Pharmacodynamic Material Basis of Astragali Radix and Angelicae Sinensis Radix Drug Pair in Supplementing Qi and Activating Blood Circulation / 中国实验方剂学杂志

ObjectiveTo evaluate the effect of Astragali Radix （AR）-Angelicae Sinensis Radix （ASR） drug pair on supplementing Qi and activating blood circulation in rats with Qi deficiency and blood stasis and provide a theoretical basis for clinical rational medication and identification and quality control of compound pharmacodynamic substances from the three aspects of characteristic map， identification of pharmacodynamic substances， and comparison of blood components. MethodHigh-performance liquid chromatography （HPLC） was employed to establish the fingerprint of AR∶ASR （3∶1）， and ultra-high performance liquid chromatography-Q-Exactive Orbitrap-mass spectrometry （UPLC-Q-Exactive Orbitrap-MS） was employed to analyze the ingredients of the decoction. Adult male Wistar rats with SPF grades were selected and randomly divided into a blank group， a model group， a 3∶1 group， and a 5∶1 group. The rat model of Qi deficiency and blood stasis syndrome was prepared by controlling food intake and swimming in cold water every day. In parallel， each group was given medicine （or water） once a day. The dose of drug groups was 10.2 g∙kg-1， and the model group and blank group were given the same amount of distilled water for 15 d. Animal behavior， body weight， whole blood and plasma viscosity， thymus index， spleen index， the levels of adenosine triphosphate （ATP）， adenosine diphosphate（ADP）， von willebrand factor （vWF）， and ATP/ADP value in serum of rats were recorded. The morphology of vascular endothelium was observed by hematoxylin-eosin （HE） staining and scanning electron microscopy. UPLC-Q-Exactive Orbitrap-MS was used to analyze prototype and metabolic components in serum. ResultThe fingerprint of AR-ASR drug pair （AR-ASR 3∶1） was established. UPLC-Q-Exactive Orbitrap MS identified 49 chemical components in vitro and preliminarily identified 11 prototype components absorbed into blood in vivo. As compared with the blank group， the body mass decreased significantly （P<0.01）， the whole blood （high shear， middle shear， and low shear） viscosity and plasma viscosity were significantly increased （P<0.05， P<0.01）， the thymus index and spleen index decreased significantly （P<0.05， P<0.01）， serum ATP content decreased significantly （P<0.01）， ADP content increased significantly （P<0.01）， ATP/ADP value decreased significantly （P<0.01）， and vWF content increased significantly （P<0.01）. The results of HE staining and scanning electron microscopy showed that the vessels were partially damaged， showing the structural disorder of the intima， the bulge， defect， and roughness of the endothelium， and the obvious cell adhesion and migration in the model group. As compared with the model group， the body mass also increased significantly （P<0.01）. The results of whole blood and plasma viscosity showed that the whole blood low shear viscosity was significantly decreased in the 3∶1 group （P<0.05）. The results of thymus index and spleen index showed that 5∶1 group significantly increased the thymus index of rats （P<0.05）. The results of serum ATP and ADP levels showed that the 5∶1 group had more significant effects on ATP and ADP levels （P<0.05）， and both groups significantly reduced ATP/ADP values （P<0.01）. The results of serum vWF level showed that the vWF content in the 3∶1 group decreased significantly （P<0.05）. The results of HE staining and scanning electronic microscopy showed that the damage of vascular endothelium was improved in the treatment group and the structure of intima was neat. ConclusionAR-ASR drug pair can improve the macro and micro indexes of rats with qi deficiency and blood stasis in the 3∶1 and 5∶1 groups. Overall， the 5∶1 ratio has a better effect on supplementing Qi but 3∶1 ratio has a better effect on promoting blood circulation.

Evaluation and optimization of content determination method of Chrysanthemi Flos in Chinese Pharmacopoeia / 中国中药杂志

This study discovered that the resolution of 3,5-O-dicaffeoylquinic acid(isochlorogenic acid A) in the content determination method of Chrysanthemi Flos in Chinese Pharmacopoeia(ChP)(2020 edition) was poor, which affected accurate quantification. We tested the method in ChP with chromatographic columns of seven brands to clarify the problems in the existing method, optimized the chromatographic conditions by adjusting the mobile phase composition and elution ratio and replacing the chromatographic column packing, and carried out the reproducibility assay for the new method. The two methods were compared for the content determination results of Chrysanthemi Flos prepared from six different varieties. As evaluated by the resolution based on different chromatographic columns of seven brands, the existing method failed to separate isochlorogenic acid A and isochlorogenic acid D well. The peaks of the two components were not completely separated on three chromatographic columns, and isochlorogenic acid A and isochlorogenic acid D generated a co-effluent peak in the other four columns. Isochlorogenic acid A and isochlorogenic acid D could be completely separated under the optimized chromatographic conditions. The difference in the peak areas of isochlorogenic acid A+isochlorogenic acid D obtained by the optimized method and the method in ChP was not significant, with deviation less than 3.0%, which further proved that the result measured by the method in ChP was the co-effluent of isochlorogenic acid A and isochlorogenic acid D. The optimized method can ensure the accurate quantification of isochlorogenic acid A. The existing content determination method of Chrysanthemi Flos has the problem of poor resolution. It is recommended to revise the chromatographic conditions for the content determination method of Chrysanthemi Flos to improve the resolution of isochlorogenic acid A and ensure its accurate quantification.

Effects of electroacupuncture on gastric emptying in patients undergoing hepatobiliary surgery with preoperative fasting and drinking under enhanced recovery after surgery protocol / 中华麻醉学杂志

Objective:To evaluate the effect of electroacupuncture (EA) on gastric emptying in patients undergoing hepatobiliary surgery with preoperative fasting and drinking under the enhanced recover after surgery (ERAS) protocol.Methods:Seventy-six patients of both sexes, aged 18-75 yr, with body mass index of 18-25 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, who underwent elective laparoscopic hepatectomy or cholecystectomy from January 2019 to December 2020, were divided into 2 groups ( n=38 each) using a random number table method: control group (group C) and EA group.Both groups used the ERAS strategy of fasting and drinking before operation.Solid food was forbidden after 20: 00 the night before surgery, and 12.5% preoperative oral carbohydrate drinks 800 ml was taken orally from 20: 00 to 22: 00, and preoperative oral carbohydrate drinks 400 ml was taken orally from 5: 30 to 6: 00 on the morning of surgery.The bilateral Zusanli, Zhongwan, Neiguan, and Taichong were stimulated at 7: 30 in group EA, while sham acupoints were stimulated in group C. All the patients underwent ultrasonography of the gastric antrum at 8: 00 for measurement of the cross-sectional area (CSA) in the supine and right lateral decubitus positions (right-lat CSA), gastric volume (GV), ratio of gastric volume to weight (GV/W), and ratio of right-lat CSA to weight (CSA/W) were measured, and Perlas A semi-quantitative grating was performed.After induction of anesthesia, the level of mucous pepsin at the esophageal entrance was quantitatively determined by enzyme-linked immunosorbent assay, and positive expression was recorded.The adverse reactions such as nausea, vomiting and aspiration during induction of anesthesia were recorded. Results:Compared with group C, the supine CSA, right-lat CSA, GV, right-lat CSA/W, GV/W, Perlas A semi-quantitative grading, positive rate of pepsin and incidence of nausea were significantly decreased in group EA ( P<0.05). Conclusions:EA can promote gastric emptying in the patients undergoing hepatobiliary surgery with preoperative fasting and drinking under ERAS protocol.

Functional connectivity changes during migraine treatment with electroacupuncture at Shuaigu (GB8) / 中西医结合学报

OBJECTIVE@#To investigate the changes in the functional connectivity (FC) in the right insula between migraine without aura (MWoA) and healthy controls by using resting-state functional magnetic resonance imaging (rs-fMRI), and to observe the instant alteration of FC in MWoA during electroacupuncture (EA) stimulation at Shuaigu (GB8).@*METHODS@#A total of 30 patients with MWoA (PM group) and 30 healthy controls (HC group) underwent rs-fMRI scans. The PM group underwent a second rs-fMRI scan while receiving EA at GB8. The right insula subregions, including the ventral anterior insula (vAI), dorsal anterior insula (dAI) and posterior insula (PI), were selected as the seed points for FC analysis.@*RESULTS@#Aberrant FC, including dAI with right postcentral gyrus, PI with left precuneus, was found among PM before EA (PMa), PM during EA (PMb) and HC. Meanwhile, decreased FC between dAI and the right postcentral gyrus was found in the PMa compared to the HC and PMb. Increased FC between the PI and left precuneus was found in the PMa compared to the HC and PMb. Correlation analysis showed that the FC value of the right postcentral gyrus in PMa was negatively correlated with the scores of Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety. The FC value of the left precuneus in PMa was positively correlated with the visual analogue scale score.@*CONCLUSION@#The alteration of FC between the right insula subregions and multiple brain regions may be an important index for MWoA. EA at GB8 was able to adjust the FC between the right insula subregions and parietal lobe, namely, the right dAI and right postcentral gyrus, and the right PI and left precuneus, thereby rendering an instant effect in the management of MWoA.

Comparison of chemical components between aerial and underground parts of Coptis chinensis based on UPLC-Q-TOF-MS~E technology / 中国中药杂志

The ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS~E) technology was employed to compare the chemical components between the aerial and underground parts of Coptis chinensis samples from different batches. According to the retention time, molecular ion peak, and LC-MS~E fragment information of the reference substances and available literature, we identified a total of 40 components. Thirty-three and 31 compounds were respectively identified in the underground part(taproots) and the aerial part(stems and leaves) of C. chinensis. Among them, 24 compounds, including alkaloids(e.g., berberine and jatrorrhizine) and phenolic acids(e.g., chlorogenic acid, quinic acid, and tanshinol), were common in the two parts. In addition, differential components were also identified, such as magnoline glucoside in the underground part and(±) lariciresionol-4-β-D-glucopyranoside in the aerial part. The analysis of fragmentation pathways based on spectra of reference substances indicated the differences among samples of different batches. Furthermore, we performed the principal component analysis(PCA) for the peak areas of C. chinensis in different batches. The results showed that the underground part and the aerial part were clearly clustered into two groups, indicating that the chemical components contained in the two parts were different. Furthermore, the results of partial least squares discriminant analysis(PLS-DA) identified 31 differential compounds(VIP value>1) between the underground part and the aerial part, mainly including alkaloids, phenolic acids, lignans, and flavonoids. This study proves that C. chinensis possesses great development potential with multiple available compounds in stems and leaves. Moreover, it sheds light on for the development and utilization of non-medicinal organs of C. chinensis and other Chinese medicinal herbs.

Literature Study on Current Status of Traditional Chinese Medicine for Chronic Atrophic Gastritis Based on PubMed and Web of Science Databases / 中国实验方剂学杂志

Objective:To review and summarize the current research status of traditional Chinese medicine（TCM） for the treatment of chronic atrophic gastritis（CAG），provide references and hints for relevant studies，and contribute to the further understanding of TCM and the application of TCM in the treatment of CAG with scientific evidence. Method:The PubMed and Web of Science databases were searched for relevant literature on the treatment of CAG with TCM from their establishment to August 31，2020. Eligible randomized controlled trials （RCTs） and animal studies were included according to the inclusion and exclusion criteria，and then the information of the included studies was extracted，summarized，and organized for further analysis. Result:A total of 4 RCTs and 21 animal studies （including 13 papers on compound studies，3 papers on single herb studies，and 5 papers on monomer studies） about TCM treatment for CAG were included in this study. RCTs showed that TCM could work well in improving the pathological state of gastric mucosa and clinical symptoms in patients. However，there were problems of low study quality，and non-uniform diagnostic criteria for gastric mucosal pathology and clinical efficiency evaluation. Animal experiments mainly focused on the study of drug mechanism exploration，and their results showed that TCM treatment of CAG was characterized by multi-target action. However，the animal experiments also had some problems such as inconsistence of CAG animal model establishment，positive drug selection，drug intervention methods as well as intervention cycles among different experiments. Conclusion:The efficacy of TCM in the treatment of CAG has gradually gained global recognition，but there is still a need for further standardization and unification of research methods. In the future，high-quality clinical trials and standardized animal experiments are still needed to conduct in-depth studies on the time for intervention，intervention methods，active ingredients and mechanisms of TCM，so as to make contributions to the full understanding and application of TCM in the treatment of CAG.

Research Progress on Pharmacological Effect of Astragali Radix-Angelicae Sinensis Radix on Invigorating Qi and Activating Blood / 中国实验方剂学杂志

Astragali Radix-Angelicae Sinensis Radix （AA） is a basic pair of drugs mainly targeting the syndrome characteristics of Qi and blood diseases. LI Dong-yuan's Danggui Buxuetang （DBT） is composed of AA， which is mainly used to tonify Qi and generate blood， with main indications of Qi deficiency and blood deficiency， blood heat and so on. It is favored by doctors because of its refined prescription and remarkable curative effect. However， there are many compatibility ratios of AA in different prescriptions in ancient books， and their efficacy and indications are also slightly different. This research showed that DBT also had the effect of invigorating Qi and activating blood， and the previous study of the group showed that 3∶1 compatibility ratio of the two herbs in the total amount of 36 g had more obvious effect of invigorating Qi and activating blood. By consulting the relevant literature， it was found that the drug pair had a certain effect of invigorating Qi and activating blood in various compatibility ratios such as 1∶1， 3∶1， 1∶5， 3∶2， 2∶1， 5∶1. The corresponding pharmacological effect mainly included regulating the energy metabolism of substances， regulating immune function， reducing blood viscosity， anti-oxidation stress， anti-inflammation， lowering blood lipids， lowering blood sugar， protecting heart function， protecting blood vessel wall， intervening angiogenesis， fighting against organ tissue fibrosis and so on. Regardless of the AA single-medicine's activating blood effect and the theory that "Qi circulation leads to blood circulation" or the drug pair's manifestation in modern pharmacological effects， all of these have confirmed that AA's effect of invigorating Qi and activating blood does exist， and the difference of action performance caused by different ratios of AA is closely related to dosage and proportion， which needs further study. Based on the study focusing on the effect of tonifying Qi and generating blood， it is easy to ignore the effect of invigorating Qi and activating blood， which limits the clinical application of the latter. Therefore， the tonifying Qi and activating blood circulation effect of the drug pair is reviewed in this paper， so as to provide a theoretical basis for its clinical rational drug use and related research.

Identification of Synthetic Cannabinoid 5F-EDMB-PICA in Suspicious Herbal Products / 法医学杂志

Objective To study the qualitative analysis strategy for unknown synthetic cannabinoid in the suspicious herbal product when no reference substance is available. Methods The synthetic cannabinoid in herbal blend was extracted with methanol. The extract was concentrated by rotary evaporator and separated and purified by preparative liquid chromatography, to obtain high purity synthetic cannabinoid sample. Gas chromatography-mass spectrometry （GC-MS）, ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-QTOF-MS） and nuclear magnetic resonance （NMR） were used to determine the structure of the prepared compound. Results High purity unknown sample （10 mg） was obtained by preparative liquid chromatography. The sample was analyzed by GC-MS, UPLC-TOF-MS and NMR, and through spectrum analysis, the unknown synthetic cannabinoid was determined as 5F-EDMB-PICA. Conclusion The method to extract unknown synthetic cannabinoid from low content herbal products by preparative liquid chromatography was established, and the structure of the unknown sample was identified by comprehensive use of GC-MS, UPLC-QTOF-MS and NMR. The information will assist forensic laboratories in identifying this substance or other compounds with similar structures in their casework.

[Correlation between water state and texture during moistening of Paeoniae Radix Alba by LF-NMR/MRI].

The changes of active ingredients content, moisture status and texture characteristics during the moistening of Paeoniae Radix Alba were studied by low-field NMR and imaging(LF-NMR/MRI) and texture analyzer, so as to analyze the correlation between LF-NMR parameters, texture characteristics and active ingredient content of Paeoniae Radix Alba during the moistening at diffe-rent times. The results showed that MRI technology could directly, vividly and accurately characterize the degree of moistening and the process of water migration, and the degree of moistening was consistent with the judgment results of traditional experience. The characteristics of moisture migration and moisture phase state in the moistening process of Paeoniae Radix Alba were that the total water content increased and existed in the form of free water, with an increased moisture mobility. In the case of dampening, the total water content did not increase, but the more watery part of the medicinal material was distributed to the less watery part, with a reduced fluidity. Finally, the medicinal materials were moistened, which can be mutually verified with the MRI results. The free water content and the total water content of Paeoniae Radix Alba had extremely negative correlations with hardness, surface toughness, internal toughness, Paeoniflorin and albiflorin contents(P<0.01). It showed that the use of LF-NMR/MRI and texture analyzer could better characterize the moistening process. It provides data characterization for the scientific connotation of "less soaking and more moisturizing, and the drug is completely saturated with water", and the traditional experience of "observing the water head". The feasible and objective evaluation method was helpful to optimize the softening process parameters, scientifically standardize the operating specifications, define the scienti-fic connotation of traditional Chinese medicine softening, and promote the inheritance and innovation of traditional Chinese medicine processing.

Rolling needle pricking-cupping therapy and traditional pricking-cupping therapy for cervical spondylosis of neck type: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between rolling needle pricking-cupping (RNP-C) and traditional pricking-cupping (TP-C) for cervical spondylosis of neck type.@*METHODS@#A total of 96 patients with cervical spondylosis of neck type were randomly divided into an RNP-C group, a TP-C group and an electroacupuncture (EA) group, 32 cases in each group. Each group was treated with EA at Jingbailao (EX-HN 15), Fengchi (GB 20), Dazhui (GV 14), Jianjing (GB 21) and @*RESULTS@#Compared before treatment, the scores of NPQ and VAS in each group were all reduced at 2 and 4 weeks into treatment and follow-up (@*CONCLUSION@#TP-C and RNP-C could both improve the cervical pain symptoms in patients with cervical spondylosis of neck type, and improve the overall function of the cervical spine, and the curative effect is similar.

Pirfenidone and nintedanib inhibit the lung alveolar regeneration in chronic pulmonary fibrosis mouse / 药学学报

The aim of this study was to determine whether the anti-fibrotic effects of pirfenidone (Pirf) and nintedanib (Nint) associated with the regulation of the alveolar epithelial type 2 cell (AEC II)-mediated lung alveolar regeneration in single- and multiple-dosage animal models of bleomycin-induced pulmonary fibrosis. All procedures involving animal treatment were approved according to the Committee on the Ethics of Animal Experiments of the Institute of Materia Medica, Chinese Academy of Medical Sciences. We found that the Pirf and Nint treatment of mice decreased the lung weight index, inflammation level, and the content of hydroxyproline compared with nontreated fibrotic mice in the single dosage model. Also, Pirf and Nint increased the oxygen saturation level and improved the lung functions in fibrotic mice, indicating that both drugs have anti-fibrotic effects in this model. However, the anti-fibrotic effects of Pirf and Nint were not observed in the multiple-dosage model. Further studies showed that Pirf and Nint decreased the expression of β-catenin, Axin2, c-Myc, Cyclin D1, and inhibited the Wnt/β-catenin signaling pathway, suggesting that Pirf and Nint did not produce anti-fibrotic effects in the multiple-dosage model due to their inhibiting the Wnt/β-catenin pathway and suppressing the stemness of AEC II, namely, suppressing AEC II-mediated lung alveolar regeneration.

The cell cycle inhibitor p21 promote mouse lung fibrosis by activating alveolar macrophages / 药学学报

This study was to determine the expression of the cell cycle inhibitor p21 in alveolar macrophages (AMs) and the role of p21 in activation of AMs in bleomycin (BLM) injury-induced lung fibrosis. The expression of CD206 in AMs was measured by immunofluorescence staining. Reverse transcription-polymerase chain reaction (RT-PCR) assay was used to detect the expression of macrophage activation markers. The coculture assay for macrophage and fibroblast was employed to explore the effect of macrophage on fibroblast activation. Immunofluorescence staining and western blotting assay were adopted to detect the expression of p21 in fibrotic tissues. AMs were treated with p21 knockdown or overexpression virus, RT-PCR and the co-culture system were used to explore the effect of p21 expression on macrophage activation. The Experimental Animal Welfare Ethics Committee of the Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College approved all of the protocols for this research. Our results showed that the expression of CD206 and macrophage activation markers was increased in AMs from fibrotic mice, indicating that AMs from fibrotic mice were associated with a profibrotic phenotype. Moreover, the expression of p21 was upregulated in AMs after BLM treatment. Depletion of p21 suppressed macrophage activation, while overexpression of p21 promoted the profibrotic phenotype of AMs from healthy mice. In summary, BLM injury causes the progressive accumulation of p21 in AMs, which induces the production of a number of profibrotic factors promoting the development of pulmonary fibrosis.

Literatures on Distribution Features of Traditional Chinese Medicine Syndromes and Syndrome Elements of Benign Prostatic Hyperplasia Based on Experience of Famous Doctors / 中国实验方剂学杂志

Objective:Based on the experience of famous doctors, the pattern of syndromes of benign prostatic hyperplasia (BPH) and the distribution of syndrome elements are defined to provide a basis for guiding clinical practice and scientific research. Method:The name list of famous doctors was defined. Relevant literatures on famous doctors' diagnosis and treatment of BPH between January 1, 1997 and December 31, 2018, were systematically retrieved in CNKI, CBM, CQVIP, Wanfang database. According to the inclusion criteria and exclusion criteria, relevant literatures were read, and eligible literatures were included. A literature analysis database was established for analysis and integration of relevant content of traditional Chinese medicine(TCM) syndromes and syndrome elements. SPSS 20.0 software was used for statistics and analysis of BPH TCM syndrome types and distribution characteristics of syndrome elements. Result:This study included a total of 141 eligible documents, involving 92 famous doctors. Based on the doctors' overall discussion of BPH and medical case examples, common types of BPH syndrome included kidney deficiency and blood stasis syndrome, bladder dampness syndrome, kidney Yin deficiency syndrome, kidney Yang deficiency Syndrome, liver Qi stagnation syndrome, main symptom factors of disease location included kidney, bladder, spleen, lung, liver, and main symptom factors of disease nature included blood stasis, Qi deficiency, heat, yang deficiency, and dampness. The characteristics of the symptoms in the medical case were collected and summarized, including frequent urinary symptoms, frequent urination, urinary drip, urgency, nocturia, difficulty in urinating, the tongue is mainly light red, red, dark red, and sputum, the tongue coating is mainly yellow, thin white, thin yellow and white greasy, and the pulse is mainly composed of deep, fine, string and slipping. Conclusion:Based on the experience of famous doctors, the core pathogenesis of BPH is deficient in origin and excessive in superficiality, the kidney deficiency is the root cause, the dampness heat is the symptom, and the compound syndrome is common.

Literature Research on Traditional Chinese Medicine Therapeutic Principles and Methods and Common Prescriptions of Benign Prostatic Hyperplasia / 中国实验方剂学杂志

Objective:Define traditional Chinese medicine (TCM) therapeutic principles and methods and common prescriptions of benign prostatic hyperplasia (BPH) based on clinical experience of famous doctors. Method:China National Knowledge Infrastructure, China Biology Medicine disc, China Science and Technology Journal Database, Wanfang database were systematically retrieved for literatures of famous doctors in diagnosis and treatment of BPH from January 1, 1997 to December 31, 2018.A literature analysis database was established for integration and analysis of relevant content of TCM therapeutic principles and methods and prescriptions. SPSS 20.0 software was used for statistics to obtain TCM therapeutic principles and methods, common prescriptions and drug distribution regularity of BPH. Result:A total of 109 qualified literatures were included in this study, involving 66 famous doctors and experts, and 9 kinds of BPH therapeutic principles were obtained, including "treatment of both symptoms and root cause of disease", "tonification and purgation in combination", "coordination of Yin and Yang". There are 55 kinds of therapies, including "promoting blood circulation for removing blood stasis", "clearing heat and promoting dampness", "warming and recuperating kidney Yang", "softening and resolving hard mass" and " invigorating kidney Qi". And BPH was mostly diagnosed and treated based on kidney, spleen and lung. Through collection and summarization, totally 38 formulas commonly used in treating BPH obtained. The most commonly used ones were "Guizhi Fuling Wan", "Zishen Tongguan Wan", "Buzhong Yiqi Tang", " Bazheng Tang" and "Jisheng Shenqi Wan". There were 217 commonly used herbs, mainly including " Astragali Radix", "Rehmanniae Radix Praeparata", "Atractylodis Macrocephalae Rhizoma", "Glycyrrhizae Radix et Rhizoma", "Angelicae Sinensis Radix", "Radix Achyranthis Bidentatae", "Peach Kernel", "Pangolin Scales", "Vaccariae Semen", "Salviae Miltiorrhizae Radix et Rhizoma", "Poria", "Rhizoma Alismatis" and "Plantain Seed". Conclusion:The treatment of BPH is based on the principles of "treatment of both symptoms and root cause of disease, and tonification and purgation in combination". The commonly used therapies include prescription for "promoting blood circulation for removing blood stasis", "clearing heat and promoting dampness" and "warming and recuperating kidney Yang". The corresponding prescriptions shall be based on symptoms.

Therapeutic effect of acupuncture on myofascial trigger points combined with low frequency bioelectrical stimulation and manipulative stretch reduction on sacroiliac joint on perinatal period separation of symphysis pubis / 中国实用妇科与产科杂志

OBJECTIVE: To observe the impact of acupuncture on myofascial trigger points(MTrPs),low-frequency electrical stimulation and manipulative stretch reduction on sacroiliac joint on perinatal period separation of symphysis pubis.METHODS: Totally 100 cases of perinatal separation of pubic symphysis in Huai'an Women and Children Health Hospital from January 2013 to July 2016 were selected.They were randomly divided into comprehensive treatment group,electrical stimulation group,manipulative reduction group,pelvic belt group and control group,20 cases in each group.The comprehensive treatment group was given acupuncture on myofascial trigger points,low-frequency electrical stimulation and manipulative stretch reduction on sacroiliac joint,the other three treatment groups were treated with their respective monotherapy,and the control group only received the brake observation.The NRS pain score and clinical efficacy were compared among the groups.RESULTS: Six days after treatment,18 cases,7 cases,4 cases,0 case and 0 case were cured in the five groups,respectively.Six weeks after treatment,20 cases,13 cases,11 cases,4 cases and 0 case were cured in the five groups,respectively.Six months after treatment,20 cases,18 cases,15 cases,13 cases and 9 cases were cured in the five groups,respectively.The treatment effect of the comprehensive group was the best,followed by the electric stimulation group,and then manipulation reduction group.CONCLUSION: acupuncture on myofascial trigger points and electrical stimulation combined with manipulative stretch reduction can not only quickly relieve the pain of patients in a short time,but also quickly make the pubic symphysis form return to normal.It has a high treatment efficiency and is less painful.So it has a high clinical value.

Efficacy and Safety of Jianpi Shengxue Granule Alone or Combined with Iron Supplement versus Iron Supplement Alone in the Treatment of Iron Deficiency Anemia in Children ：A Meta-analysis / 中国药房

OBJECTIVE： To systematically review the efficacy and safety of Jianpi shengxue granule alone or combined with iron supplement versus iron supplement alone in the treatment of iron deficiency anemia in children， and to provide evidence-based reference for iron deficiency anemia in children. METHODS： Retrieved from PubMed， Embase， Medline， Scifinder， Cochrane library， CJFD， VIP and Wanfang database during database establishment to Nov. 2018， RCT about efficacy and safety of Jianpi shengxue granule alone or combined with iron supplement （trial group） versus iron supplement alone （control group） in the treatment of iron deficiency anemia in children were collected. After the data were extracted from clinical studies that met the inclusion criteria， and the quality was evaluated with Cochrane System Evaluator Manual 5.1.0， Meta-analysis was conducted by using Rev Man 5.3 statistical software for total response rate， cure rate， the levels of hemoglobin （HB）， mean corpuscular volume （MCV）， mean corpuscular hemoglobin （MCH）， serum iron （SI）， serum ferritin （SF） elevation， the incidence of ADR. RESULTS： Totally 19 RCTs were enrolled， involving 2 259 patients. Results of Meta-analysis showed that total response rate [OR＝6.73， 95％CI （4.68， 9.68）， P＜0.001]， cure rate [OR＝2.51， 95％CI （2.06，3.06）， P＜0.001]， HB increased levels [MD＝8.91， 95％CI （6.13，11.68）， P＜0.001]， MCV increased levels [MD＝9.13， 95％CI （5.32，12.95）， P＜0.001]， MCH increased levels [MD＝2.95， 95％CI （1.75，4.15）， P＜0.001]， SI increased levels [MD＝3.66， 95％CI （2.77， 4.55）， P＜0.001]， SF increased levels [MD＝10.82， 95％CI （9.18，12.45）， P＜0.001] and the incidence of ADR [OR＝0.49， 95％CI （0.33，0.71）， P＝0.000 2] in trial group were all better than control group， with statistical significance. CONCLUSIONS： Jianpi shengxue granule alone or combined with iron supplement versus iron supplement alone can improve total response rate， cure rate， the levels of HB， MCV， MCH， SI and SF in children with iron deficiency anemia， and also decrease the incidence of ADR.

In Vitro and In Vivo Evaluation of Antitumor Activity of Ligustrum robustum, A Chinese Herbal Tea / 中国结合医学杂志

OBJECTIVE@#To examine the effect of the aqueous extract of Ligustrum robustum on tumor growth in vitro and in vivo and explore the possible molecular mechanisms.@*METHODS@#In in vitro study, cell viabilities of human cervical carcinoma cells (HeLa), human breast cancer cells (MCF-7), human prostate cancer cells (PC-3), human hepatoma cells (7721) and human colon carcinoma cells (SW480) were evaluated with cell counting kit-8. For L. robustum-treated Hela cells, early or late apoptosis were evaluated by annexin V/PI staining. Mitochondrial membrane potential was measured by staining cells with JC-1. Apoptosis was monitored by nuclear morphology based on chromatin condensation and fragmentation by 4',6-diamidino-2-phenylinole (DAPI) staining. Caspase-3 and -8 activity levels were measured by a colorimetric assay. In vivo, to evaluate the possible mechanism of L. robustum-mediated antitumor effect, nude mouse xenograft study was also conducted.@*RESULTS@#In in vitro study, L. robustum was found to be toxic to HeLa, MCF-7, PC-3, 7721, SW480, with an half maximal inhibitory concentration value of 2-5 mg/mL (P<0.05). Moreover, externalization of phosphatidylserine, loss of mitochondrial membrane potential, DNA fragmentation and activation of caspase-3 and -8 were detected in L. robustum-treated Hela cells. Using a nude mouse model bearing Hela xenografts, we found that L. robustum reduced tumor volume and tumor weight (P<0.05), but had no effect on body weight and histological damage of important organs. Intraperitoneal injection of L. robustum caused a significant reduction in serum aspartate transaminase and alanine transaminase levels (P<0.05). Furthermore, cleaved caspase-3-positive and terminal nucleotidyl transferase-mediated nick end labeling (TUNEL)-positive cells were observed in L. robustum-treated tumor tissues.@*CONCLUSIONS@#L. robustum inhibits tumor cell growth both in vitro and in vivo by inducing apoptosis in a caspase-dependent way without apparent hepatic toxicity and histological damage, which may offer partial scientific support for the ethnopharmacological claims of L. robustum as a herbal tea for its antitumor activity.

Effect of Traditional Chinese Medicine in Regulating Immune Mechanism of Chronic Urticaria / 中国实验方剂学杂志

Chronic urticaria (CU) is one of common diseases of dermatology. It has the clinical characteristics of allergy, multiple, recurrent and persistent recovery. The clinical symptoms of patients are mainly pruritus and wheal, and concurrent with vascular edema, some patients may even suffer from chest tightness, nausea and other systemic symptoms. Its pathogenesis is still unclear, and it is generally considered to be related to autoimmune, chronic infection, coagulation mechanism, vitamin D deficiency and so on. Among them, autoimmunity may be one of the important causes for chronic urticaria. Clinical studies mostly focus on immunoglobulin E, T cell subsets CD4+ T cells, CD8+ T cells, cytokines interleukin-2, interferon-γ, and complement C3, C4. Western medicine therapies mostly use antihistamines. The first generation of antihistamines have an obvious inhibitory effect on central nervous system, and side reactions, such as sedative and anticholinergic Effect. Although the second generation has a reduced inhibitory effect on central nervous system, it is easy to cause heart toxicity and relapse after drug withdrawal. Therefore, it is particularly important to find a safe and effective traditional Chinese medicine(TCM) therapy. Urticaria belongs to the category of " hidden rashes" in TCM. The etiology and pathogenesis are insufficient endowment of body elements, insufficient external defense or improper diet, damp-heat connotation. Classic prescriptions and self-prepared formulas, such as Jade Screen Powder, shall be used in the treatment of phlegm and blood stasis, with a clear clinical effect and a low recurrence rate. In addition, by reducing the level of immunoglobulin E in patients, improving CD4+ T cells, CD8+ T cell levels, regulating the levels of related cytokines, increasing the levels of complement C3, C4, these therapies could reduce IgE levels, release of anaphylatoxins, stimulation of mast cells and inflammatory reactions, and regulate the body' s immune function, with a satisfactory efficacy. Therefore, the author has summarized the clinical researches on the mechanism of traditional Chinese medicine in regulating chronic urticaria in past five years.

Sirt1 mediates improvement of isoflurane-induced memory impairment following hyperbaric oxygen preconditioning in middle-aged mice.

Hyperbaric oxygen (HBO) preconditioning (PC) has been suggested as a feasible method to provide neuroprotection from postoperative cognitive dysfunction (POCD). However, whether HBO-PC can ameliorate cognitive deficits induced by isoflurane, and the possible mechanism by which it may exert its effect, has not yet been clarified. In the present study, middle-aged mice were exposed to isoflurane anesthesia (1.5 minimal alveolar concentration [MAC]) for 2 h to establish a POCD model. After HBO preconditioning, cognitive function and expression of hippocampal sirtuin 1 (Sirt1), nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) were evaluated 24 h following isoflurane treatment, in the presence or absence of Sirt1 knockdown by short hairpin RNA (shRNA). HBO preconditioning increased the expression of Sirt1, Nrf2, and HO-1 and ameliorated memory dysfunction. Meanwhile, Sirt1 knockdown inhibited the expression of Nrf2 and HO-1 and attenuated the HBO preconditioning-associated memory improvement. Our results suggest that the application of HBO preconditioning is a useful treatment for POCD, and that Sirt1 may be a potential molecular target for POCD therapy.

Discussion on Research Focus of Ethical Review of Traditional Chinese Medicine Based on Co-Word Clustering Analysis Method / 中国医学伦理学

Objective: To tease relevant research on the ethical review of Traditional Chinese medicine in Chi-na and reveal hot topics and trends in the field.Methods: Taking the academic papers included in the domestic database on ethical review of Traditional Chinese medicine as literature samples,the BICOMB and SPSS22.0 soft-ware were used for document information mining,and the high-frequency keywords were analyzed used co-word clustering and thematic strategic diagram.Results: A total of 78 documents were retrieved,and 17 high-frequen-cy keywords were used.The four major hotspots in the field of ethical review of Traditional Chinese medicine in-cluded: institution building and system certification,GCP ethics optimization,ethical principle research,trial scheme design and project quality management.Conclusion: In recent years,the ethical review of Traditional Chi-nese medicine has been explored by scholars and institutions in China from multiple perspectives,and further re-search can be strengthened combined with the current weak areas,in order to increase the overall level of ethical review of Traditional Chinese Medicine.