Meta-analysis of Laparoscopic cyst decortication versus traditional open cyst decortication for ADPKD in China: evidence based on 362 cases and 399 controls

Objectives:To assess the safety,feasibility and clinical benefits of LCD and OCD for the treatment of ADPKD.Methods:Databases articles comparing LCD and OCD in treating PKD were collected through March 2019.After screening for inclusion and data extraction,meta-analysis was performed by the RevMan 5.3 software.Results:A total of 9 studies involving 761 patients were finally included,with 362 cases in LCD group and 399 cases in OCD group.LCD was associated with a shorter operative time(MD=-36.24,95%CI:-44.20^-28.28,P<0.00001)and postoperative hospital stay(MD=-4.04,95%CI:-5.13^-2.95,P<0.00001).Besides,LCD had an earlier time to postoperative ambulation(MD=-14.90,95%CI:-16.33^-13.48,P<0.00001)and earlier time to first flatus(MD=-1.52 days,95%CI:-1.65^-1.40,P<0.00001;MD=-10.76 hours,95%CI:-12.71^-8.81,P<0.00001).In addition,LCD had a lower intraoperative blood loss(MD=-159.81,95%CI:-243.32^-76.31,P=0.0002)and lower analgesic dosage(MD=-56.62,95%CI:-84.16^-29.08,P<0.0001).There showed no statistically significant difference between the two groups in Scr,Bun,systolic and diastolic blood pressure(all P>0.05).Conclusions:Current evidence demonstrated a shorter postoperative hospital stay,lower blood loss,less postoperative pain,and other advantages.LCD may therefore be a feasible and safe surgical approach of ADPKD.

Uremic clearance granule combined with Alprostadil in the treatment of chronic renal failure: A systematic review and meta-analysis

Objective: To evaluate whether the combination of Uremic clearance granule with Alprostadil is superior to Alprostadil alone for CRF. Methods: Relevant RCTs were searched through March 2019. Data were analyzed by Stata 15.0. Results: Nine articles involving 726 patients were enrolled in this study. Meta-analysis showed that the total effective rate [OR = 3.68 (2.44, 5.55), P < 0.001], Scr [SMD =-2.34 (-3.49,-1.19), P < 0.001], BUN [SMD =-1.80 (-2.73,-0.87), P < 0.001], Ccr [SMD = 0.71 (0.44, 0.97), P < 0.001] were better in the experimental group. But there were no significant difference in UA, CysC, 24h-Upro and incidence of adverse reactions (all P > 0.05) between two groups. No serious adverse reactions were found. Conclusions: The effect of the integrated medicine on CRF was better than Alprostadil alone. Uremic clearance granule is safe and has no obvious adverse reactions.

Baseline metabolites could predict responders with hepatitis B virus-related liver fibrosis for entecavir or combined with FuzhengHuayu tablet

BACKGROUND After receiving entecavir or combined with FuzhengHuayu tablet(FZHY)treatment,some sufferers with hepatitis B virus(HBV)-related liver fibrosis could achieve a histological improvement while the others may fail to improve even worsen.Serum metabolomics at baseline in these patients who were effective in treatment remain unclear.AIM To explore baseline serum metabolites characteristics in responders.METHODS A total of 132 patients with HBV-related liver fibrosis and 18 volunteers as healthy controls were recruited.First,all subjects were divided into training set and validation set.Second,the included patients were subdivided into entecavir responders(E-R),entecavir no-responders(E-N),FZHY+entecavir responders(FR),and FZHY+entecavir no-responders(F-N)following the pathological histological changes after 48 wk’treatments.Then,Serum samples of all subjects before treatment were tested by high performance liquid chromatographytandem mass spectrometry(LC-MS)high-performance LC-MS.Data processing was conducted using multivariate principal component analysis and orthogonal partial least squares discriminant analysis.Diagnostic tests of selected differential metabolites were used for Boruta analyses and logistic regression.RESULTS As for the intersection about differential metabolic pathways between the groups E-R vs E-N and F-R vs F-N,results showed that 4 pathways including linoleic acid metabolism,aminoacyl-tRNA biosynthesis,cyanoamino acid metabolism,alanine,aspartate and glutamate metabolism were screened out.As for the differential metabolites,these 7 intersected metabolites including hydroxypropionic acid,tyrosine,citric acid,taurochenodeoxycholic acid,benzoic acid,2-Furoic acid,and propionic acid were selected.CONCLUSION Our findings showed that 4 metabolic pathways and 7 differential metabolites had potential usefulness in clinical prediction of the response of entecavir or combined with FZHY on HBV fibrotic liver.

Changing liver stiffness predict regression in advanced fibrosis patients with chronic hepatitis B,but not in moderate fibrosis patients

Background and objective:Liver stiffness measurement(LSM)may effectively correlate to the presence of liver fibrosis,but it is controversial to use for the prediction of clinical outcomes.Therefore,we aimed to evaluate the predictive value of liver stiffness for the regression of liver fibrosis.Methods:In this study,we collected data from a clinical cohort of patients who are received anti-virus therapies for 48 weeks.180 naive chronic hepatitis B(CHB)patients,who received paired LSM and liver biopsy with pre-and post-treatments were analyzed.Two methods(FibroScan and iLivTouch)test LSM.Result:The area under the receiver operating characteristics curve(AUROC)of changing LSM for fibrosis regression is higher in advanced fibrosis patients(F5/6)than in moderate fibrosis patients(F3/4)in both FibroScan(0.719,95%CI,0.590–0.848;P=0.003;vs 0.617,95%CI,0.379–0.856,P=0.282)and iLivTouch(0.707,95%CI,0.567–0.847;P=0.011;vs 0.583,95%CI,0.422–0.744;P=0.377).A higher kappa value was received in advanced stage than in moderate stage both in FibroScan(0.392,P=0.001 vs 0.265,P=0.053)and iLivTouch(0.326,P=0.019 vs 0.030,P=0.833).Cut-off set as 4.10 kPa(sen,69.4%;spe,73.9%)in FibroScan,as 4.25 kPa(sen,56.8%;spe,72.2%)in iLivTouch.Conclusion:The changing LSM can be used for predicting the liver fibrosis regression in advanced stage of CHB patients.

Chinese Medicine Treatment of Refractory Ascites with Pleural Effusion Caused by Alcoholic Liver Disease: A Case Report

Alcohol is one of the leading causes of chronic liver disease and liver-related deaths worldwide.In particular,an overall high average level of alcohol consumption and heavy drinking binges appear to be critical factors that lead to disease and injury.Herein,we report a case who was diagnosed with refractory ascites and pleural ffusion caused by liver cirrhosis due to alcoholic liver disease.The patient was given diuretic therapy,antibiotics,reinfusion of concentrated ascites,and thoracic close drainage,but the result was disappointing.However,he responded well to Chinese medicine(CM)treatment.

Effect of ginsenoside Rg1 on hematopoietic stem cells in treating aplastic anemia in mice via MAPK pathway

BACKGROUND Aplastic anemia(AA)presents a significant clinical challenge as a life-threatening condition due to failure to produce essential blood cells,with the current the-rapeutic options being notably limited.AIM To assess the therapeutic potential of ginsenoside Rg1 on AA,specifically its protective effects,while elucidating the mechanism at play.METHODS We employed a model of myelosuppression induced by cyclophosphamide(CTX)in C57 mice,followed by administration of ginsenoside Rg1 over 13 d.The invest-igation included examining the bone marrow,thymus and spleen for pathological changes via hematoxylin-eosin staining.Moreover,orbital blood of mice was collected for blood routine examinations.Flow cytometry was employed to identify the impact of ginsenoside Rg1 on cell apoptosis and cycle in the bone marrow of AA mice.Additionally,the study further evaluated cytokine levels with enzyme-linked immunosorbent assay and analyzed the expression of key proteins in the MAPK signaling pathway via western blot.RESULTS Administration of CTX led to significant damage to the bone marrow’s structural integrity and a reduction in hematopoietic cells,establishing a model of AA.Ginsenoside Rg1 successfully reversed hematopoietic dysfunction in AA mice.In comparison to the AA group,ginsenoside Rg1 provided relief by reducing the induction of cell apoptosis and inflammation factors caused by CTX.Furthermore,it helped alleviate the blockade in the cell cycle.Treatment with ginsenoside Rg1 significantly alleviated myelosuppression in mice by inhibiting the MAPK signaling pathway.CONCLUSION This study suggested that ginsenoside Rg1 addresses AA by alleviating myelosuppression,primarily through modulating the MAPK signaling pathway,which paves the way for a novel therapeutic strategy in treating AA,highlighting the potential of ginsenoside Rg1 as a beneficial intervention.

Research Progress in Chinese Medicine Preparations for Promoting Blood Circulation and Removing Blood Stasis for Cirrhotic Patients with Portal Vein Thrombosis Following Splenectomy

This article presented an overview of the therapeutic effects of Chinese medicine(CM)preparations for promoting blood circulation and removing blood stasis for patients with portal vein thrombosis(PVT)after splenectomy.Based on published clinical researches of CM preparations for PVT after splenectomy in patients with cirrhotic portal hypertension(CPH),this paper evaluated the incidence of PVT,and explored potential active components and mechanisms of CM preparations.Safflower Yellow Injection,Danshen Injection,Danhong Injection,and Compound Danshen Dropping Pill achieved good curative effect alone or combined with anticoagulant therapy.In addition,Compound Biejia Ruangan Tablet and Anluo Huaxian Pill can also significantly improve the hemodynamic disorders of portal vein system in patients with cirrhosis.Considering the role of CM preparations in ameliorating the incidence of PVT after splenectomy in patients with CPH,we suggested that future research should provide more attention to CM alone or CM combined with anticoagulant for cirrhosis with PVT.

Endothelial injury and inflammation in patients with hyperuricemic nephropathy at chronic kidney disease stages 1-2 and 3-4

BACKGROUND Endothelial injury and inflammation are the main pathological changes in hyperuricemic nephropathy(HN);however,they have not been assessed in patients in the early,middle,and late phases of HN.AIM To investigate endothelial injury and inflammatory conditions between patients with HN at chronic kidney disease(CKD)stages 3-4 and CKD 1-2.METHODS This study enrolled 80 patients(49 and 31 with HN at CKD stage 1-2 and 3-4,respectively)from the Department of Nephrology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between July 2021 and January 2022.Plasma levels of heparan sulfate,endocan,oxidized low-density lipoprotein(Ox-LDL),E-selectin,soluble intercellular adhesion molecule-1(slCAM1),interleukin(IL)-1β,and IL-6 and urine levels of lipocalin-type prostaglandin D synthase(L-PGDS),IL-1β,and IL-6 were measured using enzyme-linked immunosorbnent assay.RESULTS Comparison between patients with HN at CKD 1-2 and those with HN at CKD 3-4 showed that age and disease course were significant factors(P<0.001 and P<0.010,respectively).There were no statistical differences in sex,heart rate,body mass index,and systolic and diastolic blood pressures.The incidence of hypertension was also significant(P=0.03).Plasma levels of heparin sulfate(P<0.001),endocan(P=0.034),E-selectin(P<0.001),slCAM1(P<0.001),IL-1β(P=0.006),and IL-6(P=0.004)and the urine levels of L-PGDS(P<0.001),IL-1β(P=0.003),and IL-6(P<0.001)were high in patients with HN at CKD 3-4 than in those with HN at CKD 1-2.The difference in plasma Ox-LDL levels was not significant(P=0.078).CONCLUSION Vascular endothelial injury and inflammation were higher in patients with HN at CKD3-4 than at CKD 1-2.Plasma heparin sulfate and slCAM1 levels are synergistic factors for CKD staging in HN.

Chinese Herbal Medicine-induced Liver Injury

The widespread use of Chinese herbal medicine (CHM) and the associated adverse reactions has attracted the attention of researchers and physicians.Reports have shown that several types of CHM can cause liver injury,with increasing numbers of cases reported every year.The difficulty in characterizing CHM-induced liver injury stems from clinical manifestations,diagnosis and pathogenesis.The clinical manifestations are varied,but gastrointestinal symptoms are the majority.The Council for International Organizations of Medical Sciences scale is currently the most commonly used method for assessing causality in cases of medicine-induced liver injury with excellent sensitivity,specificity and predictive validity.However,the pathogenesis of CHM-induced liver injury is not well understood.The classic view encompasses a contribution from "toxic metabolites" that either elicit an immune response or directly affect cellular biochemical processes or functions.In addition,poor quality and inappropriate clinical use of CHMs contribute to safety concerns.To ensure the safe use of CHMs and decrease the number of hepatotoxic cases,clinicians,researchers and pharmaceutical companies should share responsibility by regulating clinical use,strengthening basic toxicology research and establishing a strict quality control system.

Guben Tongluo Formula Protects LPS-induced Damage in Lamina Propria B Lymphocytes Through TLR4/MyD88/NF-κB Pathway

Objective The main pathological feature of immunoglobulin A nephropathy(IgAN),an autoimmune kidney disease,is the deposition of IgA immune complexes,accompanied by mesangial cell proliferation and elevated urine protein.The Guben Tongluo formula(GTF)is a traditional Chinese medicine prescription,which has predominant protective effects on IgAN.However,the therapeutic mechanism of the GTF in IgAN remains elusive.The present study aimed to determine the effects of GTF in treating IgAN via regulating the TLR4/MyD88/NF-κB pathway.Methods In the present study,lamina propria B lymphocytes were treated with different concentrations of lipopolysaccharide(LPS)(0,1,5,10 and 20 ng/mL).Flow cytometry was used to define positive CD86+CD19+cells.CCK-8 assay was used to examine cell proliferation.RNAi was used to induce TLR4 silencing.qRT-PCR and Western blotting were used to determine gene expression.Results It was found that the LPS dose-dependently increased the content of IgA and galactose-deficient IgA1(Gd-IgA),the levels of TLR4,Cosmc,MyD88 and phosphorylated(p)-NF-κB,and the ratio of CD86+CD19+and IgA-producing B cells.However,the TLR4 knockdown reversed the role of LPS.This suggests that TLR4 mediates the effects of LPS on lamina propria B lymphocytes.Furthermore,the GTF could dose-dependently counteract the effects of LPS and TLR4 overexpression on lamina propria B lymphocytes through the TLR4/MyD88/NF-κB pathway.Conclusion Collectively,these results demonstrate that the GTF can regulate the TLR4/MyD88/NF-κB pathway to treat IgAN model lamina propria B lymphocytes stimulated by LPS.

Efficacy and Safety of Yanggan Jian in Hepatitis B Virusrelated Decompensated Cirrhosis:A Randomized,Doubleblind,Controlled Trial

Background and Aims:The aim was to evaluate the efficacy and safety of Yanggan Jian(YGJ)in HBV-infected patients with decompensated cirrhosis.Methods:This randomized,double-blind controlled trial enrolled 160 patients with HBV-related decompensated cirrhosis who were already receiving or about to start antiviral therapy.Patients were randomly assigned to receive YGJ or placebo for 24 weeks,and were followed-up to 36 weeks.The primary outcome was the proportion of patients with a≥2 point reduction in Child-Turcotte-Pugh(CTP)score from baseline at week 24.Secondary outcomes were CTP class and score,serum liver function indices,mortality,incidence of hepatocellular carcinoma and variceal bleeding.Results:The proportion of patients with a CTP score reduction≥2 was significantly greater in the YGJ than in the placebo group(p=0.009);the percentage of patients with CTP class C was significantly less than that in the placebo group(p<0.05),and the YGJ group had a significantly greater mean change from baseline in CTP score at week 24(p=0.034).The improvement in measured values and change from baseline of prothrombin time,serum albumin,platelets,cholinesterase,international normalized ratio,and activated partial thromboplastin time were significantly better with YGJ than with placebo.Between-group differences in cumulative rates of variceal bleeding,hepatocellular carcinoma,death,or the frequency of any adverse event(AE),AEs related to treatment,or discontinuation because of AEs were not significant.Conclusions:YGJ significantly improved CTP scores and hepatic synthetic and reserve function in patients with HBV-related decompensated cirrhosis,and was safe and well tolerated.

Minimal change disease caused by polycythemia vera: A case report

BACKGROUND Polycythemia vera(PV),often attributed to the JAK2 V617F mutation,is characterized by enhanced red blood cell counts in the peripheral blood.PV-associated renal disease is clinically rare;to date,there have been reports of other chronic kidney diseases related to PV,but no reports on PV-associated minimal change disease.CASE SUMMARY A 37-year-old man presented with proteinuria and high red blood cell count on January 4,2021.The patient underwent bone marrow and renal biopsies,then was subsequently diagnosed with PV and minimal change in disease.Hydroxyurea was administered and proteinuria remission was achieved.The patient’s last visit was on April 14,2022.CONCLUSION We inferred that there may be a causal relationship between PV and minimal change disease.

Hepatic transcriptome delineates the therapeutic effects of Sanren Tang(三仁汤)on high-fat diet-induced non-alcoholic fatty liver disease

OBJECTIVE:To evaluate the effects of Sanren Tang(SRT,三仁汤)on a high-fat diet(HFD)-induced non-alcoholic fatty liver disease(NAFLD)in mice and to investigate the hepatic transcriptome regulated by SRT.METHODS:The primary SRT components were identified using ultra-high-performance liquid chromatography-high-resolution accurate mass spectrometry.The SRT-induced pharmacological effects on HFD-induced NAFLD were evaluated in mice for 16 weeks.Obeticholic acid was used as a control drug.Body weight,food intake,and homeostatic model assessment for insulin resistance(HOMA-IR)index were analysed.Hepatic histological changes were observed in haematoxylin and eosin-stained sections and quantified using the NAFLD activity score(NAS).Serum alanine aminotransferase(ALT)and hepatic triglyceride(TG)levels were measured.Lipids in hepatocytes were visualised by Oil red staining.RNA-sequencing was performed to determine the transcriptome profile of the liver tissue.The differentially expressed genes were validated using real-time polymerase chain reaction and Western blotting.RESULTS:Four principal compounds were identified in the SRT:adenosine,amygdalin,luteoloside,and magnolol.SRT ameliorated hepatic histology and lipid deposition in the NAFLD mice,and decreased HOMA-IR,NAS and ALT,and hepatic TG levels.Hepatic transcriptome analysis revealed 232 HFD-regulated genes that were reversed by SRT simultaneously.Retinol metabolism,cytokine-cytokine receptor interaction,and peroxisome proliferator-activated receptor(PPAR)γsignalling were the top three SRT-regulated pathways in NAFLD.CONCLUSIONS:SRT significantly ameliorated HFD-induced NAFLD,which was correlated with the regulation of genes enriched in the retinol metabolism,cytokine-cytokine receptor interaction,and PPARγsignalling pathways.

Comprehensive profiling and characterization of the absorbed components and metabolites in mice serum and tissues following oral administration of Qing-Fei-Pai-Du decoction by UHPLC-Q-Exactive-Orbitrap HRMS

Qing-Fei-Pai-Du decoction(QFPDD)is a Chinese medicine compound formula recommended for combating corona virus disease 2019(COVID-19)by National Health Commission of the People's Republic of China.The latest clinical study showed that early treatment with QFPDD was associated with favorable outcomes for patient recovery,viral shedding,hospital stay,and course of the disease.However,the effective constituents of QFPDD remain unclear.In this study,an UHPLC-Q-Orbitrap HRMS based method was developed to identify the chemical constituents in QFPDD and the absorbed prototypes as well as the metabolites in mice serum and tissues following oral administration of QFPDD.A total of 405 chemicals,including 40 kinds of alkaloids,162 kinds of flavonoids,44 kinds of organic acids,71 kinds of triterpene saponins and 88 kinds of other compounds in the water extract of QFPDD were tentatively identified via comparison with the retention times and MS/MS spectra of the standards or refereed by literature.With the help of the standards and in vitro metabolites,195 chemical components(including 104 prototypes and 91 metabolites)were identified in mice serum after oral administration of QFPDD.In addition,165,177,112,120,44,53 constituents were identified in the lung,liver,heart,kidney,brain,and spleen of QFPDD-treated mice,respectively.These findings provided key information and guidance for further investigation on the pharmacologically active substances and clinical applications of QFPDD.

X-Paste improves wound healing in diabetes via NF-E2-related factor/HO-1 signaling pathway

BACKGROUND Diabetic foot ulcers(DFU),as severe complications of diabetes mellitus(DM),significantly compromise patient health and carry risks of amputation and mortality.AIM To offer new insights into the occurrence and development of DFU,focusing on the therapeutic mechanisms of X-Paste(XP)of wound healing in diabetic mice.METHODS Employing traditional Chinese medicine ointment preparation methods,XP combines various medicinal ingredients.High-performance liquid chromatography(HPLC)identified XP’s main components.Using streptozotocin(STZ)-induced diabetic,we aimed to investigate whether XP participated in the process of diabetic wound healing.RNA-sequencing analyzed gene expression differences between XP-treated and control groups.Molecular docking clarified XP’s treatment mechanisms for diabetic wound healing.Human umbilical vein endothelial cells(HUVECs)were used to investigate the effects of Andrographolide(Andro)on cell viability,reactive oxygen species generation,apoptosis,proliferation,and metastasis in vitro following exposure to high glucose(HG),while NF-E2-related factor-2(Nrf2)knockdown elucidated Andro’s molecular mechanisms.RESULTS XP notably enhanced wound healing in mice,expediting the healing process.RNA-sequencing revealed Nrf2 upregulation in DM tissues following XP treatment.HPLC identified 21 primary XP components,with Andro exhibiting strong Nrf2 binding.Andro mitigated HG-induced HUVECs proliferation,metastasis,angiogenic injury,and inflammation inhibition.Andro alleviates HG-induced HUVECs damage through Nrf2/HO-1 pathway activation,with Nrf2 knockdown reducing Andro’s proliferative and endothelial protective effects.CONCLUSION XP significantly promotes wound healing in STZ-induced diabetic models.As XP’s key component,Andro activates the Nrf2/HO-1 signaling pathway,enhancing cell proliferation,tubule formation,and inflammation reduction.

Chemical characters and protective effect of Baqi Lingmao formula(巴芪灵猫方) on experimental liver injury

OBJECTIVE:To investigate the chemical characters of water-extract of Baqi Lingmao formula(巴芪灵猫方,BQLM formula)and its effects on anti-liver injury in model mice and live cells.METHODS:BQLM formula was composed of ten herbal medicines.We determined the contents of alkaloids,saponins,phenolic acids and flavonoid in BQLM formula by UV spectrophotometry.The active components of alkaloids and phenolic acids in BQLM formula were identified by HPLC chromatography.The anti-hepatic injury effects of BQLM formula were investigated with concanavalin A(Con A)-induced hepatitis model of mice,human liver LO2 and Hep G2.2.15 cells.RESULTS:BQLM formula(2 and 10 g/kg,orally)significantly improved the damages of liver tissues and functions caused by Con A in mice,reduced the infiltration of inflammatory cells into liver and inhibited the inflammatory cytokine secretion of interferon-γ,tumor necrosis factor-αand interleukin-6.BQLM formula simultaneously decreased the levels of alanine aminotransferase and aspartate aminotransferase of liver and serum,and recovered the superoxide dismutase and catalase activities of liver to normal levels in Con A-induced hepatic-injury mice.The serum of BQLM formula group stimulated the human liver LO2 cell proliferation in vitro.Further,BQLM formula obviously promoted the proliferation of normal hepatocytes(LO2 cells)and inhibited the hepatocytes death induced by Con A.It also significantly inhibited the proliferation of Hep G2.2.15 cells and decreased the secretion of HBs Ag and HBe Ag in vitro.CONCLUSIONS:BQLM formula has anti-inflammation and anti-hepatitis virus Beffects,and is capable of improving liver injury in vivo and in vitro.

Potential Role of EGF and EGFR in Tongue Coating Formation

Tongue coating, as a sensitive index of the physiological and pathological changes of human organs, is an important basis for the Traditional Chinese Medicine(TCM) syndrome differentiation and treatment. Mechanism of the formation and change of tongue coating is an important scientific problem. In recent years, researches indicated that in addition to apoptosis related genes, epidermal growth factor(EGF) and epidermal growth factor receptor(EGFR) also contribute to tongue coating formation. In this paper, we summarized recent studies on the potential role of EGF and EGFR in regulating the formation of tongue coating to provide some reference for the further investigations on tongue coating formation mechanisms.

Active Components Formulation Developed from Fuzheng Huayu Recipe for Anti-Liver Fibrosis

Objective:To screen the active components from Fuzheng Huayu Recipe(FZHY)and redesign a new recipe composed of the active components,and validate the effect of active components formulation from FZHY against liver fibrosis.Methods:Thirty-two components from FZHY were evaluated for their activities against liver fibrosis respectively,with 6 kinds of cell models in vitro,including oxidative stressed hepatocyte in L-02,hypoxia injured/proliferative hepatic sinusoidal endothelial cells in SK-HEP-1 and human hepatic sinusoidal endothelial cells(HHSEC),and activated hepatic stellate cell in LX-2.The comprehensive activity of each component against liver fibrosis was scored according to the role of original herbs in FZHY and cell functions in fibrogenesis.Totally 7 active components were selected and combined with equal proportion to form a novel active components formulation(ACF).The efficacy of ACF on liver fibrosis were evaluated on activation of LX-2 and proliferation of HHSEC in vitro and in liver fibrosis model mice induced by dimethylnitrosamine(DMN).Totally 72 mice were divided into6 groups using a random number table,including normal,high-dose ACF control(20μmol/L×7 components/kg body weight),model,low-,medium-,high-dose ACF groups(5,10,20μmol/L×7 components/kg body weight,respectively).Hematoxylin eosin and Sirius red stainings were used to observe inflammation and fibrosis change of liver tissue;scanning electron microscopy(SEM)and transmission electron microscopy(TEM)were utilized to observe the effect of ACF on ultrastructure of hepatic sinusoids.Results:Fifteen components from FZHY showed higher scores for their activity on against liver fibrosis.Among them,7 components including tanshinoneⅡA,salvianolic acid B,cordycepin,amygdalin,quercetin,protopanaxatriol,and schizandrin B were recombined with equal proportions to form ACF.ACF at 1,2,4μmol/L showed strong inhibitory effects on activation of LX-2 and proliferation of HHSEC in vitro(all P<0.01).Compared with the model group,ACF attenuated liver collagen deposition,improved sinusoidal capillarization in a dose-dependent manner(all P<0.05).Conclusions:ACF exerts a satisfactory effect against experimental liver fibrosis and attenuates sinusoidal capillarization,which warrant a further research and development for herbal components formulation on liver fibrosis.