[Acuuncture combined with swallowing training for post-stroke dysphagia: a randomized controlled trial].

OBJECTIVE: To observe the clinical efficacy of deep acupuncture at Lianquan (CV 23) and Yifeng (TE 17) combined with swallowing training for post-stroke dysphagia. METHODS: Sixty cases of post-stroke dys phagia were randomly divided into an observation group and a control group, 30 cases in each one. Patients in the observation group, based on the regular acupuncture treatment, were treated with deep acupuncture at Lianquan (CV 23) and Yifeng (TE 17), once a day, 30 min per treatment; also swallowing training was combined, twice a day, 20 min per treatment. Patients in the control group were treated with swallowing training. All the patients were treated with regular treatment of stroke. Six days of treatment were taken as one session, and totally 3 sessions were given with an interval of one day between sessions. The video fluoroscopic swallowing study (VFSS) dysphagia evaluation scale and Watian water swallow test (WWST) were evaluated before and after treatment also the clinical efficacy and the recovery time of two groups were compared. RESULTS: After treatment, the VFSS score in the observation group was significantly superior to that in the control group (P < 0.01); the WWST in the observation group was significantly superior to that in the control group (P < 0.01). The cured rate was 70.0% (21/30) in the observation group, which was significantly superior to 43.3% (13/30) in the control group (P < 0.01); the total effective rate was 86.7% (26/30) in the observation group, which was significantly superior to 66.7% (20/30) in the control group (both P < 0.01). The clinical recovery time in the observation group was significantly shorter than that in the control group (P < 0.01). CONCLUSION: Deep acupuncture at Lianquan (CV 23) and Yifeng (TE 17) combined with swallowing training could effectively improve post-stroke swallow function.

FLLL31, a derivative of curcumin, attenuates airway inflammation in a multi-allergen challenged mouse model.

Signal transducer and activator of transcription protein 3 (STAT3), one of the major regulators of inflammation, plays multiple roles in cellular transcription, differentiation, proliferation, and survival in human diseases. Dysregulation of STAT3 is related to the severe airway inflammation associated with asthma. FLLL31 is a newly developed compound based on the herbal medicine curcumin, which specifically suppresses the activation of STAT3. However, the function of FLLL31 on inflammatory diseases, especially on the regulation of airway inflammation, has not been fully studied. In our prior investigations, we developed a mouse model that was challenged with a mixture of DRA allergens (including house dust mite, ragweed, and Aspergillums species) to mimic the severe airway inflammation observed in human patients. In this study, we performed a series of experiments on the inflammatory regulation activities of FLLL31 in both in vitro cultured cells and our in vivo DRA-challenged mouse model. Our results show that FLLL31 exhibits anti-inflammatory effects on macrophage activation, lymphocyte differentiation, and pro-inflammatory factor production. Importantly, FLLL31 significantly inhibited airway inflammation and recruitment of inflammatory cells in the DRA-challenged mouse model. Based on these results, we conclude that FLLL31 is a potential therapeutic agent that can be used against severe airway inflammation diseases.

[Effects of modified liangge powder contained serum on LPS stimulated TLR4 expression and release of cytokines in mouse platelets].

OBJECTIVE: To observe the effects of Modified Liangge Powder (MLP) on the expressions of platelet toll like receptor 4 (TLR4) and the release of platelet-derived cytokines interleukin 8 (IL-8), beta platelet globulin (beta-TG), soluble CD40 ligand (sCD40L). METHODS: The modulating effects on the release of cytokines from mice platelets by TLR4 ligand through monoclonal antibody blocking TLR4 on platelet were compared. The stimulated platelet by LPS was incubated with low (0.94 g/mL), medium (1.89 g/mL), and high (2.84 g/mL) dose of MLP contained serum. The changes of the platelet TLR4 expression and platelet-derived cytokines were observed. RESULTS: The positive expression rate of platelet TLR4 obviously decreased (P < 0.01) and the release of sCD40L and beta-TG from platelets significantly increased (P < 0.01) after stimulated by LPS. However, the release of sCD40L and beta-TG from platelets obviously decreased by TLR4 monoclonal antibody (P < 0.05, P < 0.01). There was no statistical difference in IL-8 between before and after LPS stimulation (P > 0.05). Platelet TLR4 positive expression rate was significantly higher after incubated by medium and high doses of MLP contained serum (P < 0.01), and the releasing of sCD40L and beta-TG was lower in the serum contained groups. The inhibitory effects were enhanced in a dose-dependent manner. CONCLUSIONS: LPS induced platelet activation by TLR4 and released sCD40L and beta-TG, while the release of platelet IL-8 was not dependent on platelet TLR4-LPS pathway. MLP could inhibit LPS-stimulated sCD40L and beta-TG, inhibit the binding of platelet TLR4 and LPS in a dose-dependent manner, thus reducing the release of platelet cytokines.

[Platelet parameters and platelet Toll-like receptor 4 (TLR4) expression in patients with sepsis, and the effect of a joint treatment-plan integrating traditional Chinese and western medicine: a clinical study].

OBJECTIVE: To examine the efficacy of a treatment regimen combining modern (Western) medication and a traditional Chinese medicinal recipe Modified Liang-Ge San on sepsis, and its effect on platelet parameters/activation, platelet TLR4 expression and the intensity of inflammatory response in the patients. METHODS: 64 patients with sepsis were randomly assigned to two groups (32 each) to receive Western therapy only (group X) and Western therapy + Modified Liang-Ge San (group L). The values of: platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), the expression of TLR4 and procaspase activating compound-1 (PAC-1) in platelets, plasma concentration of soluble CD40 ligand (sCD40L) and tumor necrosis factor-α (TNF-α) were collected on the day of admission, and 3, 5, 9 days after treatment. Acute physiology and chronic health evaluation II (APACHE II) score, length of stay in intensive care unit (ICU), bleeding events and 28 day mortality in these patients were also analyzed. A group of 15 healthy volunteers (group C) were used as control. RESULTS: Compared to group C, the patients with sepsis have significantly: lower PLT (×10 9/L: 211.37±77.84 vs. 272.33±34.23, P< 0.01 ), increased MPV (fL: 10.24±0.81 vs. 9.64±0.66, P< 0.05) and PDW (fL: 17.79±1.68 vs. 15.61±1.54, P< 0.01), up-regulated platelet TLR4 [(39.93±9.07)% vs. (23.50±4.68)%] and PAC-1 expression [(42.21±8.74)% vs. (21.02±3.49)%], both P < 0.01, and higher level of sCD40L (µg/L: 6.94±1.05 vs. 3.27±0.41)and TNF-α(ng/L: 60.10±9.77 vs. 4.08±3.08), both P< 0.01. Compared to group X, group L had significantly (P< 0.05 or P< 0.01, respectively) lower value in: creatinine (µmol/L: 106.2±34.4 vs. 127.5±43.7); alanine aminotransferase (U/L: 31.7±12.5 vs. 41.9±19.9);aspartate aminotransferase (U/L: 54.1±21.6 vs. 68.5±24.1); TLR4 [(27.14±6.08)% vs. (30.92±5.47)%]; PAC-1 [(27.52±6.51)% vs. (31.24±5.77)%]; sCD40L (3.86±0.69 vs. 4.38±0.73); TNF-α (22.06±7.19 vs. 28.25±8.99), and higher PLT (261.93±55.32 vs. 231.37±63.58, P< 0.05), in the 9 days after treatment. In patients with sepsis, platelet PAC-1 expression correlated significantly to PLT ( r = - 0.409, P< 0.01 ) negatively, and MPV, PDW, platelet TLR4 expression, plasma sCD40L ( r (1) = 0.262, r (2) = 0.318, r (3) = 0.341, r(3) = 0.519, all P< 0.01) positively; sCD40L and TNF-α was positively correlated ( r = 0.542, P < 0.01 ) in these patients. In comparison with group X, the length of stay in ICU (day: 8.06±2.86 vs. 9.31±2.48), the incidence of bleeding (12.5% vs. 21.9%) and APACHE II score (12.75± 4.56 vs. 14.59± 3.97) were significantly lower (all P< 0.05) in group L on the 9 days after treatment. No significant difference was found in 28 day mortality between group L and X (15.63% vs. 18.75%, P> 0.05). CONCLUSION: In patients with sepsis, platelet TLR4 expression is elevated together with platelet activation. The joint application of Western medicine and Modified Liang-Ge San may suppress such up-regulation in TLR4/other inflammatory mediators, and alleviate platelet activation/thrombocytopenia in these patients.

[Clinical observation on treatment of multiple organ dysfunction syndrome with auxiliary treatment of Shennong No.33].

OBJECTIVE: To observe the therapeutic effect of Shennong No. 33 (SN33) in treating multiple organ dysfunction syndrome (MODS) by APACHE II and APACHE II scoring. METHODS: One hundred and twenty-nine patients of MODS were randomly divided into the treated group (n = 72) and the control group (n = 57), they were treated with comprehensive therapy and to the treated group, SN33 was given additionally. The changes of APACHE II and APACHE III scores and blood endotoxin level were observed at the time points of within 24 hrs after hospitalization, and the 3rd, 5th and 7th day. RESULTS: In the treated group, 50 patients survived and 22 died, while in the control group, 25 survived and 32 died. The APACHE II and APACHE III scores of the survivors were higher than those of the decedent (P<0.05), which in the treated group was lower than those in the control group (P<0.05). The blood level of endotoxin in the treated group was also lower than that in the control group (P<0.05). CONCLUSION: SN33 in treating MODS could improve patients' condition, lead to the lowering of APACHE scores. APACHE scoring system could be applied as the criteria for evaluating the condition and prognosis of critical patients, and the APACHE III scoring is more accurate.