Effect of Ejiao (Asini Corii Colla) and Turtle Carapace Glue on Gut Microbiota in Nude Mice with Uterine Fibroids Based on High-Throughput Sequencing of 16SrRNA Gene.

Objective: To observe the effects of Asini Corii Colla, turtle carapace glue, and other drugs on the intestinal flora of nude mice with uterine fibroids model, so as to provide evidence for the clinical application of drugs. Methods: Set up five groups: blank control group, turtle carapace glue group, turtle carapace glue and ejiao 4 : 1 mixed group, turtle carapace glue and ejiao 1 : 1 mixed group, and turtle shell glue and Salvia miltiorrhiza (danshen) 1 : 1 mixed group. Then, the model nude mice were fed ejiao, turtle carapace glue, and other corresponding drugs. Before administration, 2 weeks after administration, and 4 weeks after administration, the feces of the model nude mice were taken respectively, subpacked into labeled cryotubes, and stored at -80°C. All samples were sent for gene sequencing after completion. The differences in gut microbiota and abundance in different groups were compared by 16SrRNA segment sequencing. Results: ① There were differences in flora composition and a relative abundance among the groups, but the strains with a high relative abundance were Bacteroides, Firmicutes, and Proteobacteria; ② there were significant differences in the community structure and composition of intestinal flora between nude mice treated for 4 weeks and those not treated (p < 0.05); ③ after 4 weeks of administration, the relative abundance of Bacteroidetes in each group was higher than that before administration, and the relative abundance of Firmicutes decreased. Conclusion: Asini Corii Colla, turtle carapace glue, and other drugs with different compatibility ratios can change the composition of intestinal flora in nude mice with uterine fibroids to a certain extent; the decrease in the relative abundance of Firmicutes and the increase in the relative abundance of Bacteroidetes were important structural changes of intestinal flora in nude mice at 4 weeks after administration.

Efficacy of Chinese herbal prescriptions containing Ejiao or Velvet antler for management of uterine fibroids: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: To evaluate the efficacy and safety of the controversial Chinese herbal prescriptions containing Ejiao or Velvet antler (VA) in the treatment of uterine fibroids. METHODS: We searched 4 famous Chinese databases, the Chinese Clinical Trial Registry, PubMed, Cochrane Central, Google Scholar, Embase, and J-STAGE up to July 2019. We included all eligible randomized controlled trials (RCTs) which compared Chinese herbal prescriptions containing Ejiao or VA (E/VA) with placebo, pharmaceutical intervention, surgery, or other traditional Chinese medicines (TCMs) for uterine fibroids and assessed the risk of bias according to the Cochrane Collaboration's tool. The software Review Manager (RevMan) 5.1 was used for data analysis. RESULTS: A total of 9 RCTs involving 844 patients were identified. Meta-analyses demonstrated that TCM (E/VA) plus mifepristone reduced the volume of uterine fibroids to a greater degree than mifepristone alone [standardized mean difference (SMD): 0.59, 95% CI: 0.33 to 0.85, P<0.00001, I2=50%]; TCM (E/VA) did not enlarge the volume of fibroids when menopausal hormone therapy (MHT) significantly increased the volume (SMD: 1.06, 95% CI: 0.73 to 1.38, P<0.00001, I2=0. The uterine volume change difference was larger via combination therapy of TCM (E/VA) and mifepristone than that of mifepristone (SMD: 0.29, 95% CI: 0.09 to 0.49, P=0.005, I2=0%). The TCM (E/VA) group of had an advantage over the control group in the improvement of fibroid-related symptoms [relative risk (RR): 1.24, 95% CI: 1.15 to 1.35, P<0.00001, I2=0%]. It was found that TCM (E/VA) plus mifepristone could lower estradiol (E2) levels to a greater degree than mifepristone alone (SMD: 1.63, 95% CI: 0.42 to 2.83, P=0.008, I2=97%), as well as progesterone (P) level (SMD: 0.79, 95% CI: 0.55 to 1.04, P<0.00001, I2=43%) in non-menopausal women. A total of 5 studies reported adverse events (AEs), the TCM (E/VA) group was potentially safer than the control group, with lower incidence of AEs (RR: 0.24, 95% CI: 0.15 to 0.40, P<0.00001, I2=25.8%). DISCUSSION: TCM prescriptions containing E/VA seemed superior to the control group in shrinking the volume of uterine fibroids and uterus, improving related symptoms, and reducing non-menopausal women's E2 and P levels, with lower incidence of AEs.

Protective Effect of Compound Formula Rehmannia against Neurotoxicity and Apoptosis Induced by α-Syn in In Vivo and In Vitro Models of Parkinson's Disease.

The present study aimed to investigate the protective effect of compound formula Rehmannia (CFR) against the development of Parkinson's disease (PD). After the in vivo and in vitro models of PD were established with overexpression α-syn induced, CFR was administrated into the PD model rats for 6 weeks or SK-N-SH cells with coincubation for 48 h. Apomorphine-induced rotation test, CCK8 assay, TUNEL assay, immunofluorescence staining, and western blot assay were performed to evaluate the behavioral changes, cell viability, cell apoptosis, α-syn, GSK-3ß, P-GSK-3ß (Ser9), P-GSK-3ß (Tyr216), and ß-catenin expression in PD rats or SK-N-SH cells. PD rat behavior results showed that the rotation numbers were significantly decreased in the CFR treatment group comparing with the AAV-α-syn PD model group. The cell viability suppressed by H2O2 and α-syn in SK-N-SH model cells was also significantly improved with CFR administration. Cell apoptosis and α-syn overexpression observed in PD rats and SK-N-SH cells were also inhibited by CFR treatment. Furthermore, the protein expression of α-syn, GSK-3ß, P-GSK-3ß (Ser9), P-GSK-3ß (Tyr216), and ß-catenin in in vivo and in vitro was also significantly regulated by CFR. The present study suggested that CFR may be considered as a potential neuroprotective agent against PD, and this application will require further investigation.

Effects of shikonin from Zicao on high-fat diet-induced nonalcoholic fatty liver disease in rats.

In this study, we aim to investigate whether shikonin prevents against NAFLD. After feeding high-fat diet (HFD) for 10 weeks, Sprague-Dawley rats were received different doses of shikonin (5mg/kg/day, 10mg/kg/day and 20mg/kg/day) by gavage for the last 12 weeks of a total of 22 weeks of a HFD. Our results showed that total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol, aspartate aminotransferase and alanine aminotransferase were significantly increased, while high-density lipoprotein cholesterol was decrease, accompanied by hepatic injury and lipid accumulation in HFD-fed rats. Shikonin treatment attenuated the above biochemical and histopathological changes. Similarly, HFD-induced the increase of hepatic TC and TG levels were also ameliorated by shikonin treatment. Furthermore, shikonin observably mitigated HFD-induced the liver fibrosis and the increase of plasminogen activator inhibitor type 1, connective tissue growth factor, collagen III and IV expression. Additionally, shikonin markedly inhibited HFD-induced the decrease of proliferator-activated receptor γ (PPARγ) and matrix metalloproteinases-9 (MMP-9) expression and the increase of tissue inhibitor of metalloproteinases-1 (TIMP-1) expression in liver tissue. This study demonstrates that shikonin ameliorates hepatic lipid dysregulation and fibrosis through PPARγ and MMP-9/TIMP-1 axis, suggesting that shikonin may be a potential therapeutic agent for the treatment of NAFLD.

Acupuncture for hiccups: A systematic review protocol of high-quality randomized trials.

BACKGROUND: A Hiccup is a common disease that often occurs along with other chronic or acute conditions. At present, there is a lack of feasible therapies for hiccups, and acupuncture is a treatment method with enormous clinical practice worldwide. METHODS: Based on a pre-defined search strategy, we searched seven databases and screened them by two independent investigators, without language and publication status restriction from inception to date. We use the pre-set form to incorporate data and utilize Revman software to synthesize data. We will evaluate the risk of bias in the inclusion of the study based on the Cochrane 'Risk of bias' assessment tool. The quality of the evidence will be evaluated according to the GRADEpro software. RESULTS: This systematic review will evaluate the efficacy and safety of acupuncture treatment for hiccups. The entire process will be referred to the Cochrane handbook recommended by the Cochrane Collaboration. CONCLUSION: This review will provide systematic evidence to summarize whether acupuncture is an effective intervention in the treatment of hiccup.

Protective role of arnebin-1 in rats with nonalcoholic fatty liver disease.

OBJECTIVE: To examine the effects of arnebin-1 on nonalcoholic fatty liver disease (NAFLD) induced by a high-fat diet (HFD). METHODS: Male Sprague-Dawley rats were fed an HFD for 10 weeks and then treated with arnebin-1 at a dose of 5, 10 or 20 mg/kg/day by gavage for a further 12 weeks of a 22-week HFD. Peripheral blood and liver tissues were collected for biochemical and histopathological examination. The mechanisms of arnebin-1 on liver fibrosis and insulin resistance (IR) were determined by Western blotting and real-time quantitative polymerase chain reaction. RESULTS: Arnebin-1 treatment attenuated the increase of total cholesterol, triglycerides, low-density lipoprotein cholesterol, aspartate aminotransferase and alanine aminotransferase in serum and lipid accumulation in the livers of HFD-fed rats. Furthermore, arnebin-1 abrogated HFD-induced liver fibrosis and the increase of fibrotic biomarkers. The HFD-induced decrease of hepatic proliferator-activated receptor γ and pro-matrix-metalloproteinase (MMP)-9 levels and the increase of tissue inhibitor of metalloproteinase-1 (TIMP-1) levels were reversed after arnebin-1. Arnebin-1 attenuated IR through activating the insulin receptor substrate-1/Akt/mTOR signalling pathway. CONCLUSION: This study demonstrated that arnebin-1 ameliorates NAFLD, in part, by attenuating hepatic fibrosis and IR, suggesting that arnebin-1 may be a therapeutic agent for NAFLD treatment.

Correlation between Traditional Chinese Medicine Constitution and Dyslipidemia: A Systematic Review and Meta-Analysis.

OBJECTIVE: To study the correlation between Traditional Chinese Medicine (TCM) constitution and dyslipidemia. METHODS: CNKI, VIP, Wanfang database, CBMdisc, PubMed, and Embase were searched, and meta-analysis was performed by Review Manager 5.2 software. RESULTS: Altogether 11 studies were included with 12890 individuals. The results showed that balanced constitution was a protective factor of dyslipidemia (OR = 0.62, 95% CI 0.47~0.82) while phlegm-dampness constitution was a risk factor of it (OR = 2.50, 95% CI 2.22~2.80), and the effect of phlegm-dampness constitution in South China (OR = 3.31, 95% CI 1.71~6.43) was more obvious than that in East (OR = 2.40, 95% CI 2.06~2.80) and North China (OR = 2.24, 95% CI 1.81~2.78). CONCLUSION: This study provides evidence for the prevention and treatment of dyslipidemia in TCM. However, most of the studies included are of moderate quality; more high quality, multicenter, large-sample studies are expected to provide higher level evidence.

Computer-aided tumor diagnosis using shear wave breast elastography.

The shear wave elastography (SWE) uses the acoustic radiation force to measure the stiffness of tissues and is less operator dependent in data acquisition compared to strain elastography. However, the reproducibility of the result is still interpreter dependent. The purpose of this study is to develop a computer-aided diagnosis (CAD) method to differentiate benign from malignant breast tumors using SWE images. After applying the level set method to automatically segment the tumor contour and hue-saturation-value color transformation, SWE features including average tissue elasticity, sectional stiffness ratio, and normalized minimum distance for grouped stiffer pixels are calculated. Finally, the performance of CAD based on SWE features are compared with those based on B-mode ultrasound (morphologic and textural) features, and a combination of both feature sets to differentiate benign from malignant tumors. In this study, we use 109 biopsy-proved breast tumors composed of 57 benign and 52 malignant cases. The experimental results show that the sensitivity, specificity, accuracy and the area under the receiver operating characteristic ROC curve (Az value) of CAD are 86.5%, 93.0%, 89.9%, and 0.905 for SWE features whereas they are 86.5%, 80.7%, 83.5% and 0.893 for B-mode features and 90.4%, 94.7%, 92.3% and 0.961 for the combined features. The Az value of combined feature set is significantly higher compared to the B-mode and SWE feature sets (p=0.0296 and p=0.0204, respectively). Our results suggest that the CAD based on SWE features has the potential to improve the performance of classifying breast tumors with US.

Intensity-Invariant Texture Analysis for Classification of BI-RADS Category 3 Breast Masses.

Radiologists likely incorrectly classify benign masses as Breast Imaging Reporting and Data System (BI-RADS) category 3. A computer-aided diagnosis (CAD) system was developed in this study as a second viewer to avoid misclassification of carcinomas. Sixty-nine biopsy-proven BI-RADS category 3 masses, including 21 malignant and 48 benign masses, were used to evaluate the CAD system. To improve the texture features, gray-scale variations between images were reduced by transforming pixels into intensity-invariant ranklet coefficients. The textures of the tumor and speckle pixels were extracted from the transformed ranklet images to provide more robust features than in conventional CAD systems. As a result, tumor texture and speckle texture with ranklet transformation achieved significantly better areas under the receiver operating characteristic curve (Az) compared with those without ranklet transformation (Az = 0.83 vs. 0.58 and Az = 0.80 vs. 0.56, p value < 0.05). The improved CAD system can be a second reader to confirm the classification of BI-RADS category 3 masses.

Whole breast lesion detection using naive bayes classifier for portable ultrasound.

In recent years, portable PC-based ultrasound (US) imaging systems developed by some companies can provide an integrated computer environment for computer-aided diagnosis and detection applications. In this article, an automatic whole breast lesion detection system based on the naive Bayes classifier using the PC-based US system Terason t3000 (Terason Ultrasound, Burlington, MA, USA) with a hand-held probe is proposed. To easily retrieve the US images for any regions of the breast, a clock-based storing system is proposed to record the scanned US images. A computer-aided detection (CAD) system is also developed to save the physicians' time for a huge volume of scanned US images. The pixel classification of the US is based on the naive Bayes classifier for the proposed lesion detection system. The pixels of the US are classified into two types: lesions or normal tissues. The connected component labeling is applied to find the suspected lesions in the image. Consequently, the labeled two-dimensional suspected regions are separated into two clusters and further checked by two-phase lesion selection criteria for the determination of the real lesion, while reducing the false-positive rate. The free-response operative characteristics (FROC) curve is used to evaluate the detection performance of the proposed system. According to the experimental results of 31 cases with 33 lesions, the proposed system yields a 93.4% (31/33) sensitivity at 4.22 false positives (FPs) per hundred slices. Moreover, the speed for the proposed detection scheme achieves 12.3 frames per second (fps) with an Intel Dual-Core Quad 3 GHz processor and can be also effectively and efficiently used for other screening systems.

Automatic selection of representative slice from cine-loops of real-time sonoelastography for classifying solid breast masses.

This study aimed to evaluate the performance of automatic selection of representative slice from cine-loops of real-time sonoelastography for classifying benign and malignant breast masses. This retrospective study included 141 ultrasound elastographic studies (93 benign and 48 malignant masses). A novel computer-assisted system was developed for the automatic segmentation of the targeted lesion from cine-loops of real-time sonoelastography. Its hard ratio, defined as the ratio of the number of hard pixels within the tumor divided by the total number of pixels of the whole tumor, was also calculated. The targeted mass was segmented by edge-detection and region growing methods, with combined motion registration after manually defining the original seed. Signal-to-noise ratio (SNR(e)) and contrast-to-noise ratio (CNR(e)) of ultrasound elastogram were computed to obtain an optimum slice for differentiating benign and malignant lesions. The diagnostic results of automatic slice selection using maximum strain, maximum SNR(e), maximum CNR(e), maximum compression and the slices selected by radiologists were compared. Mann-Whitney U test, performance indexes and receiver operating characteristic (ROC) curves were used for statistical analysis. Performance using the maximum SNR(e) (accuracy 84.4%, sensitivity 83.3%, specificity 85.0% and A(z) value 0.90) was the best as compared with those of maximum CNR(e) (82.3%, 79.2%, 83.9% and 0.88, respectively), maximum compression (78.0%, 79.2%, 77.4% and 0.85, respectively), maximum strain (79.4%, 79.2%, 79.6% and 0.87, respectively) and radiologists' selection (77.3%, 77.1%, 77.4% and 0.80, respectively). Automatic selection of representative slice from the cine-loops of real-time sonoelastography is a practical, objective and accurate approach for classifying solid breast masses.