Mechanism of Chinese Herbal Compounds Capable of Invigorating Qi and Activating Blood in Intervention of Hematogenous Metastasis of Malignant Tumors： A Review / 中国实验方剂学杂志

Metastasis is the main cause of poor prognosis of malignant tumors， and intervention with metastasis is the key measure in the treatment of malignant tumors. Hematogenous metastasis， the most common tumor metastasis， falls into the category of "Chuanshe" in traditional Chinese medicine （TCM）， with Qi deficiency and blood stasis as the critical pathogenesis. In the fight against malignant tumors， TCM emphasizes the reinforcement of healthy Qi and the elimination of pathogenic factors， exhibiting its action advantages of multiple targets， multiple mechanisms， and multiple levels. Extensive clinical evidence has shown the exact efficacy of Chinese herbal compounds designed for invigorating Qi and activating blood in delaying the progression of tumor disease and prolonging the survival period of patients. In view of the important role of hematogenous metastasis in the prognosis of tumors， more and more studies have explored the effects and mechanisms of Chinese herbal compounds capable of invigorating Qi and activating blood in intervening in hematogenous metastasis. This paper summarized the relevant literature reports in China and abroad on the intervention of Chinese herbal compounds capable of invigorating Qi and activating blood in the hematogenous metastasis of malignant tumors， in order to provide a theoretical basis for the clinical application of Qi-invigorating and blood-activating therapy in the treatment of malignant tumors. It has been found that Chinese herbal compounds formulated for invigorating qi and activating blood are effective in hindering several key steps in hematogenous metastasis through various mechanisms， including regulating the expression of cell adhesion molecules， inhibiting extracellular matrix degradation and angiogenesis， enhancing the killing effect of immunity， and improving blood hypercoagulability and hyperviscosity. Furthermore， the combination of invigorating Qi and activating blood targets the pathogenesis essence （Qi deficiency and blood stasis， characterized by sthenia in origin and asthenia in superficiality） of malignant tumor much better. Some comparative studies have demonstrated that the anti-metastasis effect of Qi-invigorating and blood-activating therapy is significantly stronger than that of the Qi-invigorating or blood-activating therapy alone， and such combination avoids the possible risk of the metastasis of malignant tumors triggered by the use of either of them. This study has provided some reference for the current clinical application of TCM for improving the prognosis of malignant tumors.

Anti-fibrosis Mechanism of Buyang Huanwutang： A Review / 中国实验方剂学杂志

Fibrosis can occur in nearly all organs of the body and is an outcome of many chronic diseases. As inflammation leads to necrosis of parenchymal cells， excessive proliferation of fibroblasts and overproduction of extracellular matrix （ECM） occur in tissues and organs， which may cause structural damage and loss of function of organs in the case of continuous progression. Chinese medicine has definite effect on fibrosis and prescriptions with effects of replenishing Qi and activating blood， such as Buyang Huanwutang， are frequently used in clinical settings. Clinical research and experiments show that Buyang Huanwutang can delay the progression of fibrosis in multiple organs such as lung， heart， liver， and kidney by improving organ function， reducing ECM deposition， anti-oxidative stress， anti-inflammatory response， regulating the imbalance of matrix metalloproteinases （MMPs）/tissue inhibitors of metalloproteinases （TIMPs）， and modulating transforming growth factor-β （TGF-β）/Smad pathway. According to traditional Chinese medicine， healthy Qi deficiency is the internal cause of fibrosis， and blood stasis is an important pathological factor in the formation of fibrosis. Moreover， deficiency and stasis exist in the whole process of fibrosis and the changes of microenvironment of fibrotic organs and tissues accord with the pathological manifestations of Qi deficiency and blood stasis. This article reviews the anti-fibrosis mechanism of Buyang Huanwutang in multiple organs， which provides a science-based explanation for the treatment of fibrosis by Buyang Huanwutang and lays a foundation for further clinical research.

Analysis of cognition, trainingdemand and willing to supply of Traditional Chinese Medicine characteristic services among the elderly care workers——a case of Pudong New District, Shanghai / 中国实用护理杂志

Objective:To provide the basis for integration of Traditional Chinese Medicine (TCM) and medical care in cities by taking the elderly care workers in Pudong New District of Shanghai as a sample, investigate the current situation of cognition, training demand and willing to supply among them, promote training of TCM and medical care.Methods:From May to July 2019, nine long-term care facilities were conveniently selected around traditional Chinese medicine hospital Y in Pudong New Area, Shanghai, and 134 elderly care workers were randomly surveyed to understand the basic situation of the characteristics of traditional Chinese medicine services. Awareness, training demand and willing to supply are statistically analyzed using χ2 test to analyze their influencing factors. Results:A total of 134 elderly care workers in nine long-term care facilities were investigated by convenient method, only 37.3% (50/134) didn′t know about Traditional Chinese Medicine Characteristic Services, but 71.6% (96/134) need training. There were significant differences in the scores of cognition of the elderly care workers between different gender, age, education level, working experiences ( χ2 values were 9.512-28.057,respectively, all P<0.05), There were significant differences in the scores of training demand of the elderly care workers between different gender, age, education level ( χ2 values were 10.425, 10.569, 13.088,respectively,all P<0.05). Among the Chinese medical items, In the training needs, the daily rhythm of daily life (3.82±0.67), the classification, characteristics and efficacy of food (3.38±0.73), the common used traditional Chinese medicine (3.23±0.84), the relationship between emotion and health (3.32±0.65), exercise and health care method (3.47±0.58), acupoint massage (3.50±0.72) in the traditional Chinese appropriate technique has higher score. In terms of willing to supply, cupping in suitable techniques of Chinese medicine (3.31±0.79) had the highest score, other items with higher scores were similar to training needs. Conclusions:The awareness of the traditional Chinese medicine service of the elderly workers needs to be improved. It is necessary to strengthen the training and promotion of key projects such as daily health care, diet care, acupoint massage, sports health care, etc, and increase the training of Chinese medicine professionals. Strengthen and increase the participation rate of integrated medical, medical and nursing services.

Awareness, demands and satisfaction of Traditional Chinese Medicine service among the elderly residents in nursing home / 中华全科医师杂志

Objective:To survey the status quo of awareness, demands and satisfaction of Traditional Chinese Medicine (TCM) service among the elderly residents in nursing home.Methods:A randomized survey on the status quo of TCM service was conducted from May to July 2019 among 237 elderly in 9 long-term care facilities close to a TCM hospital in Pudong New Area. The awareness, demands, satisfaction and influencing factors were analyzed.Results:Among 237 participants, only 1(0.4%)knew the TCM and its care well, however, 195 (82.3%) showed demands of TCM service. There were significant differences in the scores of demands and satisfaction of TCM among participants with different age, education level, marital status, medical insurance and health level ( P<0.05). Among the 16 TCM services, the three with top demand scores were acupoint massage (3.54±1.21), TCM health education (3.29±1.08), TCM drug iontophoresis (3.23±1.26); the three with top satisfaction scores were TCM health education (3.38±0.94), traditional health exercise (3.33±0.95), moxibustion (3.32±1.15). The demands and satisfactory were most correlated with each other in the guidance TCM medication ( r=0.996) and TCM herb tea ( r=0.988); and least correlated in the identification of TCM constitution ( r=0.305) and acupoint massage ( r=0.484). Conclusions:Among the elderly in long-term care facilities the awareness of TCM is at a low level, while the demands of TCM service are high. It is necessary to promote TCM service for elderly in long-term care facilities through TCM health education and developing the TCM products and appropriate techniques.

Bayesian network Meta-analysis of traditional Chinese medicine injections combined with antiviral western medicine in treatment of influenza / 中国中药杂志

To systematically evaluate the efficacy and safety of traditional Chinese medicine injections combined with antiviral wes-tern medicine in the treatment of influenza by Bayesian network Meta-analysis. Four Chinese databases(CNKI, Wanfang, VIP, CBM) and three English databases(PubMed, EMbase, Cochrane Library) were retrieved by computer for randomized controlled trials(RCT) about the comparison between the combined administration of traditional Chinese medicine injections with antiviral western medicine(or with placebo) and the single administration of antiviral western medicine in the treatment of influenza, or the comparison between two different traditional Chinese medicine injections combined with antiviral western medicine in the treatment of influenza. The retrieval time was from the establishment of the databases to July 2020. Two researchers independently screen out the literatures and extracted the data according to the inclusion criteria and exclusion criteria. The included studies were evaluated by the Cochrane 5.1 bias risk assessment tool, and data analysis was conducted by ADDIS 1.16.8 and Stata 14.0. A total of 49 literatures about 5 061 cases were included finally, involving six traditional Chinese medicine injections, namely Reduning Injection, Xiyanping Injection, Tanreqing Injection, Yanhuning Injection, Qingkailing Injection and Shuanghuanglian Injection. The results of network Meta-analysis,(1)in terms of total effective rate, 6 traditional Chinese medicine injections combined with antiviral western medicine was better than antiviral western medicine alone. In terms of probability sorting, Shuanghuanglian Injection combined with antiviral western medicine ranked first.(2)There was no significant statistical difference in adverse reaction rate among all groups, but Reduning Injection ranked first in the probability sorting, due to the least side effects.(3)In terms of antipyretic time, Yanhuning Injection, Xiyanping Injection and Tanreqing Injection combined with antiviral western medicine was better than antiviral western medicine alone and Xiyanping Injection ranked first in the probability sorting.(4)In terms of cough relief time, Qingkailing Injection and Tanreqing Injection combined with antiviral western medicine was better than antiviral western medicine alone and Qingkailing Injection was superior to Yanhuning Injection. Qingkailing Injection combined with antiviral western medicine ranked first in the probability sorting.(5)In terms of the length of hospital stay, Xiyanping Injection, Tanreqing Injection and Reduning Injection combined with antiviral western medicine was superior to antiviral western medicine alone, and Reduning Injection ranked first in the probability sorting due to the shortest hospital stay. Because of the small quantity and low quality of included studies, the results of this study shall be regarded cautiously and comprehensively. In the future, multi-center, large-sample and clinical randomized controlled trials shall be conducted to verify the results.

Efficacy of acupuncture for spastic cerebral palsy in infancy stage / 中国针灸

OBJECTIVE@#To explore the therapeutic effect of acupuncture for spastic cerebral palsy in infancy stage.@*METHODS@#A total of 62 children with spastic cerebral palsy were randomized into an observation group and a control group, 31 cases in each one. Both groups were given comprehensive rehabilitation therapy (sport therapy, electronic biofeedback therapy, speech cognitive training, massage therapy). On the basis of comprehensive rehabilitation therapy, the acupuncture group was treated with acupuncture at Baihui (GV 20), Sishencong (EX-HN1), motor area, Jiaji (EX-B 2), Weizhong (BL 40), Xuanzhong (GB 39), Zusanli (ST 36) and Hegu (LI 4), etc, the needles were retained for 15-20 min each time, once a day, 5 days a week, 45 days as a course with 10 days interval, a total of 3 courses were required. The Gesell development scale adaptive DQ scores, gross motor function measure (GMFM88) and muscular tension of adductor and gastrocnemius muscle were compared before and after treatment in the two groups.@*RESULTS@#The Gesell development scale adaptive DQ score after treatment in the observation group was increased (0.05), the change of the observation group was larger than the control group (0.05).@*CONCLUSION@#Acupuncture combined with comprehensive rehabilitation therapy can improve cognitive function, spasticity and motor function of children with spastic cerebral palsy.

Systematic Evaluation and Analysis on Dao-di Herbs Angelica Sinensis / 世界科学技术-中医药现代化

Geo-authentic habitats of Angelica Sinensis can be deduced from antiquity herbal literature's point of view. To provide basis for quality evaluation of Angelica Sinensis, this article summarized modern achievements in scientific research. To conclude genuine habitats of Angelica Sinensis, the related description of Geo-authentic habitats in ancient materia were reviewed and tested. Professional search strategy on traits and chemical characteristics of Angelica Sinensis were made to retrieve relevant literature in the CNKI database, and then the date on pharmacognostic characteristics and chemical component of crude drug from different origins were refined, and at last the date were comprehensively evaluated by Analysis of Variance, principal component and cluster analysis. and Conclusion Fourteen ancient books and one book of recent time were looked up on Herbalogical study. On this basis, twenty-six ancient origins were refined.Eight corresponding modern origins were finded through locating the place these medicines of dynasties in modern map.Combined with Frequency statistical results of modern origins and the related description of Geo-authentic habitats in ancient materia, genuine habitats of Angelica Sinensis were concluded. They are Gansu and Sichuan provinces. 75 literatures on traits and 1949 literatures on chemical characteristics of Angelica Sinensis were retrieved. The pharmacognostic characteristics of Angelica Sinensis were sumerized according to the traits. date. The results of ANOVA indicate that there exists significant difference in the quality of the samples in Gansu and Yunnan provinces among 6 different origins of Angelica Sinensis. Three principal components whose accumulated variance contribution rate was over90.641％ were obtained. Based on these principal components, samples of Angelica Sinensis from the different planting areas were clustered into three groups by within-groups linkage cluster methods. The results show that Gansu province was the best among 10 habitats. Sichuan, Yunnan Hubei, and Hubei Province were better than others habitats. The result is quite consistent with the genuine habitats of Angelica Sinensis, which is obtained from the textual research on ancient materia. The results obtained in this study can be used as references for evaluating the quality of Dao-di herbs Angelica Sinensis scientifically.

Experimental research on individual-specific rapid potassium supplementation strategy for fatal severe hypokalemia / 中华危重病急救医学

Objective To explore the effectiveness and safety of the individual-specific rapid potassium supplementation strategy, and to provide experimental basis for treating fatal severe hypokalemia. Methods An acute fatal severe hypokalemia model was reproduced in 20 healthy adult Japanese big ear white rabbits with half lethal dose (LD50) of barium chloride (BaCl2) solution 168 mg·5 mL-1·kg-1. The rabbits were divided into conventional potassium supplementation group and individual-specific rapid potassium supplementation group according to random number table method with 10 rabbits in each group. All the animals were injected with 3% KCl through the auricular marginal veins by a micro-injection pump, and the target plasma potassium concentration was 4 mmol/L. The rabbits in conventional potassium supplementation group were administered continuously potassium infusion at the standard infusion rate of 0.4 mmol·kg-1·h-1. And those in the individual-specific rapid potassium supplementation group were treated in two steps: first, a loading dose of potassium was rapidly injected within 5 minutes, and this step was repeated until the plasma potassium concentration increased to 3.5 mmol/L; second, a sustaining dose of potassium infusion was continued at the rate of 0.4 mmol·kg-1·h-1 after the increase in plasma potassium concentration. The changes in electrocardiogram, blood pressure, respiratory rate (RR), plasma potassium concentration, urine potassium concentration, urine volume, potassium content in extracellular fluid (ECF) and other parameters were monitored. The potassium supplementation, potassium excretion and potassium cross cell status were recorded. Adverse reactions and 7-day death were observed. Results Since the BaCl2 administration, the plasma potassium concentration of all experimental rabbits were significantly lower than baseline at 0.5 hour, which was decreased below 2.5 mmol/L at 2.0 hours when the ventricular arrhythmias appeared, indicating the reproduction of fatal severe hypokalemia model was successful. There was no significant difference in gender, weight, baseline heart rate (HR), RR, mean arterial pressure (MAP), blood gas analysis or K+, Na+, Cl- levels between the two groups. Compared with baseline levels, MAP was significantly decreased and RR was significantly increased before potassium supplementation in both groups, but the parameters were improved significantly and restored to the baseline after potassium supplementation. There was no significant difference in MAP or RR during potassium supplementation between the two groups. The amount of potassium supplementation in two groups showed no significant differences. However, compared with the conventional potassium supplementation group, in the individual-specific rapid potassium supplementation group, the increase in plasma potassium concentration, urine potassium concentration, and the increase in potassium content in ECF were significantly increased [the increase in plasma potassium concentration (mmol/L): 2.40±0.33 vs. 1.51±0.75, urine potassium concentration (mmol/L):164.94±18.07 vs. 108.35±19.67, the increase in potassium content in ECF (mmol): 1.17±0.16 vs. 0.73±0.35], the duration of potassium infusion was shortened (hours: 2.1±0.7 vs. 4.7±1.4), the total urine volume, renal excretion of potassium, and the amount of transcellular potassium shift were significantly decreased [total urine volume (mL):6.40±1.78 vs. 13.60±4.69, renal excretion of potassium (mmol): 1.04±0.26 vs. 1.46±0.51, amount of transcellular potassium shift (mmol): 1.39±0.21 vs. 1.84±0.62], the duration of arrhythmia was shortened (minutes: 19.60±8.92 vs. 71.80±9.84), with statistically significant differences (all P < 0.05). Hyperkalemia did not occur in both groups. The rabbits of the individual-specific rapid potassium supplementation group were all alive, while 4 died in the conventional potassium supplementation group, and statistically significant difference was found between the two groups (P < 0.01). Conclusions These data demonstrate that the individual-specific rapid potassium supplementation strategy can shorten the time for correcting hypokalemia, which is a better option to reverse life-threatening arrhythmia caused by severe hypokalemia, with a high rescue success rate. The process of potassium supplement is safe and effective.

Literature and Application Research on Shaoyao Gancao Decoction in Treating Constipation / 浙江中医药大学学报

[Objective] To study the basis of treating constipation with Shaoyao Gancao Decoction.[Method] Ancient and modern herbal and experience of famous doctors literature of Shaoyao Gancao decoction,Shaoyao(Peony) and Gancao(licorice) are reviewed and summed up.[Results] Shaoyao(Peony) and Gancao(licorice) themself have a certain purgative effect.Shaoyao is good at regulating abdominal qi and blood,"removing blood stasis and lump accumulation",eliminating abdominal evil,and thus plays a laxative effect.Gancao is good at detoxification,eliminating the toxin of stool,and thus plays a antitoxic and laxative effect.For constipation Shaoyao Gancao decoction is composed of raw Shaoyao and raw Gancao at a ratio of 3:1 to 2:1,and the general amount of raw Shaoyao is about 30g.[Conclusion]Shaoyao Gancao decoction has a good laxative effect,alone or its modified is suitable for a variety of constipation syndrome types.

Inhibitory effects of enalaprilat on rat cardiac fibroblast proliferation via ROS/P38MAPK/TGF-ß1 signaling pathway.

Enalaprilat (Ena.), an angiotensin II (Ang II) converting enzyme inhibitor (ACEI), can produce some therapeutic effects on hypertension, ventricular hypertrophy and myocardial remodeling in clinic, but its precise mechanism, especially its signaling pathways remain elusive. In this study, cardiac fibroblasts (CFb) was isolated by the trypsin digestion method; a BrdU proliferation assay was adopted to determine cell proliferation; an immunofluorescence assay was used to measure intracellular reactive oxygen species (ROS); immunocytochemistry staining and Western blotting assay were used to detect phosphorylated p38 mitogen activated protein kinase (p-p38MAPK) and transforming growth factor-ß(1) (TGF-ß(1)) protein expression, respectively. The results showed that Ang II (10(-7) M) stimulated the cardiac fibroblast proliferation which was inhibited by NAC (an antioxidant), SB203580 (a p38MAPK inhibitor) or enalaprilat; Ang II caused an burst of intracellular ROS level within thirty minutes, an increase in p-p38MAPK (3.6-fold of that in the control group), as well as an elevation of TGF-ß(1) meantime; NAC, an antioxidant, and enalaprilat treatment attenuated cardiac fibroblast proliferation induced by Ang II and decreased ROS and p-p38MAPK protein levels in rat cardiac fibroblast; SB203580 lowered TGF-ß(1) protein expression in rats' CFb in a dose-dependent manner. It could be concluded that enalaprilat can inhibit the cardiac fibroblast proliferation induced by Ang II via blocking ROS/P38MAPK/TGF-ß(1) signaling pathways and the study provides a theoretical proof for the application of ACEIs in treating myocardial fibrosis and discovering the primary mechanism through which ACEIs inhibit CFb proliferation.

Measurement of otoacoustic emissions by sound card / 生物医学工程学杂志

A new method in OAE's measurement by computer sound card is introduced. It is a measurement system using SF-1 detector. We designed the appropriate analog filter amplifier peripheral, utilized the mature technology of computer sound card, and recorded the OAE signal using Windows' API function programming by VB. The recorded signals can be analyzed by Matlab, such as digital filtering and Coherence average. The system is, in the main, cost-effective. The statistical results of the experiments proved the reliability of the method.