Characteristics of Traditional Chinese Medicine Syndromes and Treatments of COVID-19 Patients from Two Hospitals Based on “Treatment of Disease in Accordance with Three Conditions” / 中国实验方剂学杂志

ObjectiveTo explore the guidance value of “treatment of disease in accordance with three conditions” theory in the prevention and treatment of corona virus disease 2019（COVID-19） based on the differences of syndromes and traditional Chinese medicine（TCM） treatments in COVID-19 patients from Xingtai Hospital of Chinese Medicine of Hebei province and Ruili Hospital of Chinese Medicine and Dai Medicine of Yunnan province and discuss its significance in the prevention and treatment of the unexpected acute infectious diseases. MethodDemographics data and clinical characteristics of COVID-19 patients from the two hospitals were collected retrospectively and analyzed by SPSS 18.0. The information on formulas was obtained from the hospital information system （HIS） of the two hospitals and analyzed by the big data intelligent processing and knowledge service system of Guangdong Hospital of Chinese Medicine for frequency statistics and association rules analysis. Heat map-hierarchical clustering analysis was used to explore the correlation between clinical characteristics and formulas. ResultA total of 175 patients with COVID-19 were included in this study. The 70 patients in Xingtai，dominated by young and middle-aged males，had clinical symptoms of fever， abnormal sweating，and fatigue. The main pathogenesis is stagnant cold-dampness in the exterior and impaired yin by depressed heat， with manifest cold， dampness， and deficiency syndromes. The therapeutic methods highlight relieving exterior syndrome and resolving dampness， accompanied by draining depressed heat. The core Chinese medicines used are Poria，Armeniacae Semen Amarum，Gypsum Fibrosum，Citri Reticulatae Pericarpium，and Pogostemonis Herba. By contrast，the 105 patients in Ruili， dominated by young females， had atypical clinical symptoms， and most of them were asymptomatic patients or mild cases. The main pathogenesis is dampness obstructing the lung and the stomach， with obvious dampness and heat syndromes. The therapeutic methods are mainly invigorating the spleen， resolving dampness， and dispersing Qi with light drugs. The core Chinese medicines used are Poria，Atractylodis Macrocephalae Rhizoma，Glycyrrhizae Radix et Rhizoma，Coicis Semen，Platycodonis Radix，Lonicerae Japonicae Flos， and Pogostemonis Herba. ConclusionThe differences in clinical characteristics， TCM syndromes， and medication of COVID-19 patients from the two places may result from different regions，population characteristics， and the time point of the COVID-19 outbreak. The “treatment of disease in accordance with three conditions” theory can help to understand the internal correlation and guide the treatments.

Professor ZHU Liang-Chun's Academic Experience in Treating Unstable Carotid Plaques Based on Theory of Phlegm and Blood Stasis / 中国实验方剂学杂志

Unstable carotid plaque is an independent risk factor for serious cerebrovascular events including stroke， making it considered as an intervention target for the primary and secondary prevention of cardiovascular diseases. Professor ZHU Liang-chun is a national distinguished master of traditional Chinese medicine （TCM） who is adept at treating difficult miscellaneous diseases with insects. He believes that the unstable carotid plaque falls into the category of “vessel impediment” in TCM according to the disease location and characteristics. The core pathogenesis of unstable carotid plaque lies in asthenia in origin and sthenia in superficiality， with spleen-kidney deficiency as the root cause and combined phlegm and blood stasis as the manifestations. He has pointed out that both phlegm and blood stasis should be emphasized in the treatment. In addition to the commonly used herbs for strengthening spleen， removing stasis， and resolving phlegm， the insects with strong effects of searching wind and dredging collateral can be added as appropriate to strengthen the power of removing stasis and dredging collateral. According to the pathogenesis of this disease， he develops the Qutan Tongluo Wenbanfang， which has been confirmed by modern pharmacological research to be efficient in resisting inflammation， regulating endothelial cell functions， lowering lipids， adjusting metabolism， and improving blood circulation， thereby ameliorating the related biological processes of atherosclerosis， suppressing atherosclerosis， and stabilizing plaques. As proved by clinical practice， Qutan Tongluo Wenbanfang helps to reduce blood lipids and reduce the area of unstable carotid plaque， indicating that it deserves clinical promotion.

Effect of integrative medical therapy on the prognosis of patients suffering from yin syndrome type acute ischemic stroke / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of integrative medical therapy on the prognosis of patients suffering from yin syndrome type acute ischemic stroke (YS-AIS).</p><p><b>METHODS</b>A multi-center, prospective, random and parallel controlled clinical trial was carried on 606 patients of YS-AIS. Excepting the 15 patients being excluded and dropped out in the trial period, all patients were assigned to the treatment group (274 patients) treated with integrated medical protocol (i. e. Chinese medical therapy plus conventional Western medical treatment), and the control group (263 patients) treated with conventional Western medical treatment plus placebo. Patients' quality of life (QOL) and their disability level were assessed by scoring based on SS-QOL and modified Rankin scale (mRS) respectively at the terminal of the 21-day treatment (T1) and at the ends of 60-day (T2) and 90-day (T3) following-ups.</p><p><b>RESULTS</b>Patients' disability level, showed by mRS scores, was not significantly different between the two groups at T1 and T2 (P > 0.05), but with significant difference at T3 (P < 0.05). The recovery in the treatment group were more significant. Although the SS-QOL scores showed no statistical significant difference between groups (P > 0.05), improvement of QOL could be seen in the treatment group and the difference between groups was more significant as the time went by.</p><p><b>CONCLUSION</b>Integrative medical therapy could reduce the severe disability rate in patients after YS-AIS, and showed an improving trend on patients' QOL at T3.</p>

Establishment of pig acute liver failure model and the role of pig fibrinogen-like protein 2 / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To establish a pig model of fulminant hepatic failure for evaluating the pre-clinical efficacy of drug treatment on severe hepatitis, and to detect the expression of fibrinogen-like protein-2 (fgl2) prothrombinase in the model, so as to provide basis for gene therapy targeting to fgl2 for fulminant hepatic failure.</p><p><b>METHOD</b>D-galactosamine hydrochloride was used to induce pig model of fulminant hepatic failure, and the experiment animals were divided into model group (rapid injection of D-galactosamine hydrochloride by ear vein, a dose of 1.2 g/kg) and negative control group (5% Glucose). Clinical, biochemical and pathological changes of animals were observed. The expression of pigs fgl2 (pfgl2) mRNA in liver tissue was detected by real time RT-PCR, the expression of pfgl2 protein in liver tissue was detected by immunohistochemistry.</p><p><b>RESULTS</b>A pig model of fulminant hepatic failure was successfully established using the D-galactose hydrochloride; Real time RT-PCR of liver fgl2 mRNA showed that fgl2 mRNA expression was increased significantly in liver tissue of fulminant hepatic failure pig model compared with the control group (P = 0.016); Immunohistochemical staining showed that there were fgl2 protein expression in liver tissue of fulminant hepatic failure pig model, mainly in the membrane and cytoplasm of hepatocytes, inflammatory cells, liver sinusoidal endothelial cells and vascular endothelial cells of liver cell necrosis region. However, there are no fgl2 positive staining on negative control.</p><p><b>CONCLUSIONS</b>The pig model of fulminant hepatic failure induced by D-galactosamine hydrochloride is similar to human pathological process and can be used to evaluate the pre-clinical efficacy and safety of drug treatment on fulminant hepatic failure. Abnormal expression of pfgl2 at both mRNA level and protein level in the liver of fulminant hepatic failure pig model shows that pfgl2 induced coagulation pathway is also involved in the development of fulminant hepatic failure. Gene therapy targeting fgl2 genes for fulminant hepatic failure may provide a new means for the treatment of fulminant hepatic failure.</p>

Construction of shRNA of Fulminant Hepatitis Related Gene mfgl2 and Investigation of Its Biological Effects in vitro / 中国病毒学

This study was designed to explore the RNA interference technique in inhibition of the expression of the mouse fibrinogen like protein 2 (mfgl2), which has been reported to be involved in the development a variety of diseases including fulminant viral hepatitis. A plasmid named p-mfgl2shRNA,complementary to the sequence of mfgl2 was constructed, while another short hairpin RNA (shRNA)which was a mutated form of the mfgl2shRNA sequences was used as a control. A plasmid named pEGFP-mfgl2 expressing the mfgl2-EGFP fusion protein was also constructed for the screening of the effect of p-mfgl2shRNA on mfgl2 expression. By cotransfection of p-mfgl2shRNA and pEGFP-mfgl2 or pcDNA3.1-mfgl2 expression construct into CHO cells or HeLa cells, the inhibition of mfgl2 expression by mfgl2shRNA was analyzed by direct observation through fluorescent microscopy, FACS, RT-PCR and immunohistochemistry staining. The experiments showed the significant inhibitory effect of p-mfgl2shRNA on mfgl2 expression at 48h post-transfection in both CHO and Hela cell lines with the inhibitory efficiency as high as 80.1%. The study demonstrated that the construct of p-mfgl2shRNA successfully interfered with the mfgl2 expression in vitro.

Thinking and challenge induced by the hypothesis of breaking stagnant and eliminating blood stasis in Treating acute cerebral hemorrhage by rF VII a / 中国中西医结合杂志

Definite therapeutic effect has obtained by TCM in treating acute cerebral hemorrhage (ACH) according the TCM theory of "blood circulating outside the vessels is the stasis" using breaking stagnant and eliminating blood stasis (Poxue Zhuyu) method, but no material involving the natural development of stoke in superacue stage (0 - 4 hrs after onset of the disease) being presented so far. It has been proved by randomized, double-blinded multi-centeric clinical trials that recombinant activated factor VII (rF VII a) could decreased the morbidity and disability of patients suffered from ACH, suggesting that use hemostasis treatment in ACH during superacu stage should be stressed, and the drugs for Poxue Zhuyu should be used cautiously in the period of 0 - 4 hrs after onset. The hemorrhagic disorder could be eliminated by using drugs for Poxue Zhuyu and other medicines in rational combination.

Inhibitory effect of artesunate on human esophageal carcinoma cells and the possible mechanism / 中国肿瘤生物治疗杂志

Objective: To explore the inhibitory effect of artesunate(Art)on human esophageal carcinoma cells and to study the related mechanism.Methods: Nude mice were inoculated with Eca109 cells subcutaneously on the left upper limbs to establish esophageal carcinoma model.The model mice were divided into 5 groups: first group received 100 mg/kg Art,second group 200 mg/kg Art,third group 300 mg/kg Art,forth group 3 mg/kg cisplatin(DDP),and the fifth group received normal saline.Mass and volume changes of transplant tumors in different groups were observed.Flow cytometry was used to detect the cell cycle,apoptosis,and the expression of CDC25A protein,Smad3 protein and TGF-?protein in the transplanted tumors in mouse model.RT-PCR was used to detect the expression of CDC25A,Smad3 and TGF-?mRNA in the transplanted tumors.Results: Nude mouse model bearing human esophageal carcinoma was success- fully created.Compared with the control group,the volume and mass of transplant tumors in Art groups were significantly smaller(P