehydroabietic acid,hesperetin,berberine,and Panax Notoginseng saponins.Additionally,germacrone,forsythin,geniposide,and protocatechuic acid can inhibit the activation or migration of stellate cells and improve liver fibrosis.Toosendanin,paeoniflorin,chrysin,and the classical prescription Huanglian decoction can significantly inhibit the proliferation of liver cancer cells and promote their apoptosis for the treatment of hepatocellular carcinoma.The activation of the farnesol X receptor pathway can improve bile metabolism in the liver,thus,significantly alleviating cholestatic liver disease.Its representative drugs include the TCM extracts pterostilbene and arbutin.In this review,we summarize the advances made in research on TCM used in the treatment of liver diseases in 2021,providing a reference for further development of TCM for the prevention and treatment of liver diseases.

Efficacy and Safety of Lianhua Qingke Tablets in the Treatment of Long Coronavirus Disease (COVID) Cough: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Clinical Study

Lianhua Qingke tablets,a patented traditional Chinese medicine that has validated clinical efficacy for treating cough caused by severe acute respiratory syndrome coronavirus 2 infection,lack rigorous evidence-based research evaluating their effect on long coronavirus disease(COVID)cough.A randomized,double-blind,placebo-controlled,multicenter clinical study was conducted among patients with long COVID cough from 19 hospitals and 23 community health centers in China.Patients were randomized 1:1 to receive either Lianhua Qingke tablets or placebo orally for 14 days(four tablets,1.84 g,three times a day).The primary endpoint indicator was the disappearance of cough,with the remission of cough also considered.Among 482 randomized patients,480(full analysis set 480;per-protocol set 470;safety set 480)were included in the primary analysis.According to the full analysis,the time until cough disappearance was significantly shorter in the trial group than in the control group,with a significant increase in the 14-day cough disappearance rate.Accordingly,the time to cough remission was significantly shorter in the trial group than in the control group.The change in the total symptom score was significantly greater in the trial group than in the control group on days 7 and 14,consistent with the results indicated by the visual analog scale(VAS)and cough evaluation test(CET)scores.No serious adverse events were recorded during the study.Lianhua Qingke tablets significantly improved the clinical symptoms of patients with long COVID cough.

Integration of multi-omics in investigations on the mechanisms of action of Chinese herbal medicine interventions in metabolic diseases

The rapid development of bioinformatics has provided novel approaches and methods for exploring the mechanisms of disease treatment via Chinese herbal medicines.Compound Chinese herbal medicines formulas have complex compositions and are characterized by their multiple constituents and diverse array of biological targets.Therefore,the mechanisms of action of most compound Chinese herbal medicines formulas cannot be adequately explained using a single pathway.Omics technologies describe high-throughput-based analytical and detection techniques,which include transcriptomics,proteomics,and metabolomics and provide multilayer parameter information that can be integrated to characterize the overall relationships involved in the therapeutic effects of Chinese herbal medicines formulas.Through their combination with network biology and drug effect networks,omics technologies also enable investigations into the mechanisms of disease treatment in traditional Chinese medicine.The integration of multiple omics technologies is in line with the concept of holism in traditional Chinese medicine and provides an approach for combining modern science and technology with traditional Chinese medicine theories.In recent years,omics technologies have been widely used to elucidate the mechanisms of action of Chinese herbal medicines.The latest studies employing multi-omics integration for investigating the mechanisms of action of Chinese herbal medicines interventions in metabolic diseases have devoted greater attention to in-depth explorations of disease pathogenesis.This paper provides a review of the following multi-omics technologies,which are used in research on the treatment of common metabolic diseases(e.g.,type-2 diabetes mellitus,nonalcoholic fatty liver disease):network pharmacology combined with metabolomics,16S rRNA sequencing combined with transcriptomics,16S rRNA sequencing combined with metabolomics,and 16S rRNA sequencing combined with network pharmacology and metabolomics.

The effect of Jiangan Xiaozhi Formula on oxidative stress and inflammatory factors in patients with non-alcoholic fatty liver disease

Objective:To investigate the effects of Jiangan Xiaozhi Formula(JGXZ)on oxidative stress and inflammatory factors in patients with non-alcoholic fatty liver disease(NAFLD).Methods:Between September 2022 and December 2023,our hospital admitted a total of 58 patients with NAFLD.These patients were split into two groups at random:one for experimentation and the other for control.There were 27 patients in the experimental group at the end,compared to 26 in the control group,reasonable exercise,weight management,lipid regulation,and oral polyene phosphatidylcholine capsules(PPC).The experimental group received JGXZ in addition to the above treatments for 12 consecutive weeks.Changes in Traditional Chinese Medicine(TCM)syndrome scores,blood lipids,liver function indicators,the levels of oxidative stress markers,such as malondialdehyde(MDA),glutathione peroxidase(GSH-Px),and superoxide dismutase(SOD),as well as serum inflammatory factors,such as interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α),were measured both before and after treatment.Results:After treatment,both groups showed significant reductions in TCM syndrome scores(P<0.05)and improvements in blood lipids,liver function indicators,inflammatory factors,and oxidative stress markers(P<0.05).Improvements were noticeably better in the experimental group than in the control group.(P<0.05).Conclusion:JGXZ can significantly improve clinical symptoms,regulate blood lipids,and protect liver function in patients with NAFLD.Its mechanism may be related to inhibiting inflammatory responses and regulating the balance of the oxidation-antioxidation system.

Anti-bacterial mechanism of baicalin-tobramycin combination on carbapenem-resistant Pseudomonas aeruginosa

BACKGROUND Pseudomonas aeruginosa(P.aeruginosa)is an important cause of nosocomial infections,and contributes to high morbidity and mortality,especially in intensive care units.P.aeruginosa is considered a'critical'category bacterial pathogen by the World Health Organization to encourage an urgent need for research and development of new antibiotics against its infections.AIM To investigate the effectiveness of baicalin combined with tobramycin therapy as a potential treatment method for carbapenem-resistant P.aeruginosa(CRPA)infections.METHODS Polymerase chain reaction(PCR)and RT-PCR were used to detect the expression levels of drug-resistant genes(including VIM,IMP and OprD2)and biofilmrelated genes(including algD,pslA and lasR)in CRPA that confer resistance to tobramycin,baicalin and tobramycin combined with baicalin(0,1/8,1/4,1/2 and 1MIC).RESULTS There was a correlation between biofilm formation and the expression of biofilmrelated genes.In addition,VIM,IMP,OprD2,algD,pslA and lasR that confer biofilm production under different concentrations in CRPA were significantly correlated.The synergistic effect of baicalin combined with tobramycin was a significant down-regulation of VIM,IMP,algD,pslA and lasR.CONCLUSION Baicalin combined with tobramycin therapy can be an effective treatment method for patients with CRPA infection.

The Fang’s hypoglycemic formula improves insulin resistance in type 2 diabetes mellitus by regulating mitochondrial autophagy

Background:To investigate the pharmacological effects of Fangshi Jiangtang decoction(FSJT)on type 2 diabetes mellitus(T2DM)model rats and explore its mechanism of action from the perspective of mitochondrial autophagy.Methods:Sixty Sprague Dawley rats were randomly divided into six groups after one week of adaptive feeding:Control group,T2DM model group,metformin group(0.2 g/kg by gavage),and FSJT low,medium,and high dose groups(9.5,19,38 g/kg by gavage).Except for the Control group,the other five groups were given a high-fat diet.The treatment lasted for 8 weeks,and blood glucose levels were measured weekly.Eight weeks later,blood samples were collected from the rats,and serum was separated for the determination of HbA1c,oral glucose tolerance test,and homeostatic model assessment for insulin resistance index.The pancreas of the rats was collected,weighed,and fixed.The same part of the pancreas was used for hematoxylin-eosin.Kits were used to detect triglycerides,total cholesterol,interleukin-1β,interleukin-6,tumor necrosis factor-α,malondialdehyde,glutathione peroxidase,and superoxide dismutase in pancreatic tissue to assess the effects of FSJT on inflammation and oxidative stress in T2DM rats.Western blot analysis was performed to detect the expression of VDAC1,TOM20,COXⅣ,PINK1,Parkin,beclin1,light chain 3,and selective autophagy adaptor protein P62 to evaluate the effects of FSJT on mitochondrial autophagy in T2DM model rats.Results:Compared with the T2DM model group,FSJT intervention significantly reduced blood glucose,HbA1c,oral glucose tolerance test,and homeostatic model assessment for insulin resistance index in T2DM model rats,alleviated pancreatic tissue lesions,reduced levels of total cholesterol,triglycerides,interleukin-1β,interleukin-6,tumor necrosis factor-α,and malondialdehyde,increased glutathione peroxidase and superoxide dismutase activities,downregulated the expression of VDAC1,TOM20,COXⅣ,and P62 proteins,and upregulated the expression of PINK1,Parkin,Beclin1,and light chain 3 proteins.Conclusion:FSJT can improve insulin resistance in T2DM by promoting the activation of mitochondrial autophagy.

Dr. Shi Yanqing's Experience in Acupuncture Treatment of Paralysis Agitans

Dr. Shi Yanqing (施延庆), a chief physician of traditional Chinese medicine, is an expert using warm-needling therapy to treat obstinate and miscellaneous diseases. In his long years of clinical practice, Dr. Shi has treated several tens of paralysis agitans cases, and obtained quite good therapeutic effects as is introduced in the following.

Effects of Qingwen Baidu decoction on coagulation and multiple organ injury in rat models of sepsis

Background:Sepsis-induced coagulopathy and multiple organ dysfunction syndromes are the leading causes of death in patients with sepsis.Qingwen Baidu decoction(QWBD)can effectively improve the clinical manifestations of sepsis and ease inflammation,but its effects on coagulation functions and multiple organ injuries remain unclear.Methods:100 healthy,male Sprague-Dawley rats were randomly divided into the sham group,the cecal ligation and puncture(CLP)group,the low-dose QWBD group,and the high-dose QWBD group,with 25 rats in each group.The sepsis model was established using CLP.Blood was collected to measure platelet count,serum creatinine(Cr),blood urea nitrogen(BUN),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)levels,as well as coagulation function.The total protein in bronchoalveolar lavage fluid(BALF)was determined in each group of rats.The lung,liver,and kidney tissues were harvested,and statistics were calculated on the wet-to-dry(W/D)weight ratio.Changes in histopathology and thrombin level were evaluated in each group.The remaining ten rats in each group were observed daily to record the number of surviving rats.Such observation was made consecutively for 7 days to calculate survival rates.Results:After model establishment,ALT,AST,Cr,and BUN levels were significantly elevated(P<0.01).The BALF protein content and lung W/D weight ratio were significantly increased(P<0.01).Furthermore,the survival rate of rats was significantly reduced in the CLP group compared with the sham group.After the treatment,rats in the high-dose QWBD group had lower ALT(P<0.05),AST(P<0.01),Cr(P<0.05),BUN(P<0.01)levels,lower BALF protein content(P<0.05)and lower lung W/D weight ratio(P<0.01)than the CLP group.However,rats in the high-dose QWBD group had significantly better pathological changes in the lung,liver,and kidney compared to the sham group.After the treatment,the platelet level in the peripheral blood was elevated(P<0.05)and both activated partial thromboplastin time and prothrombin time were significantly shortened(P<0.01).The fibrinogen level was significantly increased(P<0.01).Finally,thrombin positive expression areas in the lung,liver,and kidney were significantly decreased in the high-dose QWBD group.Conclusion:QWBD can improve coagulation disorders caused by sepsis and has a protective effect on multiple organ injuries in rats.

Antioxidative effect of peroxiredoxin-3 in the rat myocardium exposed to renal ischemia-reperfusion injury

Background:Peroxiredoxin-3(Prx-3)is known to be involved in the clearance of cellular hydrogen peroxide and plays an important role in protecting the myocardial tissue against damage of oxidative stress.However,the role of Prx-3 in protecting the myocardial tissue against renal ischemia/reperfusion(I/R)-induced myocardial injury(RI/RMI)remains unknown.We aimed to examine the antioxidative effect of Prx-3 using a rat RI/RMI model in an attempt to find a new approach to the prevention and treatment of myocardial injury induced by renal I/R.Methods:A RI/RMI rat model was established to detect the renal histopathology and renal functions by hematoxylin-eosin staining staining and commercially available assay kits.The myocardial antioxidant activity and the expressions of mRNA and protein of Prx-3 in the myocardial tissue were measured by real-time polymerase chain reaction and Western blotting assay,respectively.Results:Compared with the normal and control groups,the serum level of blood urea nitrogen and serum creatinine was significantly increased in the I/R group(P<0.05).Histopathological changes in the kidneys were also more obvious,including glomerular cystic and renal interstitial hemorrhage,renal tubular epithelial cell edema,and tubular type formation.The mRNA and protein expressions of Prx-3 were increased significantly in the RI/MRI rat model as compared with those in the normal and control groups.Conclusion:Oxidative damage occurred in the remote myocardium after renal I/R and Prx-3 was able to enhance the self-regulatory ability of the myocardium against damage from oxidative stress after RI/MRI.

Effect of Jiangan Xiaozhi decoction on endoplasmic reticulum stress signaling pathway in methionine and choline deficiency diet-induced mice

Objective:To investigate the therapeutic effects of Jiangan Xiaozhi decoction on nonalcoholic steatohepatitis(NASH)mice model and its effects on the endoplasmic reticulum stress(ERS)signaling pathway.Methods:NASH mice model was established by methionine-choline deficient(MCD)diet induction and intragastric administration of Jiangan Xiaozhi decoction.The therapeutic effects of the decoction on NASH mice model were evaluated by measuring the body weight,hepatic index,and blood lipids and analyzing liver function-related biochemical markers,liver hematoxylin and eosin staining,and liver oil red O staining after the administration of the decoction in the mice model.Next,the levels of glucose-regulated protein 78(GRP78),inositol-requiring enzyme 1(IRE1),and X-box binding protein 1(XBP1)in the liver tissue of the mice were measured using Western blotting to investigate the mechanism underlying the treatment of NASH mice model by Jiangan Xiaozhi decoction.Results:Jiangan Xiaozhi decoction improved the body weight and hepatic index;reduced the levels of total cholesterol,transglutaminase,alanine transaminase,and aspartate aminotransferase;and improved pathological changes caused by hepatocyte necrosis,inflammatory cell infiltration,ballooning,and fat accumulation in the liver tissue of NASH mice model.The Western blot results showed that Jiangan Xiaozhi decoction reduced the levels of GRP78,IRE1,and XBP1 proteins in the liver tissues of NASH mice model.Conclusion:Jiangan Xiaozhi decoction has therapeutic effects on NASH mice model.The mechanism of its action may be related to the regulation of level of GRP78,IRE1,and XBP1 proteins in liver tissue and improvement of ERS.

Effects of nuciferine on Nrf2/HO-1 signaling pathway in adipose tissue of obesity model rats

Objective:This study aimed to explore the therapeutic effect of nuciferine on high-fat diet-induced obesity in rats and the influence of nuciferine on nuclear factor erythroid 2-related factor 2(Nrf2)/heme oxygenase-1(HO-1)signaling pathway in the adipose tissue.Methods:A total of 40 male Sprague Dawley(SD)rats were evenly divided into the normal,model,positive control,and nuciferine groups,using the random number table method.Except for the normal group,rats in the other groups were fed with high-fat diet for 12 weeks to establish the obesity model.During the model establishment,rats in the positive control group received atorvastatin calcium 2 mg/kg,rats in the nuciferine group received nuciferine 20 mg/kg,and rats in the normal and model groups received normal saline 2 mL,daily through intragastric administration for 12 consecutive weeks.After model establishment and administration,the body weight,Lee’s index,and blood lipids of rats in each group were measured,and hematoxylin and eosin(HE)staining was performed on the liver and adipose tissues to evaluate the therapeutic effect of nuciferine on obesity rat model.Additionally,the levels of superoxide dismutase(SOD),malondialdehyde(MDA),and glutathione peroxidase(GSH-Px)in the serum of rats in each group were determined,and the gene expressions of Nrf2 and HO-1 in the adipose tissue of rats in each group were detected through quantitative polymerase chain reaction(qPCR)to investigate the mechanism of action of nuciferine in the treatment of obesity.Results:After 12 weeks of model establishment and administration,we observed that compared with the model group,nuciferine could significantly reduce the body weight,Lee’s index,and serum triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)levels and increase the serum high-density lipoprotein cholesterol(HDL-C)level in obesity rat model(P<0.05 or P<0.01).HE staining revealed that nuciferine could significantly alleviate liver steatosis in obesity rat model and improve the cell morphology in epididymal adipose tissue.Moreover,nuciferine could elevate serum SOD and GSH-Px activities in obesity rat model and lower the serum MDA level(P<0.05 or P<0.01).The qPCR indicated that nuciferine could upregulate the gene expression of Nrf2 and HO-1 in the adipose tissue of obesity rat model(P<0.05 or P<0.01).

Laparoscopic surgery for early gallbladder carcinoma:A systematic review and meta-analysis

BACKGROUND There is a controversy as to whether laparoscopic surgery leads to a poor prognosis compared to the open approach for early gallbladder carcinoma (GBC)We hypothesized that the laparoscopic approach is an alternative for early GBC.AIM To identify and evaluate the safety and feasibility of laparoscopic surgery in the treatment of early GBC.METHODS A comprehensive search of online databases,including MEDLINE (PubMed),Cochrane libraries,and Web of Science,was performed to identify noncomparative studies reporting the outcomes of laparoscopic surgery and comparative studies involving laparoscopic surgery and open surgery in early GBC from January 2009 to October 2019.A fixed-effects meta-analysis was performed for 1-and 5-year overall survival and postoperative complications,while 3-year overall survival,operation time,blood loss,the number of lymph node dissected,and postoperative hospital stay were analyzed by random-effects models.RESULTS The review identified 7 comparative studies and 8 non-comparative studies.1068 patients (laparoscopic surgery:613;open surgery:455) were included in the meta-analysis of 1-,3-,and 5-year overall survival with no significant differences observed [(HR=0.54;95%CI:0.29-1.00;12=0.0%;P=0.051),(HR=0.75;95%CI:0.34-1.65;I^2=60.7%;P=0.474),(HR=0.71;95%CI:0.47-1.08;I^2=49.6%;P=0.107),respectively].There were no significant differences in operation time[weighted mean difference (WMD)=18.69;95%CI:-19.98-57.36;I^2=81.4%;P=0.343],intraoperative blood loss (WMD=-169.14;95%CI:-377.86-39.57;I2=89.5%;P=0.112),the number of lymph nodes resected (WMD=0.12;95%CI:-2.95-3.18;I^2=73.4%;P=0.940),and the complication rate (OR=0.69;95%CI:0.30-1.58;I2=0.0%;P=0.377) between the two groups,while patients who underwent laparoscopic surgery had a reduced length of hospital stay (WMD=-5.09;95%CI:-8.74--1.45;I2=91.0%;P=0.006).CONCLUSION This systematic review and meta-analysis confirms that laparoscopic surgery is a safe and feasible alternative to open surgery with comparable survival and operation-related outcomes for early GBC.

Jian-Gan-Xiao-Zhi decoction ameliorates high-fat high-carbohydrate diet-induced non-alcoholic fatty liver disease and insulin resistance by regulating the AMPK/JNK pathway

Background:Non-alcoholic fatty liver disease(NAFLD)can cause insulin resistance(IR)and diabetes.Our previous studies have demonstrated that Jian-Gan-Xiao-Zhi decoction(JGXZ)could be effective for the treatment of NAFLD and IR.However,the possible mechanism underlying the effects of JGXZ on NAFLD and IR remains unknown.Methods:Fifty rats received a high-fat high-carbohydrate(HFHC)diet for 12 weeks to induce NAFLD.After 4 weeks of HFHC treatment,rats were orally treated with JGXZ(8,16,and 32 g/kg weight)for 8 weeks.Ten rats in the control group received standard chow.In the positive control group,rats were orally treated with metformin(90 mg/kg weight)for 8 weeks.After JGXZ and metformin treatment,H&E staining was conducted on rat livers and serum biochemical markers,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),triglyceride(TG),and total cholesterol(TC),were measured using test kits.Moreover,a fasting blood glucose test and an oral glucose tolerance test(OGTT)were conducted.Serum levels of insulin were determined using ELISA kit,and the homeostatic model assessment of insulin resistance(HOMA-IR)was calculated.The levels of total insulin receptor substrate-1(IRS1),AMP-activated protein kinase-α(AMPKα)and c-Jun N-terminal kinase(JNK)as well as the levels of phosphorylation of IRS1(p-IRS1),phosphorylation of AMPK(p-AMPK)and phosphorylation of JNK(p-JNK)were measured using western blotting.Results:The body weights in JGXZ low-,middle-,and high-dose groups were lower than those in the model group(P<0.05,P<0.01,P<0.01,respectively).The serum levels of AST(P<0.05 in JGXZ middle-and high-dose groups),ALT(P<0.01 in JGXZ middle-dose group and P<0.05 in JGXZ high-dose group),TG(P<0.01 in JGXZ middle-and high-dose groups),and TC(P<0.01)upon JGXZ treatment were lower those than in NAFLD model rats.H&E staining showed that JGXZ treatment reduced steatosis of the hepatocytes in NAFLD model rats.JGXZ decreased the levels of fasting blood glucose(P<0.01),HOMA-IR(P<0.01),AUC(area under the curve)of the OGTT(P<0.05)and p-IRS1(P<0.01 in JGXZ middle-and high-dose groups,P<0.05 in JGXZ low-dose groups).Moreover,JGXZ regulated the hepatic AMPKα/JNK pathway in NAFLD model rats,which reflected the induction of p-AMPKαand inhibition of p-JNK.Conclusion:This study showed that JGXZ improved liver function and reduced steatosis of the hepatocytes in NAFLD model rats.Moreover,JGXZ improved IR in NAFLD model rats.The possible mechanism underlying the effects of JGXZ on NAFLD and IR involves the modulation of the AMPK/JNK pathway.

Jiangtangjing ameliorates type 2 diabetes through effects on the gut microbiota and cAMP/PKA pathway

Background:During the clinical use of Jiangtangjing granules,we have found that they improve glucose metabolism and relieve symptoms in patients with type 2 diabetes mellitus.We aimed to further investigate the hypoglycemic effects of Jiangtangjing granules and the mechanisms involved.Methods:Type 2 diabetes mellitus was induced in rats by high-fat diet feeding and streptozotocin injection.The rats were then orally administered Linagliptin(3 mg/kg)or Jiangtangjing granules(13 g crude preparation/kg)for 4 weeks.The therapeutic effects of Jiangtangjing granules on glucose metabolism were then investigated.The serum glucagon-like peptide-1,insulin and glycosylated hemoglobin concentrations were measured using enzyme linked immunosorbent assay.Immunohistochemistry and quantificational real-time polymerase chain reaction were performed to quantify glucagon-like peptide-1 protein expression and cAMP,protein kinase A,and Epac1 mRNA expression,respectively.In addition,amplicon sequencing of bacterial 16s rDNA genes in rat feces was also performed to analyze the richness and diversity of the intestinal microbiota and to determine the relative abundances of the dominant bacterial phyla in the intestinal contents of the rats.Results:Jiangtangjing reduced fasting blood glucose concentration(P<0.05)and blood glucose concentrations during oral glucose tolerance testing(P<0.01),increased serum glucagon-like peptide-1 concentration after glucose administration(P<0.05)and improved glucose tolerance(P<0.05).It also increased glucagon-like peptide-1 protein expression(P<0.05)and the mRNA expression of cAMP(P<0.05),PKA(P<0.05),and Epac1(P<0.05)in the jejunum.Jiangtangjing also affected the composition of the intestinal microbiota in rats with type 2 diabetes mellitus.Specifically,it increased the relative abundance of Bacteroides and reduced that of Actinobacteria.Conclusion:Jiangtangjing granules have anti-diabetic effects,increasing circulating insulin concentration and glucose tolerance.These effects may be mediated by increases in glucagon-like peptide-1 secretion via upregulation of the cAMP/PKA signaling pathway in the jejunum and alterations in the composition of the intestinal microbiota.

Genetic variants associated with endometriosis patients:a systematic review

Endometriosis is defined as the presence of endometrium-like tissue outside the uterus,80%of which occur in the ovaries.It is characterized by an estrogen-dependent produces periodic and repeated bleeding,and may be accompanied by clinical symptoms such as dysmenorrhea,fatigue,dysuria,deep dyspareunia,and infertility.Due to the complex etiology and the yet-unknown pathogenesis of endometriosis,and the treatment effect is not ideal,causing significant physical and mental harm to reproductive-age women;thus,it has become a hot research topic.Endometriosis is still a mysterious disease of unknown origin and pathogenesis.Genetic factors are known to affect the manifestation and progression of endometriosis.A selection of genetic studies revealed genetic mutations and polymorphisms of endometriosis and their effects on the risk of developing this disease.This paper aimed to discuss the genetic variants associated with the risk of endometriosis and provided information to enrich the gene spectrum of endometriosis.

Efficacy of suspended moxibustion stimulating Shenshu(BL23)and Guanyuan(CV4)on the amygdala-HPA axis in rats with kidney-Yang deficiency symptom pattern induced by hydrocortisone

OBJECTIVE:To investigated the effects of suspended moxibustion stimulating Shenshu(BL23)and Guanyuan(CV4)acupoints on the amygdala and HPA axis in our rat model and elucidated the possible molecular mechanisms of moxibustion on kidney-Yang deficiency symptom pattern(KYDS).METHODS:Sixty male Sprague Dawley rats were randomly divided into a control group(n=12)and an experimental group(n=48).Rats in the experimental group were given intramuscular injections of hydrocortisone to establish a KYDS model.The 48 rats successfully modeled were then randomly divided into a model group(model,n=12),a carbenoxolone intraperitoneal injection group(CBX,n=12),a moxibustion group(moxi,n=12),and a moxi+CBX group(n=12).In the moxi,the Shenshu(BL23)and Guanyuan(CV 4)acupoints were treated with moxibustion for 14 d.After treatment,measures were taken of serum levels of corticosterone(CORT),adrenocorticotropic hormone(ACTH),and corticotropinreleasing hormone(CRH).The expression of mineralocorticoid receptors(MRs),glucocorticoid receptors(GRs),11beta-hydroxysteroid dehydrogenase type 1(11β-HSD1),CRH,and ACTH in the rats’amygdala,hypothalamus,or pituitary(as appropriate)was detected.Data were analyzed using one-way analysis of variance.RESULTS:Compared with those of the control group,the serum levels of CRH,ACTH,and CORT;the mRNA and protein expressions of MR,GR,and 11β-HSD1 in the amygdala;the mRNA and protein expressions of 11β-HSD1 in the hypothalamus;the CRH mRNA expression in the amygdala and hypothalamus;and the ACTH mRNA expression in the pituitary of the rats in the model group were all significantly decreased(P<0.05 or 0.01).After treatment with moxibustion,all the aforementioned observation indices except for 11β-HSD1 m RNA expression were ameliorated compared with those in the model group(P<0.05 or 0.01).CONCLUSIONS:Suspended moxibustion can effectively improve the serum levels of ACTH,CRH,and CORT and can up-regulate the mRNA and protein expressions of MR,GR,11β-HSD1,CRH,and ACTH in the amygdala and hypothalamus of KYDS rats.This may be one of the molecular mechanisms with which moxibustion alleviates KYDS.

基于复杂网络探究针灸治疗急性痛风性关节炎的临床特点

目的:基于复杂网络探讨针灸治疗急性痛风性关节炎(AGA)的选穴和穴位配伍规律,以及疗法的应用特点,为AGA的针灸治疗提供参考依据。方法:检索中国知网(CNKI)、重庆维普数据库(CQVIP)、万方数据知识服务平台(Wanfang)、中国生物医学文献服务系统(SinoMed)、PubMed、科学网(WOS)和荷兰医学文摘数据库(EMBASE)从建库至2023年3月31日的针灸治疗AGA文献。根据纳入及排除标准筛选文献后建立针灸处方数据库。应用SPSS Modeler 18.1和Gephi 0.9.7软件对腧穴进行关联规则分析和复杂网络分析。结果:共筛选145篇文献,提取382条针灸处方,涉及104个腧穴,总使用频次1288次。使用频次最高的腧穴为阿是穴,经脉选用以足太阴脾经、足阳明胃经较多;疗法以毫针刺和放血较为常见。关联规则结果显示“阿是穴-足三里”、“三阴交-足三里”支持度最高,体现了远近配穴、表里配穴的原则。对主穴进行复杂网络分析,获得了以阿是穴、足三里、三阴交、阴陵泉及太冲为主的核心腧穴配伍组合。配穴选择包括辨证取穴和辨部取穴,注重对证候和关节相关症状的改善。结论:针灸治疗AGA遵循主穴与辨证或辨部位配穴相结合原则,主穴选择注重调理本虚之脏腑,配穴选择注重对证和症的改善,重视疗法效应特异性。