Clinical Observation of Bupi Qingfei Decoction in Treatment of Bronchiectasis Colonized by Pseudomonas aeruginosa / 中国实验方剂学杂志

Objective:To evaluate the clinical efficacy of Bupi Qingfei decoction in the treatment of bronchiectasis colonized by<italic> Pseudomonas aeruginosa</italic> （PA） （lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome）. Method:A total of 72 bronchiectasis patients colonized with PA （ lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome ） were randomly divided into the observation group （36 cases， two cases were lost to follow-up and three dropped out） and control group （36 cases， three cases were lost to follow-up and four dropped out）. There were 31 cases in the observation group and 29 cases in the control group completing the trial. Patients in the observation group were treated with Bupi Qingfei decoction orally，once in the morning and again in the evening， one bag every other day， and simulated azithromycin tablet at the dose of 0.5 g，once every other day， while those in the control group with azithromycin tablet at 0.5 g，once every other day， and simulated Bupi Qingfei decoction， once in the morning and again in the evening， one bag every other day. Patients in both groups received health education and postural expectoration. The treatment lasted for 24 weeks，followed by a 24-week follow-up. The frequency of acute exacerbation，quality of life （St. George's Respiratory Questionnaire） score，traditional Chinese medicine （TCM） syndrome score，lung function ［forced expiratory volume in one second percentage of predicted（FEV₁%pred） and FEV₁/forced vital capacity（FVC）］， and serum immunoglobulin （Ig）A，IgE，IgG，and IgM levels of the two groups were evaluated after treatment. Result:The frequencies of acute exacerbation after 24 weeks of treatment and during the 24-week follow-up in the observation group were lower than those in the control group （<italic>P</italic><0.05）. The total quality of life （St. George's Respiratory Questionnaire） score and symptom scores in the observation group after 24 weeks of treatment were significantly decreased as compared with those before treatment （<italic>P</italic><0.05）. There was no significant improvement in the quality of life in the control group either after 24 weeks of treatment or during the 24-week follow-up. The effective rate against TCM syndrome in the observation group was 64.52%（20/31） after 12 weeks of treatment，which was obviously higher than 31.03%（9/29） in the control group （<italic>χ</italic>²=6.726，<italic>P</italic><0.05）. After 24 weeks of treatment，the effective rate in the observation group was 83.87%， slightly higher than 68.97% in the control group. After 12 and 24 weeks of treatment，the scores of cough，expectoration，fatigue，anorexia，spontaneous sweating，abdominal distension， and loose stool in the observation group were better than those in the control group （<italic>P</italic><0.05）. There were no significant changes in lung function and serum immunoglobulin classes in the two groups. Conclusion:Bupi Qingfei decoction is effective in reducing the frequency of acute exacerbation， alleviating the symptoms， and improving the quality of life of bronchiectasis patients colonized by PA （lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome）.

Koumine Alleviates Lipopolysaccharide-Induced Intestinal Barrier Dysfunction in IPEC-J2 Cells by Regulating Nrf2/NF-κB Pathway.

Gelsemium elegans Benth. (G. elegans), a traditional Chinese medicine, has great potential as an effective growth promoter in animals, however, the mechanism of its actin remains unclear. Here, we evaluated the protective effects of koumine extract from G. elegans against lipopolysaccharide (LPS)-induced intestinal barrier dysfunction in IPEC-J2 cells through alleviation of inflammation and oxidative stress. MTT and LDH assays revealed that koumine significantly reduced LPS cytotoxicity. Transepithelial electrical resistance (TEER) and cell monolayer permeability assays showed that koumine treatment attenuated the LPS-induced intestinal barrier dysfunction with no particularly different effects in tight junction proteins such as ZO-1, claudin-1, and occludin. LPS-triggered inflammatory response was also suppressed by koumine, as evidenced by the downregulated inflammatory factors, including TNF-α, IL-6, IL-1ß, NO, iNOS, and COX-2, which was closely connected with the inhibition of NF-κB pathway for the decrease of phosphorylation of IκBα and NF-κB and nuclear translocation of p-p65. Amount of reactive oxygen species (ROS) and MDA induced by LPS was also reduced by koumine through activation of Nrf2 pathway, and increased in the levels of Nrf2 and HO-1 degradation of keap-1 to promote anti-oxidants, including superoxide dismutase (SOD) and catalase (CAT). To summarize, koumine-reduced the oxidative stress and inflammatory reaction triggered by LPS through regulation of the Nrf2/NF-κB signaling pathway and preventing intestinal barrier dysfunction.

Vitamin D and nifedipine in the treatment of Chinese patients with grades I-II essential hypertension: a randomized placebo-controlled trial.

OBJECTIVES: Low vitamin D status has been shown to be associated with hypertension. We planned to research the effect of vitamin D and nifedipine in the treatment of patients with essential hypertension. METHODS: Patients with grades I-II essential hypertension were enrolled in this single-center, double-blind, placebo-controlled trial in Beijing. All patients received a conventional antihypertensive drug (nifedipine, 30 mg/d). One hundred and twenty-six patients were randomly assigned to receive vitamin D (n=63, 2000 IU/d) or a placebo (n=63) as an add-on to nifedipine, by the method of permutated block randomization. Ambulatory blood pressure monitoring was performed at baseline (month 0), at month 3 and at month 6. RESULTS: In vitamin D supplementation group, there was a significant increase in mean 25-hydroxyvitamin D levels from baseline (19.4 ± 11.6 ng/ml) to 6 months (34.1 ± 12.2 ng/ml; p<0.001). At 6 months, the primary end points, a difference in the fall of 24-h mean blood pressure, between the groups was -6.2 mmHg (95% CI -11.2; -1.1) for systolic blood pressure (p<0.001) and -4.2 mmHg (95% CI -8.8; -0.3) for diastolic blood pressure (p<0.001) under intention to treat analysis. In patients with vitamin D <30 ng/ml at baseline (n=113), 24-h mean blood pressure decreased by 7.1/5.7 mmHg (p<0.001). Safety and tolerability were similar among the two groups. CONCLUSIONS: Vitamin D supplementation can reduce blood pressure in patients with hypertension, it can be an adjuvant therapy for patients with grades I-II essential hypertension. CLINICAL TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry, it is available in Website: http://www.chictr.org/cn/; REGISTRATION NUMBER: ChiCTR-ONC-13003840.