Effect of Jingui Shenqiwan Combined with Fracture Three-stage Syndrome Differentiation on Recovery of Patients with Osteoporotic Vertebral Compression Fractures After Operation / 中国实验方剂学杂志

Objective:To evaluate the short-term and long-term efficacy of Jingui Shenqiwan combined with three-stage syndrome differentiation on osteoporotic vertebral compression fractures (OVCFs) after operation, and its regulatory effect on biomarkers of bone metabolism. Method:One hundred and thirty-five patients were randomly divided into control group (67 cases) and observation group (68 cases) by random number table. A total of 58 patients in control group completed the treatment (4 patients were exfoliated, 2 patients were lost to follow-up, 3 patients were eliminated); and 60 patients in observation group completed the treatment (3 patients were exfoliated, 2 patients were lost to follow-up, 3 patients were eliminated). Both groups patients were given calcitonin injection through intramuscular injection, 20 u/time, 1 time/week, for 12 weeks, calcium carbonate D3 chewable tablets (Ⅱ), 1 tablet/time, 2 times/day, and alendronate sodium tablets, 70 mg/time, 1 time/week. Patients in control group got Bushen Jiangu capsule, 4 grains/time, 3 times/day. And patients in observation group got modified Jingui Shenqiwan combined with fracture three-stage symptom differentiation, 1 dose/day. The courses of treatment in the two groups were 24 weeks, and a 24 week follow-up was provided. Before the operation and at the 12th and 24th week after operation, the short-term efficacy indexes, such as back pain, lumbar function, traditional Chinese medicine （TCM） syndromes and complications, were recorded. And the long-term efficacy indexes, such as recovery of responsible vertebral body, lumbar function, bone density and quality of life and incidence of 48 week re-fracture, were also recorded. Before and after operation, levels of bone alkaline phosphatase (BALP), osteocalcin (BGP), tartrate resistant acid phosphatase-5b (TRAP-5b), type I collagen carboxy terminal prepeptide (PICP), type I collagen cross-linked C-terminal peptide (β-CTX) and N-MID-OT were detected, and the safety was evaluated. Result:The comprehensive efficacy in observation group was superior to that in control group (Z=2.026, P<0.05). At the 12th and 24th week after operation, scores of back pain, lumbar function and TCM syndromes were all lower than those in control group (P<0.01), and score of lumbar function at the 48th week after operation was also lower than that in control group (P<0.01). Bone density was higher than that in control group at the 24th and 48th week after operation, and score of quality of life was lower than that in control group (P<0.01). At the 24th and 48th week after operation, Cobb angles were less than those in control group, and heights of responsible centrums (anterior, central, posterior) were higher than those in control group. Cumulative incidence of complications in control group was 51.72% (30/58), which was higher than 26.67% (16/60) in control group (χ2=7.784, P<0.01). The levels of BGP were higher than those in observation group at the 24th and 48th week after operation, and the levels of BALP, TRAP-5b, PICP, β-CTX and N-MID-OT were all lower than those in control group (P<0.01). And there was no side effect relating to Jingui Shenqiwan. Conclusion:Modified Jingui Shenqiwan combined with fracture three-stage symptom differentiation can reduce the symptoms of back pain and promote the recovery of lumbar function, with a significant short-term comprehensive efficacy. In the long term, it can improve the strength of responsible centrums, restore the anatomical structure of injured centrums, increase the bone density of centrums, further improve the lumbar function, reduce the occurrence of complications, regulate the markers of bone metabolism, and improve osteoporosis.

Catechins induced acute promyelocytic leukemia cell apoptosis and triggered PML-RARα oncoprotein degradation.

BACKGROUND: It has recently been reported that the extracts of green tea polyphenol have cancer preventive effects. In this study, we investigated the effect of the natural composition from green tea leaves Catechins on acute promyelocytic leukemia (APL). METHODS: In vitro, APL cell lines NB4, retinoic acid-resistant NB4-R1 and NB4-R2 were treated with different concentrations of Catechins. Cell viability and cell apoptosis were analyzed using MTT assay and flow cytometric assay, respectively. Expression of proteins related to apoptosis and PML-RARα oncoprotein were assessed by Western blot. In vivo anti-tumor activity of Catechins was examined in nude mice xenografted with NB4 cells and in situ cell apoptosis was detected by terminal deoxytransferase-catalyzed DNA nick-end labeling assay. RESULTS: Catechins at micromolar concentration levels significantly inhibited APL cell proliferation and induced cell apoptosis, in association with mitochondria damage, ROS production and caspase activation. The anti-apoptotic Bcl-2 family member Bcl-xL was down regulated, with pro-apoptotic member Bax remaining unchanged. Moreover, Catechins induced the degradation of PML-RARα oncoprotein. Catechins-mediated apoptotic effect was also observed in primary APL cells without affecting normal hematopoietic progenitor cells. In the murine xenograft model, Catechins remarkably inhibited tumor growth and induced in situ leukemic cell apoptosis. CONCLUSIONS: Catechins might be a potential candidate for APL treatment by activating intrinsic apoptotic pathway and targeting PML-RARα oncoprotein.

[Eeffects of Coptis Chinensis on vasoconstrictive activity of isolated thoracic aorta of normoxic and chronic intermittent hypobaric hypoxic rats].

OBJECTIVE: To observe the effects of Coptis Chinensis on vasoconstrictive activity of isolated thoracic aorta rings of normoxic and chronic intermittent hypobaric hypoxic (CIHH) rats, and to investigate the underlying mechanisms. METHODS: Young male Sprague-Dawley rats were randomly divided into normoxic group and CIHH group: the fonnrmer were not given any special treatment; the latter were exposed to hypoxia in a hypobaric chamber simulating 5000 m altitude (PB = 404 mmHg, PO2 = 84 mmHg, 11.1% O2), 6 hours daily for 28 days. The isolated thoracic aorta rings of rats were prepared and perfused in thermostat, and the effects of Coptis on vasoconstrictive activity of aorta rings were recorded, the mechanisms were investigated simultaneouly. RESULTS: Coptis Chinensis significantly decreased NE and KC-induced vasoconstriction of normoxic and CIHH rats' isolated aortic rings, but the inhibitive effects had no obvious discrepancy between the two groups. The contractive amplitude had no marked change after the removal of endothelium. When calculated by Logit Loglinear analysis, IC50 of NE and KCl-induced contractive amplitude in normoxic group were respectively 2.99 g/L and 6.14 g/L, while they were 3.45 g/L and 5.81 g/L in CIHH group. The inhibitive effect of Coptis on vasoconstrictive activity of both groups could be partly decreased by Glibenclamide and nitro-L-arginine methyl ester; Indomethacin suppressed the effect on normoxic group as well. Also Coptis significantly inhibited NE-induced both intracellular and extracellular calciumion-depended vasoconstriction. CONCLUSION: Coptis Chinensis obviously relaxes isolated thoracic aorta rings of normoxic and CIHH rats, but the effects are endothelium-independent and have no marked discrepancy between the two groups. The mechanisms of the effects may be related to the opening of ATP-sensitive K+ channel, raise of nitric oxide concentration in both groups, and the increasing of PGI2 in normoxic group. Besides, Coptis may inhibit sarcoplasmic reticulum releasing Ca2+ and decrease the inflow of extracellular Ca2+ via cell membrane.