Efficacy and safety of triple therapy containing berberine hydrochloride, amoxicillin, and rabeprazole in the eradication of Helicobacter pylori.

OBJECTIVE: To estimate the effectiveness and safety of triple therapy containing berberine, amoxicillin, and rabeprazole in the eradication of Helicobacter pylori (H. pylori). METHODS: This prospective, randomized controlled, open-label, noninferiority trial included treatment-naive patients with H. pylori infection who were randomly allocated at a ratio of 1:1 into the berberine triple therapy group (berberine hydrochloride 300 mg thrice daily, amoxicillin 1 g twice daily, and rabeprazole 10 mg twice daily) or standard bismuth-containing quadruple therapy group (amoxicillin 1 g twice daily, rabeprazole 10 mg twice daily, clarithromycin 500 mg twice daily, and bismuth tartrate 200 mg twice daily) for 14 days. Negative 13 C/14 C-urea breath test at 4 weeks after completion of the therapy was regarded as successful eradication. RESULTS: Altogether 262 and 262 patients received berberine triple therapy and bismuth-containing quadruple therapy, respectively. Both intention-to-treat (79.8% vs 80.9%, P = 0.742) and per-protocol analyses (83.6% and 85.1%, P = 0.636) showed comparable eradication rate between the two groups, indicating a noninferior eradication rate (the lower limit of the 95% confidence interval over -10% [-7.9% and -7.87%, respectively]). Adverse events more commonly occurred in the bismuth-containing quadruple-therapy group (8.8% vs 16.0%, P = 0.012), while patient compliance and symptom improvement of the two regimens were comparable. CONCLUSION: Triple therapy containing berberine, amoxicillin and rabeprazole is noninferior to bismuth-containing quadruple therapy in the initial treatment for H. pylori eradication.

[Curcumin improves cardiac fibrosis by inhibiting endothelial-mesenchymal transition through NRF2-DDAH-ADMA-NO pathway].

The present study analyzed the correlations between curcumin(Cur), nuclear factor E2 related factor 2(NRF2)-dimethylarginine dimethylaminohydrolase(DDAH)-asymmetric dimethylarginine(ADMA)-nitric oxide(NO) pathway, and endothelial-mesenchymal transition(EndMT) based on SD rats with cardiac fibrosis, and explored the effect and mechanism of Cur in resisting cardiac fibrosis to provide an in-depth theoretical basis for its clinical application in the treatment of heart failure. The cardiac fibrosis model was induced by subcutaneous injection of isoprenaline(Iso) in rats. Thirty-two rats were randomly divided into a control group, a model group, a low-dose Cur group(100 mg·kg~(-1)·d~(-1)), and a high-dose Cur group(200 mg·kg~(-1)·d~(-1)), with eight in each group. After 21 days of treatment, cardiac function was detected by echocardiography, degree of cardiac fibrosis by Masson staining, expression of CD31 and α-SMA by pathological staining, expression of VE-cadherin, vimentin, NRF2, and DDAH by Western blot, and ADMA level by HPLC. Compared with the model group, the Cur groups showed alleviated cardiac fibrosis, accompanied by increased CD31 and VE-cadherin expression and decreased α-SMA and vimentin expression, indicating relieved EndMT. Additionally, DDAH and NRF2 levels were elevated and ADMA and NO expression declined. Cur improves cardiac fibrosis by inhibiting EndMT presumedly through the NRF2-DDAH-ADMA-NO pathway.

[Comparative study on macroscopic and microscopic identification of Celastrus aculeatus and Kadsura heteroclite].

OBJECTIVE: To compare and identify Celastrus aculeatus and Kadsura heteroclita with pharmacognosy methods for analyzing the quality of the crude drug. METHODS: Pharmacognosy study on Celastrus aculeatus and Kadsura heteroclite was carried out through plant identification, crude drug identification and microscopic characteristics identification. The characteristics of Celastrus aculeatus and Kadsura heteroclite were compared. RESULTS: There were significant differences between Celastrus aculeatus and Kadsura heteroclite in appearance of cork, attachments on internal surface of cork,shape of leave edge, number of lateral vein, type of stoma and vessel, and the crystals, the stone cells and the fibers in the same part of both drugs. CONCLUSION: The pharmacognosy characteristics of both crude drugs can be used for identification and quality control on Celastrus aculeatus and Kadsura heteroclite.

[Pharmacognostical identification of the leaf of Uncaria hirsuta Havil].

OBJECTIVE: To perform a pharmacognostical study of the leaf of Uncaria hirsuta Havil. METHODS: The specimens of Folium Uncariae Hirsutae were collected for studying its characteristics, microscopic appearance and thin-layer chromatography. RESULTS: The leaf of Uncaria hirsuta Havil was characterized by numerous multicellular non-glandular hairs, 2 lines of palisade tissue, a diacytic type of stoma, and clustered crystals in its parenchyma. At least two kinds of alkaloids identical to the control were identified in the specimens. CONCLUSION: The results can be used as the evidence for identification, formulation of the quality-control standards as well as further utilization of Folium Uncariae Hirsutae.