[Mechanism of Huangqi Guizhi Wuwu Decoction in treatment of rheumatoid arthritis based on UPLC-LTQ-Orbitrap-MS, network pharmacology, and cell experiment].

In this study, ultra-high performance liquid chromatography-linear ion trap/electrostatic field orbit trap combined-type mass spectrometry(UPLC-LTQ-Orbitrap-MS) was used to analyze the main active components of Huangqi Guizhi Wuwu Decoction(HQGZ). A total of 50 active components were identified from HQGZ and 108 potential targets of the components related to the treatment of rheumatoid arthritis were retrieved based on network pharmacology, including 87 key targets, followed by Gene Ontology(GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment of the targets. The result indicated that HQGZ may exert therapeutic effects mainly through the sphingolipid signaling pathway, tumor necrosis factor(TNF) signaling pathway, as well as the positive regulation of ribonucleic acid(RNA) polymerase Ⅱ promoter transcription, inflammatory response and other biological processes. At the same time, cell experiment was performed to verify the key proteins in the TNF signaling pathway. The results demonstrated that HQGZ significantly reduced the expression of caspase-3(CASP3), TNF, relaxed(RELA) protein, and IkappaB kinase beta(IKBKB) in fibroblast-like synoviocytes induced by TNF-α. The results of UPLC-LTQ-Orbitrap-MS, network pharmacology and cell experiment showed that the active components in HQGZ may inhibit inflammatory response and regulate immune function and cell apoptosis by modulating key proteins in TNF signaling pathway to treat rheumatoid arthritis.

[Prescription regularity of famous veteran traditional Chinese medicine Doctor Yu Guoyou for treating gastrointestinal failure based ondata mining].

Gastrointestinal failure is a kind of severe systemic inflammatory response, and often complicated with multiple organ dysfunction syndrome. Integrated traditional Chinese and Western medicine have a better curative effect in treating it. This study collected the famous veteran TCM physician Yu Guoyou's 175 prescriptions for treating 89 cases of gastrointestinal failure, calculated the frequency of traditional Chinese medicines and their categories, and analyzed the medication regularity with system clustering method, so as to summarize Yu's frequently used drugs and prescriptions. The results showed the top three most frequently used drugs aremagnolia bark, bitter orange, and rhubarb, which are components of Xiaochengqi decoction; Among the traditional Chinese medicines, medicines of tonifying deficiency, regulating qi, clearing heat, eliminating phlegm and dissipating dampness are most commonly used. Among the tonic medicines, those for tonifying Qi accounted for 2/3, which was the largest proportion; At the same time, some new prescriptions and new drug combinations were excavated and could be used as the reference for clinical medication. According to the findings, when differentiating syndromes of gastrointestinal failure, Yu regards the spleen and stomach Qi deficiency as the root cause and the heat toxin, blood stasis, Qi stagnation and dampness as the symptoms. In the treatment of gastrointestinal function failure, Yu gives priority to strengthening spleen, regulating Qi and purgation, prescribes medicines for dissolving blood stasis and detoxication, dissipating dampness, clearing heat and eliminating phlegm according to syndrome types. In other words, the treatment is based on syndrome differentiation, and the prescription is modified according to symptoms. In particular, Yu attaches importance to stomach-Qi recuperation and gastrointestinal function recovery in the process of treatment.

[Research status on regulation of Chinese herbal compound on intestinal microecology].

The ralationship between traditional Chinese medicine (TCM) and intestinal microecology is increasingly being given more and more attention. Combined with the devolopment of intestinal microecology disciplines, effects of TCM on regulation of intestinal microecology have been gradually explained. Both clinical studies and animal experiments have confirmed that TCM can maintain the balance of intestinal microecology and regulate the intestinal flora. The author arrangemented the documents related to Chinese herbal compound adjusting intestinal flora in the recent ten years, summarized that the Chinese herbal compound which can strength spleen and replenish Qi, relax bowels and regulate Qi, dissipate dampness and check diarrhea, clear away heat and toxic materials, promote digestion and relieve stasis had certain regulation effects on intestinal microecology, providing basis for revealing the TCM essence of intestinal microecology.

[Effect of yangyin yiqi huoxue recipe on immune balance of Th1/Th2 in serum and submaxillary glands of NOD mice with Sjogren's syndrome].

OBJECTIVE: To observe the effect of Yangyin Yiqi Huoxue Recipe (YYHR) on expression of interferon-gamma (IFN-gamma), IL-2, IL-4, IL-10, and immune balance of Th1/Th2 in serum and submaxillary glands of non-obese diabetic (NOD) mice with Sjogren's syndrome (SS), and to explore its mechanisms. METHODS: Totally 32 NOD mice were randomly into 4 groups, i.e., the model group, the Chinese medicine group [CM, administered with YYHR at the dose of 0.4 mL by gavage (100 g/kg)], the Western medicine group [WM group, administered with hydroxychloroquine 0.4 mL by gavage (60 mg/kg)], and the combined group [administered with YYHR (50 g/kg) and hydroxychloroquine (60 mg/kg) 0.4 mL by gavage], 8 mice in each group. Eight Balb/C mice were recruited as the normal control group. Mice were sacrificed to withdraw blood after 8 weeks. The submaxillary gland was excised. Serum levels of IFN-gamma, IL-2, IL-4, and IL-10 were detected by ELISA. Protein expression of IFN-gamma, IL-2, IL-4, and IL-10 in submaxillary glands was detected by SP method. RESULTS: Compared with the normal group, levels of IFN-gamma, IL-2, IL-4, and IL-10 in serum and submaxillary glands all increased in the model group (P < 0.05). Levels of IFN-gamma and IL-10 in serum in the CM group and the combined group were lower than those of the WM group (P < 0.05). Serum levels of IFN-gamma and IL-2 in submaxillary glands in combined group were lower than those of the WM group (P < 0.05). The ratio of IFN-gamma/IL-4 in serum and submaxillary glands in the model group were higher than that of the rest groups (P < 0.05). Besides, it was the nearest to that of the normal group. CONCLUSIONS: YYHR could decrease the levels of Th1 and Th2 related cytokines and the ratio of IFN-gamma/IL-4 in serum and submaxillary glands of NOD mice with SS. It could achieve therapeutic effects through adjusting immune balance of Th1/Th2 in SS mice.

[Effect of prescriptions replenishing vital essence, tonifying Qi and activating blood on TNF-alpha, IL-1beta expressions in serum and submaxillary gland of NOD mice with Sjogren's syndrome].

OBJECTIVE: To observe effect of prescriptions replenishing vital essence, tonifying Qi and activating blood on expression of tumor necrosis factor-alpha (TNF-alpha) and interleukin-IP (IL-1beta) in serum and submaxillary gland of non-obese diabetic (NOD) mice with Sjogren's syndrome. METHOD: Thirty-two NOD mice were divided into four groups at random: the model group, the traditional Chinese medicine (TCM) group, the hydroxychloroquine group, the TCM and western medicine (WM) group, with 8 mice in each group. Eight Balb/C mice were taken as the normal normal control group. The TCM group was orally administered with 0.4 mL decoction replenishing vital essence, tonifying Qi and activating blood (100 g x kg(-1)) everyday; the hydroxychloroquine group were given 0.4 mL hydroxychloroquine (60 mg x kg(-1)) everyday; the TCM WM group were given 0.4 mL decoction, replenishing vital essence tonifying Qi and activating blood (50 g x kg(-1)) and hydroxychloroquine (60 mg x kg(-1)) everyday. Mice were sacrificed after eight weeks, and their arterial blood and tissues of submaxillary gland were collected. The levels of TNF-alpha, IL-1beta in serum were detected by ELISA. Expressions of TNF-alpha, IL-1beta protein in submaxillary gland were detected by immunohisto-chemistry. RESULT: Compared with other groups, TNF-alpha, IL-1beta in serum and submaxillary gland in the model group were higher (P < 0.05). The normal group showed lower serum TNF-alpha level than other groups (P < 0.05), but without statistical significance compared with the TCM group. IL-1beta in serum in the TCM group and the TCM WM group were lower than that of the hydroxychloroquine group (P < 0.05), but without statistical significance compared with the normal group. TNF-alpha protein expression in the TCM group and the TCM WM group showed no significant difference compared with the normal group, whereas the TCM WM group were notably lower than that of the hydroxychloroquine group (P < 0.05). IL-1beta expression in the TCM WM group showed no significant difference compared with the normal group. CONCLUSION: The decoction replenishing vital essence, tonifying Qi and activating blood can decrease the levels of TNF-alpha, IL-1beta in serum and submaxillary gland of NOD mice with Sjogren's syndrome. It may improve pathological damage of submaxillary gland by regulating Th1/Th2 cell factors, in order to achieve the therapeutic effect on SS.

[Effect of nourishing Yin, strengthening Qi and activating blood decoction on Fas/FasL in salivary glands of NOD mice with Sjogren's syndrome and their mRNA expression].

OBJECTIVE: To observe the effect of nourishing Yin, strengthening Qi and activating blood decoction on Fas/FasL in salivary glands of NOD mice with Sjogren's syndrome and their mRNA expression. METHOD: Thirty-two NOD mice were randomly divided into the model group, the traditional Chinese medicine group (TCM group, orally given 0.4 mL nourishing Yin, strengthening Qi and activating blood decoction as per 100 g x kg(-1) everyday), the hydroxychloroquine group (given 0.4 mL hydroxychloroquine as per 60 mg x kg(-1) everyday), the traditional Chinese medicine and western medicine group (TCM WM group, given nourishing Yin, Strengthening Qi and activating blood decoction 50 g x kg(-1) and hydroxychloroquine 60 mg x kg(-1), 0.4 mL everyday), with eight mice in each group. Eight Balb/C mice were selected as the normal control group (normal group). All of mice were killed after eight weeks, and their submaxillary glands were dissected. The expression levels of Fas/FasL were examined by immunohistochemical method, and the FasL mRNA was detected by RT-PCR. RESULT: The expression levels of Fas/FasL in salivary glands of the model group were higher than that of other groups (P < 0.05). The expression level of FasL of the normal group was much lower than that in the hydroxychloroquine group (P < 0.05). The relative expression level of Fas mRNA in salivary glands of the model group was higher than that in other groups, but the control group was notably lower than other groups (P < 0.05). The expression level of FasL mRNA in salivary glands of the model group was higher than that in TCM and TCM WM groups (P < 0.05). But the expression level in TCM WM group was notably lower than the hydroxychloroquine group (P < 0.05). CONCLUSION: The nourishing Yin, strengthening Qi and activating blood decoction could down-regulate the expression level of Fas/FasL in salivary glands of NOD mice with Sjogren's syndrome and their mRNA expression, and had a better efficacy after being combined with hydroxychloroquine. The nourishing Yin, strengthening Qi and activating blood decoction might treat the Sjogren's Syndrome by reducing apoptosis which is regulated by Fas/FasL

Effects of dan wei powder tea bag on aggregation of blood platelet in vivo and in vitro.

OBJECTIVE: To observe effects of Dan Wei Powder (Powder for treating the gall bladder and stomach) Tea Bag (DWSTB) on the aggregation rate of blood platelet in vivo and in vitro. METHODS: Increase of the platelet aggregation rate in the rat in vivo was induced by carrageenin, and increase of the rabbit platelet aggregation rate in vitro was induced by adenosine diphosphate (ADP) and collagen, respectively. The effects of DWSTB on the platelet aggregation rate were investigated in vivo and in vitro, respectively. RESULTS: The maximum in vivo platelet aggregation rate in the rat was significantly decreased after administration of 2.0 and 4.0 g x kg(-1) DWSTB (P < 0.05, P < 0.01). The maximum rabbit platelet aggregation rate induced by ADP and collagen in vitro were suppressed significantly by 2.0-16.0 mg x mL(-1) and 2.0-8.0 mg x mL(-1) DWSTB, respectively (P < 0.05, P < 0.01). And the effect of DWSTB on platelet aggregation was raised with increase of its dose. CONCLUSION: Dan Wei Powder Tea Bag can restrain the aggregation of platelet in vivo and in vitro.

[Analysis on the common causes for traditional Chinese medicinal injection induced adverse reactions and the preventive countermeasures].

As a new dosage form, TCM injection is commonly used in clinical practice. But the increasing events of adverse drug reactions (ADRs) could even seriously endanger patients' lives. The causes of TCM injection inducing ADRs might be the unstable quality of preparation; the irrational clinical use and operation; the sensitive physique of patient and the change of patients' primary illness, etc. For preventing the occurrence of ADRs, based on guaranteeing the stable quality of product, putting stress on accurate usages and normalized operations in clinical practice, enhancing the monitor on ADRs and the precautionary awareness in medical units are very important.

[Clinical analysis of hepatic veno-occlusive disease induced by Sedum aizoon].

OBJECTIVE: To discuss the clinical characteristics and precautionary measures of hepatic veno-occlusive disease (VOD) caused by Sedum aizoon. METHOD: The VOD induced by Sedum aizoon were reports in 41 patients comimg from national medical journals from 1998 to 2007 and their use and dose were analyzed. RESULT: The results shows that ADR of Sedum aizoon was serious. VOD has relationship with it, s dose use time the age of the patients and individual difference. CONCLUSION: To avoid of VOD induced by Sedum aizoon, it should be done through strengthening study on pharmacology and toxicology of Sedum aizoon. Enhancing patients of safety awareness, standardizing usage and dosage to guide the clinically rational use of drugs.

[Effect of puerarin on levels of TGF-beta1 and alpha-SMA in rats with alcoholic injury liver].

OBJECTIVE: To investigate the regulatory effects of puerarin on the levels of transforming growth beta1 (TGF-beta1) and alpha-smooth muscle actin (alpha-SMA) in rats with alcoholic injury liver, and to probe into the prevention and cure mechanism of puerarin on alcoholic liver injury. METHOD: Seventy five SD rats were randomly divided into 5 groups: normal group 10 rats. model group 20 rats (alcohol etc mixed liquor twice per day), control group 15 rats (alcohol etc mixed liquor + complex biejia ruangan pian 1 g kg(-1) d(-1)), puerarin high dose group 15 rats (alcohol etc mixed liquor + puerarin tablet 1.5 g kg(-1) d(-1)), puerarin low dose group 15 rats (alcohol etc mixed liquor + puerarin pill 0.75 g kg(-1) d(-1)). After 8 weeks. femoral vein blood of the rats were taken out in all rats and then rats were sacrificed to obtain liver samples. Samples were collected to observe pathological change and to detect expression of TGF-beta1, and alpha-SMA in liver tissue. RESULT: Pathological change and hepatic fibrosis integration of liver tissue in model group were significantly changed compared with other group (P<0.05). Meanwhile the level of TGF-beta1 and alpha-SMA in both high and low dose puerarin groups were significantly decreased compared with model group (P<0.01). Furthermore the level of alpha-SMA of puerarin high dose group were significantly decreased compared with control group (P<0.05), whereas there was no significant difference between puerarin low dose group and model group. CONCLUSION: There was an ascend in the level of TGF-beta1 and alpha-SMA expression in rats with alcoholic injury liver, and puerarin has regulatory effects on the expression of TGF-beta1 and alpha-SMA.

[Effects of gastrodin injection on blood pressure and vasoactive substances in treatment of old patients with refractory hypertension: a randomized controlled trial].

OBJECTIVE: To examine and determine the contents of endothelin (ET) and nitric oxide (NO) in plasma, and to observe the effects of gastrodin injection on blood pressure, ET and NO levels in old patients with refractory hypertension. METHODS: A total of 63 old patients with refractory hypertension, 30 patients with common hypertension and 30 healthy people were included. The contents of ET and NO in plasma of patients in different groups and healthy people were examined and analyzed. The old patients with refractory hypertension were randomly divided into two groups: gastrodin-treated and routine treatment groups. Besides conventional hypotensive drugs, intravenous drip infusion of 1 000 mg gastrodin was administered to the patients in gastrodin-treated group for two courses (4 weeks), while the patients in routine treatment group were treated only with conventional hypotensive drugs. The changes of blood pressure, ET and NO levels before and after treatment in different groups were measured. RESULTS: The plasma level of ET in refractory hypertension group was higher than that in common hypertension group (t=3.27, P=0.008), while the level of NO was lower (t=-3.81, P=0.002). The systolic pressure and pulse pressure difference in gastrodin-treated group were decreased significantly after one course of treatment (t=1.85, P=0.03; t=1.74, P=0.04). The level of ET in gastrodin-treated group decreased gradually after treatment, but there were no significant difference between before treatment and two courses of treatment, while the level of NO in gastrodin-treated group was increased after treatment (t=-2.70; P=0.04). CONCLUSION: Gastrodin injection is beneficial to old patients with refractory hypertension, and can improve the balance of ET and NO levels in plasma.

Effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on reproductive endocrine activity and immune functions in patients with primary Sjogren's syndrome.

OBJECTIVE: To investigate the effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on the reproductive endocrine-immune network and its mechanisms in patients with primary Sjogren's syndrome (pSS). METHODS: Seventy pSS patients were randomly assigned to two groups using a randomized digital table: the integrative therapy group (36 cases) and the control group (34 cases). Thirty healthy subjects were taken as a normal group. The control group was treated with hydroxychloroquine sulfate tablets alone, and the integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets. The treatment course was 6 months for both groups. Before and after treatment, serum estradiol (E2), testosterone (T), luteinizing hormone (LH), prolactin (PRL) by radioimmunoassay and immunoglobulin (IgG) by immunodiffusion, erythrocyte sedimentation rate (ESR) by Westergren, interferon-γ (IFN-γ) and interleukin-4 (IL-4) by enzyme linked immunosorbent assay were determined. RESULTS: E2 and T levels in all patients were lower than those of normal subjects before treatment (P<0.05) and were increased significantly after 6-month treatment (P<0.05). ESR, FSH, LH, IgG, IFN - γ, IL - 4 and ratios of E2/T, and IFN -γ/IL in the patients were higher than those of normal subjects before the treatments (P<0.05), and were reduced significantly after the treatments (P<0.05). The T and IFN - γ levels and E2/T ratio in the patients treated with integrative therapy were reduced significantly compared with the control group (P<0.05). However, the PRL levels before and after treatment were not significantly changed in the two groups (P>0.05). The ratios of E2/T and IFN -γ/IL-4, and levels of IgG and ESR were positively correlated before and after treatment (P<0.05). CONCLUSIONS: The ratios of E2/T and IFN -γ/IL-4 might be used as indicators of pSS activity. Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with Western medicine could improve the therapeutic effect by regulating the reproductive endocrine-immune network in pSS patients.

Effect of Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood on the Th1/Th2 immune balance in peripheral blood in patients with primary Sjogren's syndrome.

OBJECTIVE: To observe the effect of Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood on the expression of interferon-γ (IFN-γ)/interleukin-4 (IL-4) in peripheral blood and disease activity in primary Sjogren's syndrome (pSS) patients, and to study the relationship between the immune balance of Th1/Th2 and the disease activity. METHODS: A total of 66 pSS patients were randomized with tossing coins method into two groups: the integrative therapy group (34 cases) and the control group (32 cases); and 28 healthy subjects were taken as the normal group. The integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets and the control group was treated with hydroxychloroquine sulfate tablets. The treatment course was 3 months for both groups. The levels of serum immunoglobulin G (IgG), erythrocyte sedimentation rate (ESR), IFN-γ and IL-4 in peripheral blood were measured before and after treatment. RESULTS: Compared with the normal group, the levels of IgG, ESR, IFN-γ and IL-4 were significantly increased in pSS patients (P<0.05). Remarkably, after 3 months of treatment, these levels were dramatically decreased in both the integrative therapy group and the control group, although still higher than the normal group. The levels of IgG, ESR, IFN-γ and IL-4 in the integrative therapy group were lower than the control group and the same group before treatment (P<0.05). The ratio of IFN-γ/IL-4 also significantly decreased after treatment. Moreover, the level of IFN-γ and the ratio of IFN-γ/IL-4 in the integrative therapy group were significantly lower than the control group (P<0.05). For all patients the ratio of IFN-γ/IL-4 before and after treatment was positive correlated with the levels of IgG and ESR. CONCLUSION: Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood can alleviate the disease activity of pSS by regulating the immune balance of Th1/Th2.

Therapeutic effect of Chinese herbal medicine for strengthening qi, nourishing yin, and removing stasis on serum osteopontin and quality of life of patients with primary Sjogren's syndrome.

OBJECTIVE: To observe the therapeutic effect of Chinese herbal medicine for strengthening qi, nourishing yin, and removing stasis on serum osteopontin (OPN) and quality of life (QOL) in patients with primary Sjogren's syndrome (pSS) and to study the correlation between OPN level and the disease. METHODS: Sixty-eight pSS patients were randomly assigned to two groups: the treatment group (35 cases) treated by Chinese herbal medicine for strengthening qi, nourishing yin, and removing stasis combined with hydroxychloroquine sulfate tablet (HCQ) and the control group (33 cases) treated by HCQ only. Both were treated for 3 months. Before and after treatment, immunoglobulin G (IgG) level, erythrocyte sedimentation rate (ESR), and OPN level were measured. The QOL in patients was evaluated using the Short Form-36 Health Survey (SF-36) before and after treatment. Thirty healthy females were taken as the normal control. RESULTS: Before treatment, levels of IgG, ESR, and OPN in patients were higher than those in the normal control. After 3 months of treatment, those in both treatment groups decreased but were lower in the treatment group than those in the control group (P<0.05). The scores of 8 dimensions of SF-36 were lower in the pSS patients than those in the normal control (P<0.05) and higher in the treatment group than in the control group after treatment (P<0.05). Furthermore, there was a positive correlation between the levels of OPN and the levels of IgG and ESR, and a negative correlation between OPN levels and the overall score of SF-36 (P<0.05). CONCLUSIONS: Chinese herbal medicine for strengthening qi, nourishing yin, and removing stasis could alleviate pSS disease and improve the QOL. In addition, the OPN level might be used as an evaluating index for pSS disease.

Short-term effect of combined therapy with Jinlong Capsule and transcatheter arterial chemoembolization on patients with primary hepatic carcinoma and its influence on serum osteopontin expression.

OBJECTIVE: To observe the clinical combination effect of Jinlong Capsule (JLC) and transcatheter arterial chemoembolization (TACE) on the patients with primary hepatic carcinoma (PHC) and JLC' s influence on serum osteopontin (OPN) expression and elucidate the correlation between the serum OPN level and curative effect of JLC and TACE. METHODS: A total of 98 patients with PHC were observed in a randomized controlled trial (RCT). They were assigned to the Chinese medicine (CM) group (53 patients who were treated with TACE and JLC) and the intervention group (45 patients who were treated with TACE only). The serum OPN levels were measured before and after treatment by quantitative sandwich enzyme-linked immunosorbent assay (ELISA). Forty healthy people were assigned to the control group. The clinical efficacy was observed and Karnofsky score (KPS) was graded. RESULTS: The clinical efficacy of the CM group (60.38%) was better than that of the intervention group (40.00 %), and the KPS (84.35+/-12.19) was higher than the intervention group (69.86+/- 11.58) (P<0.05). The serum OPN levels before and after treatment in the patients with PHC were significantly elevated compared with those in the control group (P<0.01). After treatment, the OPN levels in CM group (117.69 <+/-78.50) were significantly lower compared with those in intervention group (151.09+/-83.90, P<0.05). The OPN levels of responders were remarkably lowered than the non-responders after treatment, and the level of OPN in the CM group was lower than the intervention group (P<0.05). CONCLUSIONS: The short-term clinical efficacy and the quality of life of patients with PHC can be improved by combining JLC with TACE. The serum OPN levels in PHC patients can reflect the curative effect of treatment and the prognosis of the disease.