Comparative efficacy and safety of Chinese medicine injections as an adjunctive therapy for cervical cancer in Chinese patients: a network meta-analysis.

CONTEXT: Chinese medicine injections (CMIs) are widely used as adjuvant therapy for cervical cancer in China. However, the effectiveness of different types of CMIs remains uncertain. OBJECTIVE: To assess the effectiveness and safety of CMIs when used in conjunction with radiotherapy (RT) or concurrent chemoradiotherapy (CCRT), particularly in combination with cisplatin (DDP), docetaxel plus cisplatin (DP), and paclitaxel plus cisplatin (TP). MATERIALS AND METHODS: Randomized controlled trials (RCTs) were searched in databases including CNKI, WanFang, VIP, SinoMed, PubMed, Cochrane Library, Embase, and Web of Science from inception to September 2023. We calculated the risk ratio with a 95% confidence interval and the surface under the cumulative ranking area curve (SUCRA) for the clinical efficacy rate (CER), the efficacy rate by Karnofsky Performance Status (KPS), and the rates of leukopenia reduction (LRR) and gastrointestinal reactions (GRR). RESULTS: Forty-seven RCTs were included, including nine CMI types: Aidi, Fufangkushen, Huangqi, Kangai (KA), Kanglaite (KLT), Renshenduotang, Shenqifuzheng (SQFZ), Shenmai (SM), and Yadanzi. KLT and KA were likely optimal choices with radiotherapy for CER and KPS, respectively. KA and KLT were optimal choices with RT + DDP for CER and GRR, respectively. KLT was the likely optimal choice with RT + DP for CER and KA for both KPS and GRR. SM and SQFZ were the likely optimal choices with RT + TP for CER and LRR, respectively. CONCLUSIONS: The optimal recommendation depends on whether CMIs are used with radiotherapy or concurrent chemoradiotherapy. More high-quality RCTs are needed to confirm further and update the existing evidence.

Effects of Paeonia lactiflora Extract on Estrogen Receptor ß, TPH2, and SERT in Rats with PMS Anxiety.

This study is to investigate the effect of Paeonia lactiflora extract on PMS anxiety and on expression of estrogen receptor ß (ERß), tryptophan hydroxylase-2 (TPH2), and serotonin transporter (SERT) in the premenstrual syndrome (PMS) anxiety model rats. The vaginal smear and open field test were used to screen rats in nonreception phase of estrus cycle with similar macroscopic behaviors and regular estrus cycle. PMS anxiety model rats were prepared by electrical stimulation. RT-PCR and immunofluorescence were used to measure the expression of ERß, TPH2, and SERT. Compared with normal rats, the total distance in the open field test of the model rats was significantly increased (P < 0.05). The model rats showed nervous alertness, irritability, and sensitivity to external stimuli. After treatment with the Paeonia lactiflora extract, the total distance of rats was significantly reduced (P < 0.05). In reception stage, there was no significant difference in the mRNA and protein expression of ERß, TPH2, and SERT. In nonreception stage, the expression of ERß and TPH2 in the model group was significantly decreased (P < 0.05) as compared with the control group, but not SERT. Abnormal changes of the above indicators were reversed after the administration of the Paeonia lactiflora extract. In conclusion, Paeonia lactiflora extract can increase the expression of ERß and TPH2 and decrease SERT in PMS model rats, which may be one of the mechanisms underlying the effect of Paeonia lactiflora extract on PMS.

[Analysis of rational clinical uses of traditional Chinese medicine injections and factors influencing adverse drug reactions].

OBJECTIVE: To rationalize the clinical use and safety are some of the key issues in the surveillance of traditional Chinese medicine injections (TCMIs). METHOD: In this 2011 study, 240 medical records of patients who had been discharged following treatment with TCMIs between 1 and 12 month previously were randomly selected from hospital records. Consistency between clinical use and the description of TCMIs was evaluated. Research on drug use and adverse drug reactions/events using logistic regression analysis was carried out. RESULT: There was poor consistency between clinical use and best practice advised in manuals on TCMIs. Over-dosage and overly concentrated administration of TCMIs occurred, with the outcome of modifying properties of the blood. Logistic regression analysis showed that, drug concentration was a valid predictor for both adverse drug reactions/events and benefits associated with TCMIs. CONCLUSION: Surveillance of rational clinical use and safety of TCMIs finds that clinical use should be consistent with technical drug manual specifications, and drug use should draw on multi-layered logistic regression analysis research to help avoid adverse drug reactions/events.

Anti-ultraviolet radiation effects of Coptis chinensis and Phellodendron amurense glycans by immunomodulating and inhibiting oxidative injury.

HPLC analysis proved that Coptis chinensis glycan contained Ara, Man, and Gal. The monosaccharide constituents of Phellodendron amurense glycan were determined by HPLC analysis. HPLC analysis proved that P. amurense glycan contained Ara, Xyl, Glu, and Gal. FT-IR spectrum of C. chinensis glycan and P. amurense glycan showed the characteristic absorption peaks of carbohydrate polymers. Exposure of the human skin to ultraviolet radiation (UVR) leads to depletion of cutaneous antioxidants, regulation of gene expression and ultimately to the development of skin diseases. In the present study, free radical scavenging activity of C. chinensis and P. amurense glycan were evaluated. The photoprotective effect of C. chinensis and P. amurense glycan against UV-induced oxidative damage was also investigated in skin. At the concentration range employed, the two glycans showed strong free radical scavenging activity. Ultraviolet radiation reduced skin antioxidant enzyme and immunity activities in animals. Administration of C. chinensis and P. amurense glycans dose-dependently significantly increased skin antioxidant enzyme and immunity activities in animals. In conclusion, C. chinensis and P. amurense glycans present photoprotective properties, which can be attributed to molecules, such as flavonoids and carotenoids, which act as UV-absorbing molecules and as antioxidants, as well as stimulate immunity activities in animals.

[Treatment of premenstrual syndrome with Chinese medicine formula, baixiangdan capsule: implications for neuron viability and GABA(A) receptor modulation in rat cortex].

OBJECTIVE: To explore the effects of Baixiangdan capsule (BXD), a Chinese medicinal formula, on the premenstrual syndrome (PMS) rats with Liver-qi invasion and the possible underlying micro-mechanisms. METHOD: Wistar rats were randomly assigned to two groups, nomal group and BXD group After evaluated by macro-behavior observation and open-field test, MTT assay and the whole-cell patch clamp recording were performed respectively to evaluate the effects of serum from BXD capsule-treated rats on the viability and GABA(A) R-induced currents of cortical neurons in vitro. RESULT: In the open-field test, the crossing score, rearing score and total score of BXD rats decreased significantly (P < 0.05), compared by the normal rats. Compared with cells exposed to serum of normal rats, the viability values of those incubated with serum of BXD group for 24 h and 48 h significantly increased (P < 0.05), measured by MTT assay. The results of whole-cell patch clamp recording showed that concentration-response relationship curves revealed an EC50 value of (29.0 +/- 4.4) micromol x L(-1) and a Hill coefficient of 1.07 for normal-exposed cultures, (63.5 +/- 8.2) micromol x L(-1), 1.04 for BXD-exposed cultures after incubation for 24 h. Furthermore, the difference in EC50 values was statistically significant (P < 0.01), that in the Hill coefficient was not obvious. CONCLUSION: BXD capsule could significantly decrease crossing score and total score of open-field test and effectively enhance the neuron viability and GABA(A) receptor activity in rat cortex. Paeonimetabolins I and paeonol may play a significant role in treating PMS model rats with Liver-qi invasion by BXD capsule, and paeonol may target at GABA(A) receptor, especially.

[Effects of Baixiangdan capsule on location and expression levels of GABA(A) receptor beta2 subunit in hippocampus of PMS model rats with liver-qi invasion].

OBJECTIVE: To explore the effects of Baixiangdan capsule(BXD), a Chinese herbal compound, on the location and expression levels of GABA(A) receptor beta2 subunit (GABA(A)Rbeta2) in hippocampus of PMS model rats with liver-qi invasion. METHOD: After vaginal smear examination and open field test, the selected SD rats were randomly divided into 3 groups Normal group, PMS model group with liver-qi invasion and PMS BXD-administration group with liver-qi invasion (BXD was administered with oral dosage of 10 g x kg(-1) body weight every day for 5 days). PMS model rats with liver-qi invasion were induced by electric stimulating, and evaluated by macro-behavior observation and open-field test. The location and expression of GABA(A) receptor in hippocampus were measured by fluorescence microscopy and western blot respectively. RESULT: Compared with the normal group, the open field scores and GABA(A) Rbeta2 expression of PMS model rats with liver-qi invasion were increased significantly, and the distribution of GABA(A) receptor is more concentrated. However, the scores and GABA(A) beta2 expression of PMS BXD-administration group with liver-qi invasion were decreased markedly. Compared with the PMS model group the location had no significant change. CONCLUSION: One of micro-mechanisms of PMS model rats with liver-qi invasion may be related with the high expression of GABA(A) Receptor beta2 subunit in hippocampus, and the Chinese medicinal formula, BXD granule, had an adjust on the above abnormal changes.