Chinese herbal medicine for chronic heart failure:a multicenter,randomized,double-blind,placebo-controlled trial

Objective:The purpose of this study was to assess the efficacy and safety of Chinese herbal medicine(CHM)in the treatment of chronic heart failure(CHF)patients according to syndrome differentiation.Methods:In this multicenter,randomized,double-blind,placebo-controlled clinical trial,a total of 220 CHF patients were assigned to receive CHM or placebo granules without decoction according to syndrome differentiation in addition to their standard western treatment for 4 weeks.The change in the left ventricular ejection fraction(LVEF)was the primary outcome,and the changes in the TCM syndrome scores(TCM-SS)and New York Heart Association functional classification(NYHA-FC)were the secondary outcomes.

Comparison of pharmacokinetics of different oral Panax notoginseng saponins using ultra-high performance liquid mass spectrometry

Objective:To discuss and compare the plasma pharmacokinetics after three oral Panax notoginseng saponin(PNS)administrations in beagle dogs.PNS is the main active ingredient of the traditional Chinese medicine(TCM)Panax notoginseng.Although its outstanding therapeutic efficacy has been demonstrated by various researchers,its broader application is restricted by the low bioavailability of PNS.Methods:An ultra-high performance liquid chromatographyetandem mass spectrometry(UPLC-MS/MS)method for the simultaneous quantification of notoginsenoside R1,ginsenoside Rg1,ginsenoside Rb1,ginsenoside Rd,and ginsenoside Re in beagle dog plasma was developed and validated.The plasma samples were subjected to liquideliquid extraction with acetone and methanol,and separated on an ACQUITY C18 column(100×2.1 mm ID,1.7 mm)using acetonitrile and water as the mobile phase with a run time of 4.5 min.Results:The analytes were detected without interference in Selected Reaction Monitoring mode with positive electrospray ionization.The validated method was successfully used in comparative pharmacokinetic studies of the five saponins in beagle dogs after oral administration of three PNS preparations.Blood samples were collected up to 192 h after administration and pharmacokinetic parameters were calculated using DAS 3.20 and SPSS 17.0.The AUC_(0-t)values of Re and R1 were significantly higher in soft capsules than in hard capsules.However,the AUC_(0-t)values between hard and soft capsules were not significantly different for the other three componentsdRb1,Rd and Rg1.Conclusion:Our intuitive analysis suggests that the bioavailability of PNS in soft capsules is greater than in hard capsules.

37 CASES OF MYOGENIC TORTICOLLIS TREATED BY SCALP AND BODY ACUPUNCTURE

Congenital myogenic torticollis is akind of disease due to unilateral spasm ofmusculus sternocleidomastoideus whichleads to ipsilateral tilt of head.In terms

Effect of Jianpi Liqi recipe on diabetic dyspepsia and its effect on blood lipid level

Objective:To observe the clinical effect of Jianpi Liqi Decoction on diabetic gastroparesis.Methods:80 patients were randomly divided into 2 groups,Treatment and control groups,40 cases per group,The treatment group used Jianpi Liqi recipe,One dose a day,Take it twice,Six times a week,For 4 weeks;Control group with mosapride citrate,5 mg,each Three times a day,Take continuously for 4 weeks.Observe the two groups before treatment,2 weeks after treatment,4 weeks after treatment,Subjective symptoms(early satiety,abdominal distention,upper abdomen burning,upper abdomen pain)score;Before and after treatment,The contents of FBG,2 hPG,HbA1c,TC,GAS,MLT in the two groups.Results:The scores of early satiety,abdominal distention,burning sensation of upper abdomen and pain of upper abdomen were decreased,Intra-group comparisons,Differences were statistically significant(P<0.05);After treatment,the gastric emptying rate increased in both groups,A more significant increase in the treatment group(P<0.05);Treatment group after treatment TC,TG,LDL-C decreased more significantly(P<0.05);After treatment,the GAS,MLT content of both groups increased significantly,Intergroup comparisons,and the difference was statistically significant(P<0.05).Conclusion:Jianpi Liqi Decoction is effective in treating Diabetic gastroparesis,High security,it is worth clinical use.

Vagus nerve stimulation protects against cerebral injury after cardiopulmonary resuscitation by inhibiting inflammation through the TLR4/NF-κB and α7nAChR/JAK2 signaling pathways

BACKGROUND: Our previous research proved that vagus nerve stimulation(VNS) improved the neurological outcome after cardiopulmonary resuscitation(CPR) by activating α7 nicotinic acetylcholine receptor(α7nAChR) in a rat model, but the underlying mechanism of VNS in neuroprotection after CPR remains unclear.METHODS: In vivo, we established a mouse model of cardiac arrest(CA)/CPR to observe the survival rate, and the changes in inflammatory factors and brain tissue after VNS treatment. In vitro, we examined the effects of α7nAChR agonist on ischemia/reperfusion(I/R)-induced inflammation in BV2 cells under oxygen-glucose deprivation/reoxygenation(OGD/R) conditions. We observed the changes in cell survival rate, the levels of inflammatory factors, and the expressions of α7nAChR/Janus kinase 2(JAK2) and toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB).RESULTS: In vivo, VNS preconditioning enhanced functional recovery, improved the survival rate, and reduced hippocampal CA1 cell damage, and the levels of inflammatory mediators after CA/CPR. The application of α7nAChR agonists provided similar effects against cerebral injury after the return of spontaneous circulation(ROSC), while α7nAChR antagonists reversed these neuroprotective impacts. The in vitro results mostly matched the findings in vivo. OGD/R increased the expression of tumor necrosis factor-alpha(TNF-α), TLR4 and NF-κB p65. When nicotine was added to the OGD/R model, the expression of TLR4, NF-κB p65, and TNF-α decreased, while the phosphorylation of JAK2 increased, which was prevented by preconditioning with α7nAChR or JAK2 antagonists.CONCLUSION: The neuroprotective effect of VNS correlated with the activation of α7nAChR. VNS may alleviate cerebral IR injury by inhibiting TLR4/NF-κB and activating the α7nAChR/JAK2 signaling pathway.

Clinical Observation on the Combined Use of Acupuncture and Herbal Medicine for Treatment of Chloasma

Objective:To observe the clinical effects of the combined use of acupuncture and herbal medicine for treatment of chloasma.Methods:Totally 60 patients were randomly divided into a treatment group of 30 cases,treated by acupuncture and herbal medicine,and a control group of 30 cases,administered Vitamin C and Vitamin E.The clinical effects were observed.Results:The total effective rate of the treatment group is 93.3%better than that of the control group(76.7%) ,the difference was significant(P<0.01) .Conclusion:Combined use of acupuncture and herbal medicine may yield definite therapeutic effects in treating chloasma patients.

Left-sided vagus nerve stimulation improves cardiopulmonary resuscitation outcomes in rats as effectively as right-sided vagus nerve stimulation

BACKGROUND: Our group previously reported that right-sided vagus nerve stimulation(RVNS) significantly improved outcomes after cardiopulmonary resuscitation(CPR) in a rat model of cardiac arrest(CA). However, whether left-sided vagus nerve stimulation(LVNS) could achieve the same effect as RVNS in CPR outcomes remains unknown.METHODS: A rat model of CA was established using modified percutaneous epicardial electrical stimulation to induce ventricular fibrillation(VF). Rats were treated with LVNS or RVNS for 30 minutes before the induction of VF. All animals were observed closely within 72 hours after return of spontaneous circulation(ROSC), and their health and behavior were evaluated every 24 hours.RESULTS: Compared with those in the RVNS group, the hemodynamic measurements in the LVNS group decreased more notably. Vagus nerve stimulation(VNS) decreased the serum levels of tumor necrosis factor-alpha(TNF-α) and the arrhythmia score, and attenuated inflammatory infiltration in myocardial tissue after ROSC, regardless of the side of stimulation, compared with findings in the CPR group. Both LVNS and RVNS ameliorated myocardial function and increased the expression of α-7 nicotinic acetylcholine receptor in the myocardium after ROSC. Moreover, a clear improvement in 72-hour survival was shown with VNS pre-treatment, with no significant difference in efficacy when comparing the laterality of stimulation. CONCLUSIONS: LVNS may have similar effects as RVNS on improving outcomes after CPR.

E-cadherin-transfected Neural Stem Cells Transplantation for Spinal Cord Injury in Rats

The effects of E-cadherin-transfected neural stem cells（NSCs） transplantation for spinal cord injury（SCI） in rats were investigated. Sixty SD rats were randomly divided into model control group, NSCs group, empty plasmid group and E-cadherin overexpression group（n=15 each）. The animal SCI model was established by using the modified Allen＇s method. NSCs were cultured. Rats in NSCs group were subjected to NSCs transplantation. E-cadherin gene eucaryotic expression vector and pcDNA3.1-E-cadherin were respectively transfected into cultured NSCs, serving as empty plasmid group and E-cadherin overexpression group respectively. At 7th day after transplantation, neurological function of all rats was assessed by Tarlov score. After rats were sacrificed in each group, the number of BrdU and Nestin positive cells was counted by immunohistochemistry. Immumofluorescence method was used to detect the expression of neurofilament protein（NF） and glial fibrillary acidic protein（GFAP）. As compared with model control group, the Tarlov score and the number of of BrdU and Nestin positive cells, and the expression of NF and GFAP in NSCs group, empty plasmid group, and E-cadherin overexpression group were increased significantly（P〈0.05）, and those in the E-cadherin overexpression group were increased more significantly than the other transplantation groups（P〈0.05）. It was suggested that E-cadherin could be conductive to nerve regeneration and repair probably by promoting the proliferation and differentiation of NSCs.

TREATMENT WITH ACUPUNCTURE AT ZUSANLI (St 36) FOR EPIGASTRIC PAIN IN THE ELDERLY

Acupuncture at a single point is a spe-cial feature in the treatment of acute symp-toms for its simplicity and effectiveness.Theauthor experienced many cases of acuteepigastric pain treated with acupuncture at asingle acupoint with satisfactory results.Pain in the elderly is most often of

Relationship between peroxiredoxins protein family levels and osteoporosis in postmenopausal woman

Objective:To observe the expression levels of the main molecules of peroxiredoxins (Prdxs) protein family (Prdx1, Prdx2, Prdx4 and Prdx6) in women with postmenopausal osteoporosis (PMOP), and to analyze their clinical diagnostic values.Methods: Patients diagnosed with PMOP in Hubei Provincial Hospital of Traditional Chinese Medicine and Wuhan Hospital of Traditional Chinese Medicine from May 2016 to March 2018 were included as the study group (72 cases), postmenopausal women with normal bone mineral density (BMD) in the same period were also collected as the control group (51 cases). Levels of Prdx1, Prdx2, Prdx4 and Prdx6 in plasma were determined by ELISA. mRNA levels of Prdx1, Prdx2, Prdx4 and Prdx6 in peripheral blood mononuclear cells (PBMC) were determined by reverse transcription quantitative polymerase chain reaction (RT-qPCR). The correlations between Prdxs and clinical parameters were analyzed. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic values of Prdxs for PMOP.Results: Prdx1, Prdx4 and Prdx6 levels in the study group were significantly lower than those in the control group (P<0.05). The mRNA expression levels of Prdx1 and Prdx6 of PBMC in the study group were significantly lower than those in the control group (P<0.05). Several Prdxs protein levels (plasma) or mRNA levels (PBMC) in the study group were significantly correlated with lipid levels or inflammatory markers levels (P<0.05). The area under the curve (AUC) of plasma Prdx6 for diagnosing PMOP was 0.794 (95% CI =0.714-0.874). And the AUC of mRNA relative expression of Prdx6 in PBMC for diagnosing PMOP was 0.725 (95% CI =0.635-0.814).Conclusion: The decreased expression of Prdxs protein family (especially Prdx1 and Prdx6) is closely related to the incidence of PMOP, and the decreased Prdxs protein family may promote the occurrence of osteoporosis through the abnormal lipid metabolism pathway and the increased systemic inflammation pathway. The detections of Prdx6 levels in plasma and PBMC are of good diagnostic values for PMOP.

Effects of Electro-Acupuncture at Zusanli,Guanyuan for Sepsis Patients and Its Mechanism through Immune Regulation

Objective： TO evaluate the effect of electro-acupuncture on Zusanli （ST 36）, Guanyuan （RN 4） in patients with sepsis, and explore its mechanism in term of immune regulation. Methods： In this prospective randomized controlled trial, 60 patients with sepsis were randomly assigned to the control group and the intervention group equally by block randomization. Patients in the control group received routine treatment and those in the intervention group received electro-acupuncture at bilateral Zusanli and Guanyuan in addition to routine treatment, respectively. The mortality at 28 days, Acute Physiology and Chronic Health Evaluation （APACHE）- II score were compared to evaluate the effect, and the levels of T cell subsets （CD3＋, CD4＋, CD8＋, CD4＋/CD8＋） and monocytes of human leukocyte antigen （HLA）-DR using flow cytometry were compared to explore the mechanism of this combined treatment. ]Results： Fifty-eight patients completed the trial with 29 in each group. There was no significant difference of mortality in the 28th day between the two groups, with 5 death of 29 patients in the intervention group （17.2%） and 9 of 29 in the control group （31.0%）. After treatment, APACHE-11 score of both groups was significantly decreased, however, score of the intervention group was lower than the control group （13.28＋7.07 vs. 17.10＋5.83; P〈0.01）. The levels of CD3＋, CD4＋, CD8＋ and CD4＋/CD8＋ ratio of the intervention group improved after treatment and were higher than the control group （59.71% ± 11.94% vs. 52.54% ±11.86%; 36.46% ± 7.60% vs. 31.58%± 10.23%; 18.40%±8.82% vs. 23.07% ± 7.30%; 2.38± 1.14 vs. 1.54±0.80, respectively; all P〈0.05）. The expression of HLA-DR significantly increased after treatment in the intervention group than that in the control group （7.28% ± 9.26% vs. 1.27% ± 7.00%; P〈0.01）. Conclusion： Electro-acupuncture at Zusanli and Guanyuan could improve clinical curative effect in patients with sepsis, which might be achieved by regulation of the immune system.

Effect of warming Yang and removing blood stasis method on matrix metalloproteinases/tissue inhibitor metalloproteinases levels secreted by cultured endometrial cells from patients with endometriosis

OBJECTIVE:To investigate the effect of Chinese medicines using the warming Yang and removing blood stasis method on levels of matrix metalloproteinases(MMPs)/tissue inhibitor metalloproteinases(TIMPs) secreted by cultured endometrial cells from patients with endometriosis.METHODS:Ectopic and eutopic endometrial cells obtaind from 15 endometriosis patients were cultured in vitro,and divided randomly into five groups:high dose;moderate dose;low dose;nemestran;blank control.The three dose groups were treated with a decoction prepared according to the principle of warming Yang and removing blood stasis;nemestran and 0.9%NaCI were administered to the nemestran group and balnk control group,respectively.Eutopic endometrial cells obtaind from 10 hysteromyoma patients were cultured in vitro,as the normal control group,0.9%NaCI were administered to the normal control group.Cell culture supernatants were collected and levels of matrix metalloproteinase-1(MMP-1),matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),tissue inhibitor metalloproteinase-1(TIMP-1) and tissue inhibitor metalloproteinase-2(TIMP-2) detected by enzyme-linked immuno sorbent assay(ELISA).RESULTS:Compared with the normal control group,levels of MMP-1,MMP-2,and MMP-9 in eutopic and ectopic endometrium cell supernatants in the blank control group were increased,whereas levels of TIMP-1 and TIMP-2 were decreased(P <0.05).Compared with the blank control group,levels of MMP-1 and MMP-2 in ectopic and eutopic endometrium cell supernatants cultured in low-dose,middle-dose,and high-dose groups were decreased,whereas levels of TIMP-1 and TIMP-2 were increased significantly(P < 0.05).CONCLUSION:The warming Yang and removing blood stasis method affects expression of MMPs andTIMPs.

Therapeutic Observation of Point-towards-point Electroacupuncture for Cervical Spondylotic Radiculopathy

Objective: To compare the therapeutic efficacies of point-towards-point electroacupuncture(EA), EA with Jiaji points(EX-B 2), and Jing Fu Kang in treating cervical spondylotic radiculopathy(CSR), and to explore the optimal treatment protocol. Methods: Totally 160 patients with CSR were randomized into three groups: a point-towards-point group(n=60) treated with EA with point-towards-point method; a Jiaji group(n=60) treated with EA at cervical Jiaji(EX-B 2) points; a medicine group(n=40) treated with oral administration of Jing Fu Kang alone. The clinical efficacies were compared afterwards. Results: After treatment, the recovery rate and total effective rate of the point-towards-point group were significantly better than that of the Jiaji group and medicine group(both P<0.01). After 1-week treatment, the symptom and function score of the point-towards-point group was significantly better than that of the Jiaji group and medicine group(both P<0.01); the point-towards-point group and Jiaji group both achieved significant improvements in the symptom and function score(P<0.01, P<0.05). After 2-week treatment, the three groups all achieved marked improvements in the symptom and function score(P<0.01). At the end of treatment, in comparing the symptom and function score, the point-towards-point group was significantly different from the medicine group(P<0.01) and Jiaji group(P<0.05); the difference between the Jiaji group and medicine group was also statistically significant(P<0.05). Conclusion: Point-towards-point EA can rapidly improve the symptoms and function of CSR patients, and it's superior to EA at Jiaji(EX-B 2) and oral administration of Jing Fu Kang in comparing the clinical efficacy.

Treatment of 52 Cases of Rheumatoid Arthritis in the Active Stage by Acupuncture

将临床确诊为活动期类风湿关节炎52例采用针刺加西药治疗,30 d 为1疗程。治疗前后临床症状体征和免疫学指标比较差异显著(P<0.05,P<0.01)。针刺联合西药治疗活动期类风湿关节炎能有效调节体液免疫和提高临床疗效。

温和灸联合氯雷他定治疗儿童变应性鼻炎:随机对照研究

目的探讨温和灸联合氯雷他定治疗儿童变应性鼻炎(AR)的疗效。方法将80例患儿随机分为对照组和观察组,每组40例。对照组予氯雷他定治疗,观察组予温和灸联合氯雷他定治疗。治疗前后评定鼻部症状总评分(TNSS),测定血清嗜酸性粒细胞(EOS)计数及白介素(IL)-27和巨噬细胞移动抑制因子(MIF)水平。并在治疗后评价疗效。结果观察组有效率高于对照组(P<0.05);治疗后,两组TNSS总分均降低(P<0.05),观察组TNSS总分低于对照组(P<0.05);两组血清EOS计数均较治疗前降低(P<0.05),观察组血清EOS计数低于对照组(P<0.05);对照组血清IL-27水平与本组治疗前无统计学差异(P>0.05),血清MIF水平较本组治疗前降低(P<0.05),观察组血清IL-27水平较本组治疗前升高(P<0.05),血清MIF水平较治疗前降低(P<0.05),且均与对照组有统计学差异(P<0.05)。结论温和灸联合氯雷他定治疗儿童AR疗效确切,可显著改善患儿鼻部症状,降低血清EOS计数,这可能与其调节患儿血清IL-27和MIF水平有关。