Effect of Qingkailing injection on platelets function preserved in vitro / 中国输血杂志

【Objective】 To investigate the effect of Qingkailing injection on platelet function preserved in vitro. 【Methods】 A total of 15 bags of plateletpheresis (≥250 mL/bag), adding Qingkailing injection(1.25 mL/bag) at the final concentration of 1%, were stored at 22 ℃ with gentle agitation as the experimental group, and samples were collected on day 1, 3, 5, 8, 10 and 14 to detect the thromboelastogram (TEG), CD62p expression rate and mitochondrial membrane potential (JC-1). The control group was set up synchronously, with the same volume and storage conditions as the experimental groups, and samples were taken on day 1, 3 and 5 after preservation to undertake the same test items as the experimental groups. The differences of detection indexes between the two groups were compared. 【Results】 1) In the experimental group, there was no significant change in K and α during day 1 to 14(P>0.05). The R value (min) increased from 6.12±1.58 to 11.02±2.26, and the CI value changed from 0.27±1.24 to -10.47±3.51 (P0.05), but decreased to 53.18±2.71 on day 8 and 22.88±3.45 on day 14 (P0.05), but JC-1 (%) was 86.75±3.88 vs 70.36±19.8 on day 5 (P<0.05). In the experimental group, JC-1(%) was 81.04±9.50 vs 71.38±8.77 vs 82.77±7.17 on day 8, 10 and 14, respectively. 【Conclusion】 The activation and aggregation as well as anti-apoptosis function of plateletpheresis, adding Qingkailing injection at the final concentration of 1%, are similar to those of routine preservation.

Study on synergistic effect of Qingkailing Injection and Shengmai Injection on organ injury in endotoxemia rats / 中国中药杂志

As a dangerous disease with rapid progression, endotoxemia is easy to induce the damage to multiple organs. However, its specific and efficient treatment methods are still lacking at present. Both Qingkailing Injection(QKLI) and Shengmai Injection(SMI) have been proved effective in anti-inflammation, anti-endotoxin and organ protection. In this study, carrageenan and endotoxin were injected successively into rats to establish an endotoxemia model. Different doses of QKLI and SMI were administered to the endotoxemia rats by intraperitoneal injection separately or in combination. Then the count of white blood cells, the number of platelets, the content of cytokines, biochemical indexes, organ coefficient and pathological changes of main organs in the rats were detected. The results showed that the rats in the model group had obvious symptoms of endotoxemia, i.e., leucopenia, thrombocytopenia, increase in cytokines(IL-6 and TNF-α) and biochemical indexes of liver and kidney function as well as pathological damage to liver, kidney and lung. QKLI alone can alleviate the above symptoms of endotoxemia and the organ injury. SMI alone is less effective in improving disseminated intravascular coagulation(DIC) and cytokine secretion complicated with endotoxemia, but capable of reducing the inflammation degree of the lung, liver and kidney. The combination of QKLI and SMI remarkably increased the number of platelets in the peripheral blood, improved the liver and kidney function and reduced inflammatory factors, with lung, liver, kidney and other organ structures protected well. Moreover, the improvement effect of the combination of QKLI and SMI was stronger than those of the two injections alone at fixed doses, indicative of a synergistic effect.

Overview of systematic reviews of Qingkailing Injection / 中国中药杂志

Qingkailing Injection is one of the most commonly used traditional Chinese medicine injections with significant clinical application for the treatment of multiple diseases. This study aims to analyze the systematic reviews( SRs) of Qingkailing Injection,in order to provide reference for the clinical application of Qingkailing Injection and the development of relevant clinical practice guidelines. We searched CNKI,CBM,Wanfang,VIP,Pub Med,Cochrane Library and EMbase to collect SRs from the time of database establishment to August 2020. The eligible SRs were included according to the inclusion and exclusion criteria. AMSTAR 2 was used to assess the methodological quality. The diseases,drugs in combinations and results were extracted and analyzed. A total of 24 SRs were selected,including 10 for the treatment of acute cerebrovascular diseases,9 for respiratory infections,2 for viral hepatitis,1 for chronic obstructive pulmonary disease,and two for the adverse effects of Qingkailing Injection. Only three entries of AMSTAR 2 item were fully reported by over 70%,and the rest were reported by less than 70%,with no report about item 2,3 and 10. Twenty-nine outcome indicators were correlated with the included SRs,of which three mostly frequent outcomes were effectiveness,adverse reaction,and neurological deficit scores,showing a good efficacy of Qingkailing Injection. The common severe adverse reaction was anaphylaxis,and mild adverse reactions were skin and mucous membrane reactions. The most frequently combined drug was antibiotics,mainly Penicillin and Penicillin+Pioneeromycin. The existing evidences showed that the methodological quality of SRs of Qingkailing Injection needed to be improved and Qingkailing Injection had an obvious efficacy. However,the selection of outcome indicators for clinical trials and SRs shall be standardized,and the reporting of basic information,such as drug combination,shall be strengthened to provide more powerful clinical services.

Clinical Research of Qingkailing Injection in Adjuvant Treatment of Sepsis and Heat Syndrome in Children / 中国实验方剂学杂志

Objective:To evaluate the clinical efficacy of Qingkailing injection in the treatment of children with sepsis and heat syndrome， and investigate its anti-inflammatory， anticoagulant and protective effects. Method:Eighty patients were randomly divided into control group and observation group with forty cases in each group according to the number table. Both groups received comprehensive treatment measures such as fluid resuscitation， anti-infection， anti-inflammatory， anticoagulation， vasoactive drugs， and protection of vital organ functions. While patients in observation group additionally took Qingkailing injection， 5-10 mL each time， intravenous drip after dilution， 1 time/day. Treatment course was five days in both groups. Before and after treatment， the scores of quick sequential organ failure assessment （qSOFA）， pediatric critical illness score （PCIS） and acute physiology and chronic health evalution Ⅱ （APACHEⅡ） were graded； procalcitonin （PCT）， serum amyloid A protein （SAA） before and after treatment， heparin-binding protein （HBP）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， high-sensitivity C-reactive protein （hs-CRP）， interleukin-6 （IL-6）， IL-10， N-terminal brain sodium Peptide precursor （NT-proBNP）， high-sensitivity cardiac troponin T （hs-cTnT） level， cardiac troponin I （cTnI）， creatine kinase isoenzyme （CK-MB）， <italic>D</italic>-dimer （<italic>D-</italic>D ）， fibrinogen （FIB） and antithrombin Ⅲ （AT-Ⅲ） levels were detected. Result:The APACHEⅡ and qSOFA scores in the observation group were lower than those in the control group （<italic>P</italic><0.05）， while the PCIS score was higher than that in the control group （<italic>P</italic><0.05）. The levels of PCT， SAA，HBP，TNF-<italic>α</italic>， hs-CRP and IL-6 in the observation group were lower than those in the control group （<italic>P</italic><0.01）， while the IL-10 level was higher than that in the control group （<italic>P</italic><0.01）. The levels of NT-proBNP， hs-cTnT， cTnI， CK-MB， <italic>D</italic>-D and FIB in the observation group were lower than those in the control group （<italic>P</italic><0.01）， while the AT-Ⅲ activity was higher than that in the control group （<italic>P</italic><0.01）. Conclusion:Qingkailing injection as the adjuvant therapy in children with sepsis and fever syndrome， can play the role of anti-inflammatory， anticoagulant， reducing infection and myocardial damage， thereby reducing the severity of the disease and improving the prognosis.

Synergistic Effect of Xiangdan Injection and Qingkailing Injection on Organ Injury Caused by Acute Inflammation and Thrombosis in Rats / 中国实验方剂学杂志

Objective:To investigate the synergistic effect of Xiangdan injection （XDI） and Qingkailing injection （QKLI） in the treatment of inflammation and thrombosis animal model based on changes of thrombus， inflammatory indexes， organ function， and pathological changes. Method:A total of 100 male SD rats were randomly divided into a normal control group， a model group， XDI groups （2.5， 5 mL·kg^-1）， QKLI groups （5， 10 mL·kg^-1）， and XDI + QKLI groups ［（2.5+5） mL·kg^-1，（2.5+10） mL·kg^-1，（5+5） mL·kg^-1，and （5+10） mL·kg^-1］ according to the body weight， with 10 rats in each group. Rats were treated correspondingly by intraperitoneal injection once a day for 4 days. The normal control group and the model group received normal saline. On the second day of administration， the model was induced in rats except those in the normal control group. Specifically， 25 mg·kg^-1carrageenan was injected intraperitoneally into the rats， followed by an injection of 50 μg·kg^-1 lipopolysaccharide （LPS） through the tail vein 16 hours later. Twenty-four hours after LPS injection， the rats were detected for liver index， kidney index， the number of platelets （PLT）， thrombus length， and biochemical indicators such as aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， alkaline phosphatase （ALP）， creatinine， and blood urea nitrogen （BUN）. Enzyme-linked immunosorbent assay （ELISA） was used to determine the content of inflammatory factors interleukin-6 （IL-6） and tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）. Hematoxylin-eosin （HE） staining was used to observe the histopathological changes of heart， liver， lung， and kidney， as well as the grading of organ injury. Result:Compared with the normal group， the model group showed decreased PLT， lengthened thrombus in the tail， increased liver index， elevated content of ALT， ALP， BUN， IL-6， and TNF-<italic>α</italic> （<italic>P</italic><0.05， <italic>P</italic><0.01）， and damaged liver， lung， and kidney tissues （<italic>P</italic><0.05， <italic>P</italic><0.01）. Compared with the conditions in the model group， XDI at 5 mL·kg^-1 reduced serum ALT and ALP in rats （<italic>P</italic><0.05， <italic>P</italic><0.01）， QKLI at 5 and 10 mL·kg^-1reduced serum levels ALT and ALP， and TNF-<italic>α </italic>content<italic> </italic>（<italic>P</italic><0.05， <italic>P</italic><0.01）. XDI at 5 mL·kg^-1 or QKLI at 10 mL·kg^-1 relieved the LPS-induced lung injury （<italic>P</italic><0.05）， the combination of XDI and QKLI decreased the levels of ALT， AST， ALP， and TNF-<italic>α， </italic>and the effect was predominant in the combination of XDI and QKLI at 5 and 10 mL·kg^-1（<italic>P</italic><0.05， <italic>P</italic><0.01）. Additionally， the length of the tail thrombus was significantly shortened （<italic>P</italic><0.05）， and the degree of lung injury was also reduced （<italic>P</italic><0.05）. The serum levels of ALT and BUN， TNF-<italic>α</italic> content， and liver index of rats were reduced after the combination of XDI and QKLI as compared with those in the single drug groups at the same dose （<italic>P</italic><0.05， <italic>P</italic><0.01）. Conclusion:XDI or QKLI can improve or inhibit organ function， organ injury， and inflammatory response in the rat model of inflammation and thrombosis. The combination of the two drugs shows a synergistic effect in reducing the length of venous thrombus， improving liver and kidney function， inhibiting inflammatory factors， and protecting lung， liver， kidney， and other organs.

Application of traditional Chinese medicine Qingkailing to extend platelet storage in vitro: the metabolism and morphology study / 中国输血杂志

【Objective】 To study the metabolism and morphology changes of platelets in vitro using traditional Chinese medicine named Qingkailing injection as the additive solution, and to explore the viability of Qingkailing in the extension of platelet storage. 【Methods】 Apheresis platelets, adding 1% final concentration of Qingkailing injection, were taken as experiment groups, and sampled on 1, 3, 5, 8, 10 and 14 days(6 time points)of storage. Apheresis platelets without adding Qingkailing injection were taken as the control, and sampled on 1, 3 and 5 days(3 time points)of storage. The platelet count, morphology scores, biochemical parameters, pH and response rate of hypotonic shock during agitated storage(22 ℃) were tested. 【Results】 1) No significant change in platelet count was noticed in both experimental group(within 14 days) and the control(within 5 days)(P>0.05). The MPV and PDW of both groups increased at any sampling time within 5 days(P<0.05). 2) The morphology score of experimental groups and the control all decreased within the storage period(P<0.05), but its decrease of the control was greater than that of the experimental groups, especially on day 8(P<0.05). 3)Glucose, lactate dehydrogenase, lactate, Na+, and K+ values increased or decreased in varying degrees(P<0.05), while Cl- value stayed almost the same during 14 days(P>0.05). Glucose, lactate dehydrogenase, lactate and Na+ value changed significantly in the control within 5 days(P<0.05), while K+ and Cl- value did not(P>0.05). Within 5-day storage, the glucose consumption, lactate dehydrogenase and lactate generation in the control were significantly greater than those in experimental groups(P<0.05), but the added value of Na+, K+ and Cl- showed no significant difference(P>0.05). 4) pH value, relative to the baseline of day 1, decreased in both groups within 5 days, and its decreasing trend was significant in the control (P<0.05), but not in the experimental group(P>0.05). No significant difference was noticed in the response rate of hypotonic shock in experimental groups within 8 days, while significant decrease was noticed in the control within 5days(P<0.05). The response rate of hypotonic shock in experimental groups were significantly higher than that in the control on day 3 and day 5(P<0.05). 【Conclusion】 The comparison of apheresis platelets, stored in vitro, in terms of platelet count, morphology scores, biochemical parameters, pH and response rate of hypotonic shock showed that platelets, adding 1% final concentration of Qingkailing injection, could prolong the platelet storage to at least 10 days in vitro.

Exploring mechanism of Qingkailing Injection in treatment of coronavirus disease 2019 (COVID-19) based on network pharmacology and molecular docking / 中草药

Objective: To investigate the mechanism of Qingkailing Injection in the treatment of coronavirus disease 2019 (COVID-19). Methods: The active components and target proteins of Gardeniae Fructus, Isatidis Radix, Lonicerae Japonicae Flos, and other materials in Qingkailing Injection were obtained by means of literature search and TCMSP. Uniprot database was used to search the target genes corresponding to the active ingredients, and Cytoscape 3.7.2 was used to construct the drug-compound-target network. The enrichment analysis of KEGG pathway was carried out with the help of DAVID database to predict its mechanism. Core active components and potential targets of anti-COVID-19 drugs were verified by molecular docking. Results: The drug-compound- target network consisted of five drugs, 62 compounds and 70 targets. The KEGG pathway enrichment analysis included 41 signaling pathways (P < 0.05), which were mainly involved in cell apoptosis, Fc epsilon RI signaling pathway, TNF signaling pathway, etc. Molecular docking results showed that acacetin and syrigin had strong affinity with potential targets of anti-COVID-19 drugs. Conclusion: In this study, the effect of Qingkailing Injection has the characteristics of multiple components, multiple targets and multiple pathways. The active component, acacetin, can regulate the apoptosis pathway and TNF pathway by acting on CASP3, CASP8, FASLG, and other targets, so as to realize the potential therapeutic effect on COVID-19.

Effect of Qingkailing on Expression of Toll-like Receptor 4, gp91phox and Zonula Occludens-1 in Cerebrovascular Endothelial Cells Induced by Hypoxia Activating Microglias / 中国康复理论与实践

Objetive To investigate the effect of Qingkailing injection on the expression of Toll-like receptor 4 (TLR4), gp91phox and zonula occludens-1 (ZO-1) in cerebrovascular endothelial cells induced by hypoxia activation of microglias. Methods:BV2 microglia cells were divided into six groups. They were cultured in serum-free DMEM, while the Qingkailing groups of low, middle and high dosages were cultured with 0.0625%, 0.125% and 0.25% Qingkailing injection, respectively, and minocycline group with minocycline of 200 nmol/L. The groups other than control group underwent hypoxia for 24 hours and reoxygenation for 24 hours. Then, the medium of microglia was put into the medium of Balb/c endothelial cells for 24 hours. The cell viability of endothelial cells was measured with CCK-8, the concentration of nitric oxide (NO) was detected with colorimetry, and the experission of TLR4, gp91phox and ZO-1 was detected with Western blotting. Results:Compared with the control group, the cell viability and the expression of ZO-1 decreased in the model group (P < 0.01), while the concentration of NO and the expression of TLR4 and gp91phox increased (P < 0.05). Compared with the model group, the cell viability and the expression of ZO-1 increased in the Qingkailing groups and the minocycline group (P < 0.05), while the concentration of NO and the expression of TLR4 and gp91phox decreased (P < 0.05). Conclusion:Qingkailing injection may enhance the survival and function of cerebrovascular endothelial cells by inhibiting the hypoxia activation of microglias, reducing the expression of TLR4 and gp91phox, and increasing the expression of ZO-1.

Qingkailing Injection () for Treatment of Children Pneumonia Induced by Respiratory Syncytial Virus: A Meta-Analysis of Randomized Controlled Trials / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Qingkailing Injection (, QKL) for treatment of children pneumonia caused by respiratory syncytial virus (RSV).</p><p><b>METHODS</b>Randomized clinical trials (RCTs) comparing QKL with ribavirin injection in the treatment of children pneumonia induced by RSV were searched in PubMed, Science Direct, Cochrane Library, Chinese VIP database, CNKI and Wanfang databases from their inception to March 2014. Meta-analyses were performed using RevMan 5.2 software. The methodological quality of the selected RCTs was evaluated by the Modified Jadad Score. The primary outcome measures were effective rate and the secondary outcomes were relief time of fever and cough.</p><p><b>RESULTS</b>Seven RCTs with 992 cases published from 2008 to 2013 were identified. The meta-analysis results indicated that QKL was more effective in cure rate [risk ratios (RR)=1.32, 95% CI (1.17, 1.50), P<0.01], total effective rate [RR=1.07, 95% CI (1.02, 1.13), P=0.009] and less fever clearance time [mean difference=-0.73, 95% CI (-1.22,-0.23), P=0.004], compared with ribavirin injection in the treatment of RSV-induced children pneumonia. No dead case was reported in all trials. There were 3 trials mentioned adverse events, 2 reported no obvious adverse event occurred while 1 reported adverse events described as skin hypersensitivity, elevation of ALT, a mild abnormal of hepatic and renal function in both QKL and ribavirin group.</p><p><b>CONCLUSIONS</b>QKL was an effective and relatively safe option for the treatment of RSV-induced children pneumonia. These therapeutic effects were promising but need to be interpreted with caution due to variations in the treatment and methodological weakness in the studies.</p>

Pseudoallergic reaction characteristics of Qingkailing injection and preliminary screening of allergic substances / 中国中药杂志

This study aimed to explore the characteristics and the influencing factors of Qingkailing injection (QKLI) pseudoallergic reaction, and screen out the possible pseudoallergenic substances. The results showed that ICR and Kunming mice had stronger pseudoallergic reactions than BALB/c and C57 mice after being injected with the same dose of QKLI. The pseudoallergic reaction induced by QKLI that was prepared with 0.9% saline was stronger than that prepared with 5% glucose. When the dose was twice of the clinical dose, some batches of QKLI could cause significant or suspected pseudoallergic reactions; when the dose dropped to clinically equal times, all of the batches did not induce pseudoallergic reactions in mice. Different batches of QKLI induced different pseudoallergic reactions in mice. Therefore, QKLI's pseudoallergic reactions might have a certain relationship with different body constitutions. Different solvents might affect the safety of QKLI. QKIL-induced pseudoallergic reactions had the different characteristics between batches, and the dosage should be strictly controlled in clinical use. After the comparison of pseudoallergic reactions induced by different components and different intermediates of QKLI in mice, it was preliminary believed that pseudoallergenic substances might exist in intermediate Isatidis Radix extracts and Gardenia extracts, but specific pseudoallergens shall be furthered studied in subsequent experiences.

Meta-analysis of Qingkailing Injection in treatment of viral hepatitis / 中成药

AIM The proofs of evidence-based medicine of Qingkailing Injection's effect on viral hepatitis are lack in spite of the wide use of Qingkailing Injection in medical practice.This study aims to use Meta-analysis to evaluate its clinical effect and safety.METHODS Such databases as CNKI,VIP and Wanfang were searched for randomized controlled trials related to Qingkailing Injection in treatment of viral hepatitis,which were published officially between 1996--2016.Revman 5.3 software was used to conduct Meta-analysis for the effective rate,rate of adverse reaction,the decrease rate of ALT,AST and TBIL of Qingkailing Injection.Meanwhile,subgroup analysis was conducted to the clinical effect of doses [＜ 0.5 mL/(kg · d),0.5-0.67 mL/(kg · d),＞0.67 mL/(kg · d)],treatment courses (≤ 14 d,＞ 14 d),manufacturers (Beijing University of Chinese Medicine Pharmaceutical Factory,Shenwei Pharmaceutical Company,Shanxi Taihang Pharmaceutical Company),year (1996 to 2002,2003 to 2009,2010 to 2016).RESULTS Fourteen studies were included according to the criterion.The results of Meta-analysis showed that the total effective rate,the decrease rate of ALT,AST and TBIL in Qingkailing Injection group were significantly higher than those in the control group (P ＜ 0.05).Whereas,no significiant differences were found between Qingkailing Injection group and the control group of its rate of adverse reaction (P ＞ 0.05).Subgroup-analysis showed that the effective rate of Qingkailing in doses subgroup,treatment courses subgroup,manufacturers subgroup and year subgroup were significantly higher than those of the control group.CONCLUSION Qingkailing Injection has obvious benefit in the treatment of viral hepatitis,which can reduce the activity of ALT and AST,also can reduce the content of TBIL.But we should pay attention to the prevention of allergic reaction in the clinical use.

Analysis of drug combination characteristics of Qingkailing injection for treating abnormal inflammatory factors in real world / 中国中药杂志

To analyze the drug combination characteristics of Qingkailing injection for treating abnormal inflammatory factors such as elevated white blood cells and C reactive protein in real world. The patients with Qingkailing injection for abnormal C reactive proteins and abnormal white blood cells were extracted from hospital information system (HIS) of 16 Class 3A hospitals. Then the basic information, traditional Chinese medicine and Western medicine diagnostic information, doctor's advice information, and laboratory information were analyzed; Apriori algorithm was used to construct the models, and Clementine 12.0 was used for correlation analysis to analyze the clinical medication rules and drug combination characteristics in the patients with Qingkailing injection for treatment of elevated C reactive protein and white blood cells in the real world. The results of the study showed that when Qingkailing injection was combined with one kind of western medicine and traditional Chinese medicine in treatment of patients with abnormal C reactive protein, vitamin C (159 cases, 74.30%) and Tanreqing injection (71 cases, 33.18%) were most frequently used; when it was combined with 2 kinds of traditional Chinese medicines, Xueshuantong injection plus Tanreqing injection (support degree 10.75%) were most frequently used. When Qingkailing injection was combined with one kind of western medicine and traditional Chinese medicine in treatment of patients with abnormal white blood cells, vitamin C (596 cases, 56.02%) and Ganmao Qingre granules (247 cases, 23.21%) were most frequently used; when it was combined with 2 kinds of traditional Chinese medicines, Shuanghuanglian+Ganmao Qingre granules (support degree 5.26%) were most frequently used. In the patients with abnormal C-reactive protein and white blood cells, its combinations with antibiotics and nutritional support agents were most common from the pharmacological perspective, indicating that in the treatment of abnormal C-reactive protein, white blood cells and other increased inflammatory indicators, Qingkailing injection was most frequently combined with antibiotic drugs to achieve synergistic effect.

Clinical features analysis of Qingkailing injection for adolescent patients based on real world HIS / 中国中药杂志

To explore the clinical application features of Qingkailing injection for adolescent patients. This study was based on the information from the hospitalized patients in 1998-2011 in HIS (hospital information system) of 16 tertiary hospitals in China. 615 adolescent patients with Qingkailing injection were used to investigate the clinical characteristics of Qingkailing injection. Apriori algorithm was adopted to establish the model, and Clementine 12.0 was used for correlation analysis. The results showed that male patients (355 cases) were more than female patients (243 cases); the age of the most patients was under 14 years old, with an average age of 9.40 years old; the hospital stay was most of 4-7 d; the patients were mostly concentrated in pediatrics, mainly including upper respiratory tract infection; outpatient admission to the majority (451 cases, accounting for 75.54%). The traditional Chinese medicine (TCM) syndrome mainly included phlegm-dampness internal resistance (38.46%), Qi and Yin Deficiency (11.54%), Liver qi stagnation (15.38%), and Yang deficiency syndrome (11.54%); the highest admission rate was during Slight Cold (13.01%). In combined application, the most common western medicine pair was Cephalosporin injection+vitamin C (with supporting rate of 24.6%) and the most common TCM pair was Shuanghuanglian+Ganmao Qingre granules (with supporting rate of 4.065%). The most common 3 western medicines in combined use were Potassium chloride injection+Cephalosporin injection+vitamin C (supporting rate of 15.93%); while the most common three Chinese medicines were Shuanghuanglian+Yunnan Baiyao+Ganmao Qingre granules (supporting rate of 1.138%). Qingkailing injection was also widely used in adolescent patients; the diagnosis and use were basically in line with the instructions; men were slightly more than women; age of onset, solar terms and TCM syndromes were highly consistent. Qingkailing injection was mainly combined with western medicines in combined drug use, and Chinese medicines were also available. Combined drug use was more reasonable. Based on the results of the real world HIS, Qingkailing injection could provide the idea and reference for regulating the medication in adolescent patients.

Optimization and Preliminary Methodology Study of in vitro Fresh Human Whole Blood Detection Method for Pyrogen-related Factor IL-1β / 中国药房

OBJECTIVE:To establish the detection method for pyrogen-related factor interleukin 1β(IL-1β)through optimiz-ing detection condition,and to conduct preliminary methodology study. METHODS:The in vitro fresh human whole blood detec-tion method was used. The bacterial endotoxin standard solution(5,2,0.8,0.32 EU/ml)were added into diluted blood;using di-luted RPMI 1640 as blank control,the content of IL-1β in blood sample was determined by ELISA after incubation. The relation-ship of the addition of different attenuants(RPMI 1640 culture,sterilized normal saline)and fetal bovine serum,final dilution vol-ume fraction(40%,20%,10%and 8.3%)and storage duration(2,5,6,8,26 h)with the contents of endotoxin IL-1βwere in-vestigated,and related coefficient and detection limits were calculated. Different dilution times of Qingkailing injection and Ginaton injection samples and interference solutions were added into diluted blood to detect their recovery. RESULTS:The results indicated that RPMI 1640 media and 40% diluted blood was more sensitive(detection limit was 0.128 EU/ml,r=0.993);while the addition of fetal bovine serum didn’t influence the results. The detection limits of blood sample storied at 4 ℃ for 26 h were 0.128 EU/ml (r>0.990). When Qingkailing injection and Ginaton injection were diluted 10,32 and more times,the detection method was not interfered and the recovery ranged 68%-118%. CONCLUSIONS:Established in vitro fresh human whole blood detection method can be used for the detection of pyrogen,and provides trial evidence for the pyrogen detection of TCM injection.

Effect of glucocorticoid combined with Qingkailing injection on serum IL-10 and TNF-αlevels in lobar pneumonia patients / 中国生化药物杂志

Objective To investigation effect of glucocorticoid combined with Qingkailing injection on lobar pneumonia IL-10 and serum TNF-levels.Methods 120 cases of lobar pneumonia in children were selected respiratory department fromasin our hospital in December 2012 to December 2014 as the object of study, were divided into control group and observation group, control group were treated with dexamethasone sodium phosphate injection,the observation group in the control group based on the combined with Qingkailing injection, serum IL-10, TNF-a level and curative effect were compared between the two groups pre-and post-treatment in patients.Results The total effective rate of the observation group was 86.67%, higher than that of the control group, the total effective rate was 70%(P <0.05).Before treatment, the two groups of patients with TNF-αand IL-10 were not statistically significant difference.After treatment, the two groups of patients with TNF-αand IL-10 were decreased, and lower than the control group (P<0.05) .Conclusion Glucocorticoid combined with Qingkailing injection can reduce serum IL-10, TNF-alpha level in lobar pneumonia,has a definite effect.

Long-term toxicity to respiratory system of rats by low-dose perfluoroisobutylene exposure once and possible beneficial effect of early intervention via Qingkailing injection / 中国药理学与毒理学杂志

OBJECTIVE To clarify the long-term toxicity to the respiratory system in a rat model of acute lung injury (ALI) induced by a single low-dose of perfluoroisobutylene(PFIB) inhalation expo?sure,and observe the possible beneficial effect of early intervention via Qingkailing(QKL) injection. METHODS Totally 224 male Wistar rats were randomly divided into 4 groups:normal control group in which air exposure was followed by a saline 10 mL · kg-1(ip),QKL control group in which QKL 10 mL · kg-1 was ip given after air exposure,PFIB exposure group in which rats were exposed to PFIB 280 mg·m-3 for 5 min only,and QKL treatment group in which QKL 10 mL·kg-1 was given ip at 1 h after PFIB exposure. Lung functions of rats were measured at 24 h,3,6,12,24,36 and 48 weeks after exposure. The arterial blood gas,lung coefficient,protein content in bronchoalveolar lavage fluid(BALF),hydroxy?proline(HYP) content in lung tissue and plasma,and other indicators were detected or analyzed. RESULTS Within 24 h after PFIB exposure,the lung coefficient and protein content in BALF were increased significantly(P<0.01),whereas the PaO2(P<0.01) and SaO2(P<0.05) indices in arterial blood decreased significantly in PFIB group compared with normal control. The inhalation time , exhalation time,tidal volume(TV),expired volume(EV)and relaxed time were reduced significantly (P<0.01). However,all the above indicators returned to normal in 3 weeks,but TV,EV and peak expiratory flow were significantly lower than in normal group at 48 weeks(P<0.05). HYP contents in lung tissues,compared with normal control(P<0.05),were reduced significantly within 24 h after PFIB exposure,increased significantly in 6 weeks(P<0.05),then returned to normal in 12 weeks. HYP contents in plasma increased significantly compared with normal control(P<0.05) within 24 h after PFIB exposure but returned to normal in 3 weeks. The protein contents in BALF of QKL treatment group were significantly lower than those in PFIB group(P<0.01) within 24 h after PFIB exposure. From 24 h to 24 weeks after PFIB exposure,changes of pulmonary functions were similar to those in PFIB group. At 48 weeks,TV and EV in QKL treatment group were more significantly increased than those in PFIB group(P<0.05). CONCLUSION Rats with ALI induced by a single low dose of PFIB exposure undergo compensatory repair except for pulmonary capacity and pulmonary ventilation functions. Early treatment with QKL reduces protein content of BALF and alleviates pulmonary edema,and has some beneficial effect on lung function recovery later.

Application of RBL-2H3 cells on allergenicity assessment of Qing kailing and Tanreqing Injections / 中草药

Objective: To explore the allergenicity of two kinds of Chinese materia medica (CMM) injections, Qingkailing (QKL) and Tanreqing (TRQ) Injections, with serum antibody sensitized RBL-2H3 cells. Methods: The antiserum was prepared by sc injection of allergen composed of ovalbumin (OVA), QKL, or TRQ combined with aluminum hydroxide adjuvant respectively in Wistar rats. The total IgE level in serum antibody was determined by radioimmunoassay. The RBL-2H3 cells were sensitized with serum antibodies, then stimulated by OVA, QKL, or TRQ after 48 h. The release rate of β-hexosaminidase in the supernatant was determined after the degranulation of sensitized RBL-2H3 cells. Passive cutaneous anaphylaxis (PCA) test was performed with rats, and the positive reaction rate with blue plaque in animal skin was observed. Results: Compared with the control group, the total IgE level in serum antibody was increased significantly in OVA, TRQ, and QKL groups (P < 0.05). The degranulation test revealed that the release rate of β-hexosaminidase was significantly increased in the supernatant when the cells were incubated with the antiserum and then stimulated with OVA, QKL, and TRQ. Compared with the control group, the largest relative times of release were 3.7, 1.53, and 1.98, respectively. The results of PCA test showed that the highest percentage rates of positive reaction of blue plaque were 100%, 100%, and 86% respectively. The results of RBL-2H3 cell test and PCA test have good consistency. Conclusion: The serum antibody sensitized RBL-2H3 cell model can be used for screening or assessing allergenicity of CMM injection.

Clinical Observation of Qingkailing Injection Combined with Naloxone in the Adjuvant Treatment of Chronic Obstructive Pulmonary Disease with Pulmonary Encephalopathy / 中国药房

OBJECTIVE:To observe the clinical efficacy and safety of Qingkailing injection combined with naloxone in the ad-juvant treatment of chronic obstructive pulmonary disease (COPD) with pulmonary encephalopathy. METHODS:80 COPD pa-tients with pulmonary encephalopathy were randomly divided into control group and observation group. Control group was treated with conventional treatment,including bi-level noninvasive positive pressure ventilation,conventional oxygen inhalation,anti-infec-tion,resolving sputum and relieving asthma,etc;based on the treatment of control group,observation group was additionally treat-ed with Qingkailing injection 40-60 ml by intravenous infusion,30-40 drops/min,qd+Naloxone hydrochloride injection 0.8 mg by intravenous infusion,and then Naloxone hydrochloride injection 2 mg by microinfusion pump for continuous 24 h. After 3 d,the clinic data was observed,including clinical efficacy,and pO2,pCO2,pH,CO,CI,GCS coma score before and after treatment,av-erage hospitalization time,endotracheal intubation rate and incidence of adverse reactions. RESULTS:The total effective rate in ob-servation group was significantly higher than control group,average hospitalization time and incidence of adverse reactions were significantly lower than control group(P0.05). CONCLUSIONS:Based on the conventional treatment,Qingkailing injection combined with naloxone has good efficacy and safety in the adjuvant treatment of COPD with pulmonary encephalopathy.

Studies on Anaphylactoid Reactions Induced by Traditional Chinese Medicine Injections of Qingkailing and Xuesaitong / 中国中医药信息杂志

Objective To study anaphylactoid reactions induced by traditional Chinese medicine injections (TCMI) of Qingkailing (QKL) and Xuesaitong (XST) with RBL-2H3 cells;To provide some reference for improving the screening system of TCMI induced anaphylactoid reactions.Methods The IC50 induced by QKL and XST injections was determined by MTT assay. RBL-2H3 cells were stimulated with TCMI at different concentrations or with C48/80 or culture medium. Thirty minutes later, the supernatant was collected to determine the release of histamine andβ-hexosaminidase. The cell degranulation rate and the ultrastructure changes were observed. The ICR mice were given single injection of TCMI containing Evans Blue through tail vein. The number of the animal with blue ear, the total number of blue ears and the quantity of Evans Blue of extravasation were determined 30 minutes later.Results The IC50 of both QKL injection and XST injection was 12.5μL/mL. These two injections promoted RBL-2H3 cells to release histamine andβ-hexosaminidase at higher concentrations (P<0.05,P<0.01) in a dose dependent manner. Cell morphology showed a decrease of villous on the cell surface and an increase of the internal vacuolated structure. Both injections caused the blue ears of all animal with a rate of 100%. The quantity of Evans Blue of the extravasation was significantly increased (P<0.01). The results in vitro study were in close agreement with that in vivo.Conclusion Both QKL injection and XST injection may potentially cause anaphylactoid reactions. The RBL-2H3 cell model may be valuable to evaluate the anaphylactoid reactions induced by TCMI.

Optimization of Alcohol Precipitation Techniques for Honeysuckle Extract of Qingkailing Injection by Orthogonal Test / 世界科学技术-中医药现代化

This study was aimed to optimize the alcohol precipitation techniques for honeysuckle extract in order to standardize the production of honeysuckle extract of Qingkailing Injection and reduce the differences among batches. The orthogonal test was applied in this study. The content of chlorogenic acid and galuteolin were taken as compre-hensive indicators. Multi-index comprehensive scoring method was used in the data analysis. Three influencing fac-tors, which were the fluid temperature, the stirring speed and the speed of adding alcohol, were optimized in the al-cohol precipitation techniques. The results showed that the optimal alcohol precipitation techniques were when the fluid temperature was 20℃, the stirring speed was 240 rpm and the speed of adding alcohol was one time of the ma-terial per minute. It was concluded that the optimized alcohol precipitation process was stable and feasible.