ABSTRACT
Liver fibrosis is a necessary intermediate process from the progression of chronic hepatitis B to liver cirrhosis and liver cancer. In recent years, breakthroughs have been made in the research on traditional Chinese medicine (TCM) for the prevention and treatment of chronic hepatitis B liver fibrosis. For the purpose of improving clinical outcome, multidisciplinary industry-university-research studies are conducted to explain the biological basis of TCM syndromes of chronic hepatitis B liver fibrosis, and establishment and development of a non-invasive diagnostic model with TCM characteristics, optimization of TCM/integrated traditional Chinese and Western medicine treatment regimens, and elaboration on the scientific connotation of TCM treatment can help TCM for the prevention and treatment of liver fibrosis to enter the global world.
ABSTRACT
Based on the unique syndrome characteristics of metabolic associated fatty liver disease （MAFLD） in Lingnan （岭南） area， this paper discussed the clinical experience of Huangqi （Radix Astragali） in the treatment of MAFLD in Lingnan area. It is summarized that spleen deficiency and yang weakness， and internal accumulation of damp-turbidity are the source of the disease， and at the early stage， Huangqi， commonly 15~30 g， could be used to fortify the spleen and warm the earth， thereby making the deficiency fire latent， as well as raise the clear and warm the exterior so as to inhibit damp-turbidity； medication needs to be progressively supplemented， and can be used together with Taizishen （Radix Pseudostellariae）， Baizhu （Rhizoma Atractylodis Macrocephalae）， Fuling （Poria）， and Fangfeng （Radix Saposhnikoviae） to back up the earth and inhibit dampness. Qi stagnation and blood constraint， yin dampness and heat accumulation are the pathogenesis of disease progression. Huangqi should be taken to invigorate the spleen and flourish the liver， unblock yang， and move stagnation. The dosage is often maintained at 30~60 g， to circulate the qi and unblock yang qi in the middle jiao （焦）， usually combined with Chaihu （Radix Bupleuri）， Baishao （Radix Paeoniae Alba） and Yujin （Radix Curcumae） integrating warm and cool medicinals. Stubborn turbid and fat condensing in the liver is a severe stage of the disease and may be concurrent with various pathogens such as dampness， phlegm， and heat， for which 60~90 g Huangqi should be used to invigorate blood and disperse fat， reinforce healthy qi and expel pathogens， often with medicinals that can disperse fat and direct the turbid downward such as Shanzha （Fructus Crataegi）， Juemingzi （Semen Cassiae）， Lulutong （Fructus Liquidambaris） and Zexie （Rhizoma Alismatis）. When prescribing， it is suggested to combine with other medicinals according to the season， thereby adjusting the ascending and descending of the property of Huangqi， thereby conforming to the nature of the four seasons.
ABSTRACT
In recent years, significant breakthroughs have been made in the research on the role of traditional Chinese medicine (TCM) in the prevention and treatment of chronic hepatitis B liver fibrosis. In terms of clinical research, several multicenter randomized double-blind controlled studies have been conducted with liver pathological changes as the main efficacy evaluation indicator, which have improved the level of evidence in clinical research on the TCM prevention and treatment of liver fibrosis. As for basic research, in-depth studies have been conducted on the mechanism of action of TCM in intervening against liver fibrosis at various levels, including the effect on HSC activation, apoptosis and autophagy, inhibition of liver inflammatory injury, immunoregulation, and inhibition of hepatic sinusoidal capillarization, thereby highlighting the advantages and research difficulties of TCM through "multiple components, targets, and pathways". Under the guidance of Implementation Plan for the Major Projects of Revitalizing and Developing TCM, it is crucial to conduct high-quality clinical and basic research on TCM in the treatment of liver fibrosis, produce high-quality industry achievements, and thus help TCM to be recognized around the world.
ABSTRACT
Objective To establish a simple scoring system for the diagnosis of liver fibrosis in chronic hepatitis B (CHB), and to observe its sensitivity and specificity. Methods Two hundred and thirty-three patients diagnosed as CHB by liver biopsy were divided into model group (N = 154) and validation group (N = 79). The general information, biochemical parameters and imaging data of all patients were observed. With hepatic fibrosis being obvious or not as the end point of primary study in the model group, we established a simple scoring system for the diagnosis. The cut-off, sensitivity and specificity of the system were tested in the model group by ROC curve, and its diagnostic efficacy was tested in the validation group. Results(1) A simple scoring system for the diagnosis of liver fibrosis called MDFS was established in the model group, and the dimensions of the system included sex, HBV-DNA, Fibroscan (FS) value and splenomegaly. In MDFS, male, HBV-DNA≥ 107 U/mL,FS value≥7.3 kPa, and splenomegaly were assigned 1 point, -2 points, 3 points, and 2 points respectively. (2) The best cut-off value in MDFS was 2 points.(3) ROC curve of the model group indicated that the specificity and sensitivity were 92.86% and 54.76% respectively, the area under curve(AUC) was 0.790, and the Youden index was 0.4762. In the validation group, the diagnostic cut-off value was over 2 points, and the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 52.17%, 82.35%, 2.96, and 0.58 respectively. (4) The scoring results of MDFS for different traditional Chinese medical syndromes of CHB showed that the scores of blood stasis blocking collaterals > damp-heat accumulation > deficiency of spleen and kidney yang> liver depression and spleen deficiency = stagnation of liver Qi. Conclusion The MDFS diagnostic scoring system has medium efficiency. The specificity of MDFS is relatively high and MDFs has a relatively low misdiagnosis rate for the diagnosis of obvious hepatic fibrosis in CHB. The MDFS is expected to be a noninvasive and simple diagnosing way for hepatic fibrosis in CHB.
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The high quality of Chinese and western integrative medicine talents is the premise of the integrated Chinese and Western medicine to the world. Postgraduate education is directly related to the development of Chinese and Western medicine. The Second Clinical Medical College of Guang-zhou University of Chinese Medicine integrated the declaration and organization and implementation of the national major scientific research projects with Chinese and Western Medicine. By building ech-elon team model and establishing a platform for the exchange of research and communication platform, which covers the academic, technical, scientific and technological innovation, and so on, it cultivated high-level, complex and integrated Chinese and Western Medicine talents from knowledge and skills, innovation ability, interpersonal ability, and comprehensive management ability, etc.
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Objective To evaluate the effects of propofol on the proliferation of hippocampal neurons in fetal rats in vitro.Methods Pregnant Sprague-Dawley rats at 16-18 days of gestation,were sacrificed and the fetal rats were taken out from the abdominal cavity.The hippocampal neurons of the fetal rats were isolated and seeded in culture plates.After being cultured for 9 days,the neurons were divided into 7 groups using a random number table(n =36 each):control group (C group),intralipid group (I group) and propofol 0.1,1.0,10.0,100.0,1 000.0 μmol/L groups (P1-5 groups).In group I,10％ intralipid was added to the culture media until the final concentration reached 100 μmol/L.In P1-5 groups,propofol was added to the culture media until the final concentration reached 0.1,1.0,10.0,100.0 and 1 000.0 μmol/L,respectively.The neurons were then incubated for 3 h.The proliferation of hippocampal neurons was determined by MTT assay at 12,24,36,48,60 and 72 h after the end of incubation with propofol.Results Compared with group C,the proliferation of hippocampal neurons was significantly decreased in P1-5 groups (P ＜ 0.05),while no significant change was found in group I (P ＞ 0.05).Compared with group P1,the proliferation of hippocampal neurons was significantly decreased in group P5 (P ＜ 0.05),while no significant change was found in P2-4 groups (P ＞ 0.05).Conclusion Propofol can decrease the proliferation of hippocampal neurons in fetal rats in vitro.
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Objective To explore the therapeutic effects and the possible defense mechanisms of Shenmai injection on acute lung injury.Methods SD rats were randomly divided into three groups:the control group(NS),the oleic acid group(OA)and the Shenmai injection group(SM).The modal of acute lung injury in rat(OA group and SM group)were induced by receiveing 0.1ml/kg oleic acid injection into tail vein,and NS group were injected 0.9% sodium chloride 0.1ml/kg.After in jecting loeic acid SM group were injected with Shenmai injection by 2ml each one.The expression of ICAM-1 was examined meanwhile examining breath frequency,wet/dry weight ratio,artery blood oxygen each group of rats,the histopathologieal change of lung tissue was observed.Results The W/D ratio,polymorphonuclear(PMN)infiltration,the lung interstitial edema,the extent of pulmonary alvedus wall destroys and the ICAM-1 expression in lung tissue of OA group increasingly increased compared with NS group,and SM group significantly decreased compared with OA group.Also along with time extending,the ICAM-1 expression of OA group devates gradually,while SM group does not change significantly.The arterial partial pressure of oxygen in group OA significantly decreased compared with NS group,while SM group increased compared with OA group.The microscope demonstrated that the extent of lung injury of OA group was more serious than that of NS group,while OA group was milder than OA group.Conclusion Shenmai injection can lighten oleic acid induced acute lung iniury,and cut down the expression of ICAM-1 in lung tissue.So it has a certain function to the early the acute lung injury.