Outcome Indicators in Randomized Controlled Trials on Traditional Chinese Medicine Treatment of Vertigo / 中国实验方剂学杂志

ObjectiveThis study analyzed the outcome indicators in randomized controlled trials （RCTs） on traditional Chinese medicine （TCM） treatment of vertigo， aiming to provide a reference for clinical trial protocol design and the establishment of core indicator sets for vertigo treatment. MethodCNKI， Wanfang， VIP， SinoMed， PubMed， Embase， and Web of Science were searched for the RCTs on TCM treatment of vertigo， and data extraction was conducted. ResultA total of 375 RCTs involving 33 593 patients were included， from which 482 outcome indicators were extracted， with a frequency of 2 715 and an average of seven outcome indicators used for each RCT. In addition， there were some differences in outcome indicators reported by different study groups. According to the functional properties， the reported outcome indicators were classified into nine domains： clinical symptoms and signs， TCM symptom efficacy， physical and chemical examinations， quality of life， mental health， safety events， patients’ satisfaction degree， long-term prognosis， and economic evaluation. The outcome indicators with higher frequency were clinical total effective rate， total TCM symptom score， occurrence of adverse reactions， dizziness handicap inventory （DHI） score， average flow velocity of the basilar artery， incidence of adverse reactions， average flow velocity of the left vertebral artery， average flow velocity of the right vertebral artery， plasma viscosity， and vertigo score. ConclusionThe outcome indicators reported by RCTs of TCM treatment of vertigo mainly have two problems： lack of unified standards and norms and insufficient attention to outcome indicators that can reflect the characteristics of TCM. The construction of the core indicator set for TCM treatment of vertigo should fully highlight the characteristic advantages of TCM and unify the standards and norms for the outcome indicators on this basis， so as to improve the quality of clinical research and the value of secondary research.

Anti-tumor activity of polysaccharides extracted from Pinus massoniana pollen in colorectal cancer- in vitro and in vivo studies.

The prevalence and mortality rate of colorectal cancer (CRC) have been increasing dramatically worldwide. Pinus massoniana pollen, a well-known natural food, is one of the most commonly consumed traditional medicines in China. P. massoniana pollen polysaccharides (PPPS) have antitumor effects, but it remains unclear whether they can inhibit CRC. Here, we have demonstrated that PPPS inhibited CRC cell proliferation effectively, induced morphology changes, triggered apoptosis by upregulating key apoptosis-related proteins, and arrested the cell cycle at the G0/G1 phase. Moreover, PPPS markedly inhibited CRC cell metastasis by downregulating MMP-9 and inhibiting epithelial-mesenchymal transition. In vivo, PPPS exhibited potent antitumor activity and no observable toxicity in BALB/c nude mice bearing HCT-116 tumors. Most strikingly, PPPS pre-treatment dramatically inhibited the growth of incipient tumors, although not as effectively as in the PPPS-Ther group. Thus, our results suggest that PPPS can be a potential anti-CRC agent, paving the way for developing complex carbohydrates for tumor prevention and treatment.

[Rosmarinic acid bolsters antibacterial immunity activity of macrophages by up-regulating PINK1/Parkin-mediated mitophagy].

This study aims to explore the molecular mechanism through which rosmarinic acid up-regulates mitophagy and enhances antibacterial immunity activity of macrophages. To be specific, RAW264.7 macrophages were treated with rosmarinic acid and then infected with Staphylococcus aureus. The total mRNA and proteins of the cells were then extracted. The mRNA and protein levels of phosphatase and tensin homolog(PTEN)-induced putative kinase 1(PINK1) were detected by q-PCR and Western blot, respectively. Cell mitochondria isolation kit was employed to isolate mitochondria in macrophages. Recruitment of E3 ubiquitin ligase Parkin to mitochondria and the phosphorylation of Parkin were detected by Western blot. Co-immunoprecipitation and laser confocal microscopy were employed to observe the co-localization of PINK1 and Parkin. Mitochondrial division inhibitor 1(Mdivi-1), small interfering RNA(siRNA)-directed gene knockdown, and plate-colony counting were used to detect the levels of inflammatory cytokines and the intracellular antibacterial ability, in an attempt to confirm that rosmarinic acid promotes antibacterial immunity activity of macrophages through strengthening PINK1/Parkin-mediated mitophagy. The results showed that rosmarinic acid up-regulated the mRNA and protein expression of PINK1, promoted the recruitment of Parkin from cytoplasm to mitochondria and the phosphorylation, and enhanced the interaction between PINK1 and Parkin and their co-localization in macrophages. Blocking mitophagy or knocking PINK1 significantly abrogated the promotion of macrophage antibacterial immune response by rosmarinic acid. In summary, rosmarinic acid enhances antibacterial immunity activity of macrophages through up-regulating PINK1/Parkin-mediated mitophagy.

Treatment Patterns and Survival of Patients With Advanced Non-Small Cell Lung Cancer Guided by Comprehensive Genomic Profiling: Real-World Single-Institute Study in China.

Although the National Comprehensive Cancer Network and the Chinese Society of Clinical Oncology guidelines recommend comprehensive genomic profiling of lung adenocarcinoma, it has not been widely applied in Chinese hospitals. This observational study aimed to determine real-world evidence of whether comprehensive genomic profiling can benefit the survival of patients with lung cancer. We investigated the frequency of genomic alterations, treatment strategies, and clinical outcomes in 233 patients with advanced non-small cell lung carcinoma who were routinely screened using a 508-gene panel. The most prevalent drivers were mutations of EGFR (51%), KRAS (9%), PIK3CA (7%), ALK (7%), MET (6%), and BRAF (5%). Mutations in tumor suppressor genes included TP53, KEAP1, RB1, PTEN, and APC. Median overall survival (OS) was significantly shorter among patients harboring KRAS (mutant, n = 17; WT, n = 154) and TP53 (mutant, n = 103; WT n =68) mutations (11.3 vs. 24.0 months; P = 0.16 and 18.7 vs. 28.7 months; P = 0.018, respectively). The OS was longer among patients with tumors harboring EGFR (P = 0.069) and ALK (P = 0.51) mutations. Most patients (65.4%) with the driver gene-positive (EGFR, ALK, and ROS1) tumors were received TKI treatment, whereas those with driver gene wild tumors (53.1%) chose platinum-based therapy. Univariate and multivariate analyses associated a shorter OS among patients with tumors harboring concomitant TP53 and EGFR mutations. These findings provide additional evidence from real-world on the potential importance of targeted therapies as a treatment option in NSCLC patients harboring clinically actionable mutation.

Polysaccharides from Pinus massoniana pollen improve intestinal mucosal immunity in chickens.

Intestinal mucosa is the largest immune organ in animals, and its immune function is directly related to the resistance against various diseases. Taishan Pinus massoniana pollen polysaccharides (TPPPS) have been recognized as an effective vaccine adjuvant and potential immune enhancer against viral infections. However, little is known about their direct immune-enhancing activity on intestinal mucosa. In this study, we extracted the polysaccharides from Taishan masson pine pollen to investigate its promotive effect on intestinal mucosal immunity. A total of 120 1-day-old chickens were divided into 4 groups and inoculated with PBS or 3 different doses of TPPPS (10 mg/mL, 20 mg/mL, and 40 mg/mL), respectively. Feces, intestinal specimens, and serum samples were collected from the chickens at 7, 14, and 21 d after inoculation. The antibodies in serum, mucosal secretion of IgA, structure of intestinal villi, and expressions of cytokine genes and mucosal immune-related genes in the chickens were all significantly improved by TPPPS treatments. At 21 d after inoculation following the challenge of Newcastle disease virus, the chickens inoculated with 20 and 40 mg/mL TPPPS exhibited decreased weight loss and reduced intestinal pathologic damage and viral loads in the intestine. In summary, our results demonstrate that TPPPS can enhance mucosal immunity and promote intestinal villi development. This study has established the foundation for the development of novel immune-enhancing agent with immune-regulatory effects on intestinal mucosa.

One-step synthesis of multifunctional nanoparticles for CT/PA imaging guided breast cancer photothermal therapy.

Advances in nanotheranostics have promoted the development of precision medicine, which has great potential as a weapon for clinical diagnosis and therapy of tumors. However, the combination of three functional principle components (imaging probes, therapeutic agents and surface coating) in traditional theranostic system is difficult to be achieved in only one step, while undergoing multiple synthesis procedures, time-consuming process and unknown toxicity. Herein, we fabricated iodinated polyaniline (LC@I-PANi) nanoparticles via a facile one-step synthesis approach integrating chemical oxidative polymerization and iodine-doping process for computed tomography (CT) imaging and photoacoustic (PA) imaging-guided photothermal therapy (PTT). Iodic acid (HIO3) as an oxidant induces chemical oxidation polymerization of aniline monomers. Meanwhile, iodine is incorporated into the polyaniline structural units in the process of polymerization to obtain LC@I-PANi nanoparticles. Moreover, thel-cysteine (LC) has an effect on diameter of LC@I-PANi nanoparticles, which enables nanoparticles have size-controlled spherical morphology and good colloidal stability. The hemolysis assay and cytotoxicity assessment verified the good biocompatibility of LC@I-PANi. Moreover, our LC@I-PANi nanoparticles could not only exhibit appealing PTT efficiency, but also achieve excellent CT/PA dual-mode imaging effect. The histological evaluations suggested the negligible toxicity of LC@I-PANi in vivo. This is the first time to our knowledge that multifunctional LC@I-PANi nanoparticles were prepared by an ingenious one-step method. This work not only highlights a one-step strategy that simplified the complex synthesis of LC@I-PANi nanoparticles, but also provides insight for further biomedical application of "all-in-one" theranostic agent.

Effects of Pinus massoniana pollen polysaccharides on intestinal microenvironment and colitis in mice.

The stability of the intestinal microenvironment is the basis for maintaining the normal physiological activities of the intestine. On the contrary, disordered dynamic processes lead to chronic inflammation and disease pathology. Pinus massoniana pollen polysaccharide (PPPS), isolated from Taishan Pinus massoniana pollen, has been reported with extensive biological activities, including immune regulation. However, the role of PPPS in the intestinal microenvironment and intestinal diseases is still unknown. In this work, we initiated our investigation by using 16S rRNA high-throughput sequencing technology to assess the effect of PPPS on gut microbiota in mice. The result showed that PPPS regulated the composition of gut microbiota in mice and increased the proportion of probiotics. Subsequently, we established immunosuppressive mice using cyclophosphamide (CTX) and found that PPPS regulated the immunosuppressive state of lymphocytes in Peyer's patches (PPs). Moreover, PPPS also regulated systemic immunity by acting on intestinal PPs. PPPS alleviated lipopolysaccharide (LPS) -induced Caco2 cell damage, indicating that PPPS has the ability to reduce the damage and effectively improve the barrier dysfunction in Caco2 cells. In addition, PPPS alleviated colonic injury and relieved colitis symptoms in dextran sodium sulfate (DSS)-induced colitis mice. Overall, our findings indicate that PPPS shows a practical regulatory effect in the intestinal microenvironment, which provides an essential theoretical basis for us to develop the potential application value of PPPS further.

Screening active fractions from Pinus massoniana pollen for inhibiting ALV-J replication and their structure activity relationship investigation.

The objective was to identify the active fractions of polysaccharide against replication of ALV-J and elucidate their structure activity relationship. The optimal extraction conditions were extracting temperature 90℃, pH 9 and the ratio of liquid to solid 30:1. Under these conditions, extraction yield of total polysaccharide was 6.5 % ± 0.19 %. Total polysaccharide was then purified by DEAE-52 cellulose and Sephadex G-200 gel. Three fractions, PPP-1, PPP-2, and PPP-3, were identified with molecular weight of 463.70, 99.41, and 26.97 kDa, respectively. Three polysaccharide fractions were all composed of 10 monosaccharides in different proportions. Compared with PPP-1, which was mainly composed of glucose, PPP-2 and PPP-3 contained a higher proportion of galactose, glucuronic acid and galacturonic acid. The Congo red assay indicated that the PPP-2 may have a triple helical structure, while PPP-1 and PPP-3 were absent. In vitro assay showed that there was no significant cytotoxicity among the polysaccharide fractions under the concentration of 800 µg mL-1 (P > 0.05). The antiviral test showed that PPP-2 had the strongest activity, indicating PPP-2 was the major antiviral component. The structure-activity relationship showed that the antiviral activities of polysaccharide fractions were affected by their monosaccharide composition, molecular weight, and triple helical structure, which was a result of a combination of multiple molecular structural factors. These results showed that the PPP-2 could be exploited as a valued product for replacing synthetic antiviral drugs, and provided support for future applications of polysaccharide from Pinus massoniana pollen as a useful source for antiviral agent.

Taishan Pinus massoniana pollen polysaccharide inhibits H9N2 subtype influenza virus infection both in vitro and in vivo.

The H9N2 subtype avian influenza virus (AIV) is one of the most prevalent AIV subtypes that can be found throughout most countries. Currently, due to the neglect of low pathogenic avian influenza virus (LPAIV) and monotonous control technique, an expanding H9N2 virus epizootic have been arisen and causes great economic losses in the poultry industry. Therefore, novel anti-influenza drugs are necessary for the prevention and control of H9N2 AIV. Our previous studies have found that Taishan Pinus massoniana pollen polysaccharides (TPPPS) have antiviral effects, but whether they can inhibit the H9N2 AIV remains unclear. Here, we further investigated the effects of TPPPS on the H9N2 virus and its underlying mechanisms of action. We found that TPPPS significantly inhibited the replication of the H9N2 virus in a dose-dependent manner, especially during the period of virus adsorption in vitro. Transmission electron microscopy demonstrated that TPPPS reduce infection by interfering with virus entry into host cells rather than by interacting with the H9N2 virus particles. A fluorescence quantitative PCR (qPCR) assay and an animal experiment were performed to evaluate the anti-viral effect of TPPPS in vivo. As expected, the lungs of chickens treated with TPPPS had fewer lesions and lower virus contents compared with the PBS group. In addition, pre-treatment with TPPPS clearly enhanced host disease resistance and delayed infection by the H9N2 virus. Taken together, our results reveal that TPPPS suppress H9N2 virus replication both in vitro and in vivo and therefore shows promising as an anti-AIV agent.

Taishan Pinus Massoniana pollen polysaccharide inhibits the replication of acute tumorigenic ALV-J and its associated tumor growth.

Avian leukosis virus subgroup J (ALV-J) has resulted in considerable economic losses in the poultry industry. In recent years, fibrosarcoma induced by ALV-J, which contains the v-fps oncogene, has gained momentum, and this has brought about new challenges to the poultry industry. To study the inhibitory effects of Taishan Pinus Massoniana pollen polysaccharide (TPPPS) on acute ALV-J infection and tumor development, antiviral and antitumor models of the Fu-J (SDAU1005) strain of ALV-J were established in vitro and in vivo. The results of in vitro experiments showed that TPPPS significantly inhibited viral replication in a dose-dependent manner during adsorption and pretreatment stages. The results of in vivo experiments have shown that TPPPS significantly reduced the viral load in the plasma and tumor tissues, as well as inhibited tumor growth. We further examined the difference in transcriptome expression by using RNA-Seq technology. A total of 560 differentially expressed genes were identified that included 329 up-regulated genes and 231 down-regulated genes. The up-regulated genes were mainly immune-related genes, whereas the down-regulated genes were mainly tumor-regulated genes. Gene Ontology (GO) term enrichment included immune system processes, positive regulation of immune system processes, regulation of immune system processes, leukocyte activation, cell activation, and protein binding. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed that the main immune and tumor-related pathways included T-cell receptor signaling pathway, cytokine-cytokine receptor interactions, natural killer cell-mediated cytotoxicity, PI3K-Akt signaling pathway, JAK-STAT signaling pathway, NF-κB signaling pathway, and Ras signaling pathway. In summary, our results preliminarily point to the antiviral and antitumor mechanism of TPPPS in vivo and in vitro.

Meta analysis of traditional Chinese medicine in the treatment of dry eye in recent years / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To evaluate the traditional Chinese medicine (TCM) for the treatment of dry eye effect in the past five years by using meta analysis method.· METHODS:According to the Cochrane evaluation system method,we searched Medline (January 2013 to October 2017),EMbase (2013-2017),Cochrane Library (2017),Wanfang database (2013-2017),VIP (2013-2017),and CNKI(2013-2017) for studies published.We included randomized controlled trials conducted the TCM in the treatment of dry eye.RevMan 5.0 statistical software data extraction and Meta analysis were conducted.· RESULTS:A total of 10 studies were identified,nine were from Chinese literature and one was from English literature,of which including 1 229 eyes.Nine of these studies performed BUT measurements at the end of the course of treatment.The results showed a statistically significant difference (P ＜ 0.00001).Nine studies performed tear flow measurements at the end of the course of treatment and the results showed a statistically significant difference (P ＜ 0.0001).Two studies performed FL measurements after the end of the course of treatment;the results showed no statistically significant difference (P=0.25).Three studies performed dry eye symptoms after the end of the course of treatment;the results showed that the differences were statistically significant (P=0.0003);the overall efficacy comparison,the difference between the two groups was statistically significant (P＜0.00001).· CONCLUSION:TCM treatment can significantly prolong BUT and increase tear flow,and has more advantages in the treatment of dry eye.

Basic and clinical application progression of invigorating blood and dissolving stasis Chinese medicine in ophthalmology / 国际眼科杂志(Guoji Yanke Zazhi)

Invigorating blood and dissolving stasis method is a kind of unique therapy of Traditional Chinese Medicine(TCM) treatment, which efficacy has become increasingly prominent in the treatment of ophthalmology.With the further studies of blood stasis and invigorating blood and dissolving stasis therapy, it is widely used in clinical ophthalmology, and get good effects beyond thought, especially when western medicine has no curative effects.It improved the cure rate of fundus oculi disease from the eyelids, conjunctiva, lacrimal sac, vitreous body to the choroid and retina, optic nerve and macula lutea, from surface to fundus, or pathological changes related to inflammation, degeneration, necrosis, atrophy, hyperplasia of fibrous tissue hyperplasia.This paper is aim to explain the definition of invigorating blood and dissolving stasis and make a review of basic research and clinical application about it in several diseases.

Correlation of intestinal mucosal injury with serum diamine oxidase / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the relationship between the changes of intestinal mucosal tumor necrosis factor alpha (TNF-alpha), plasma diamine oxidase (DAO) values and the degree of mucosal injuries in young rat model of colitis and thereby to explore if plasma DAO could be used as a potential index for monitoring intestinal mucosal injury.</p><p><b>METHODS</b>One hundred and four healthy young male Sprague-Dawley (SD) rats aged 5-6 weeks were randomly divided into three groups: zero time group (n = 8), model group (n = 48) and control group (n = 48). The model and control groups were further divided into 24 h, 72 h, 1 week, 2 weeks, 3 weeks and 4 weeks subgroups, respectively, with 8 rats in each. The rats in model group were given 2, 4, 6-trinitrobenzene sulfonic acid (TNBSA) via enema to induce colitis, while the rats in the control group were given normal saline (NS) solution in the same way and those in zero time group were not treated. TNF-alpha and DAO were measured by immunohistochemical technique and spectrophotometry.</p><p><b>RESULTS</b>The most serious enteric mucosal injury was seen 24 hours after giving TNBSA. Plasma DAO and TNF-alpha decreased as the intestinal mucosal injury was alleviated.</p><p><b>CONCLUSIONS</b>Plasma DAO values may be used as a marker for intestinal mucosal injury. TNF-alpha is a factor for causing mucosal injury. Young rat colitis model can be used to study intestinal mucosal injury.</p>