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BACKGROUND: Loxoprofen tromethamine is a novel structural compound related to loxoprofen. It has been used for the treatment of pain and inflammation. However, the embryo-fetal developmental toxicity (EFDT) of loxoprofen tromethamine has not been evaluated in detail in vivo. This study investigated the EFDT and toxicokinetics of loxoprofen tromethamine in rats. METHODS: The aim of this study was to investigate the potential reproductive toxicity on embryo-fetal development of loxoprofen tromethamine (0, 1, 3, and 10 mg/kg/day) and sodium cyclophosphamide (CP) (2.8 mg/kg/day) administered by intravenous injection to pregnant rats during gestation days (GDs) 6-15. Pregnant rats were euthanized on GD20. The numbers of live/dead fetuses, resorptions, implantations, and corpora lutea, gravid uterus mass, placenta mass, fetal gender ratios, body weight, and skeletal development were evaluated. In a concomitant toxicokinetic (TK) study (10 pregnant rats per group), plasma TK parameters and the tissue distribution of loxoprofen tromethamine were tested. RESULTS: On GD20, rats were anesthetized and dissected by caesarean section. The appearance, internal organs, gravid uterus weight, embryo implantation number, and implantation loss rate in maternal rats of each group did not reveal any lesions. In fetuses, there were no significant differences in the fetus weight, embryo resorption number, stillbirth number, or fetal visceral examination in all test groups compared to the negative control group. However, in the high-dose group, the fetuses showed significant differences in the anomalies of the bones compared to the negative control group. The TK study showed that in the dose range of 1-10 mg/kg, the Cmax and AUC(0-t) of loxoprofen tromethamine in animals after the first administration increased proportionally to the dose, showing linear kinetic characteristics; after the last administration, the Cmax and AUC(0-t) increased disproportionately to the dose, showing nonlinear kinetic characteristics. The results of tissue distribution show that loxoprofen tromethamine was mainly distributed in the placenta and lung after the intravenous administration to pregnant rats; the content in the liver was lower and increased sharply in the heart with increasing doses; the content in all tissues was lower than that in the plasma. Loxoprofen tromethamine in fetal tissues and organs was mainly distributed in fetal lungs, liver and heart, and the lowest content was in amniotic fluid. CONCLUSIONS: In conclusion, the no-observed-adverse-effect level (NOAEL) and lowest-observed-adverse-effect level (LOAEL) of loxoprofen tromethamine were considered to be 1 and 10 mg/kg/day, respectively.
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Cesárea , Trometamina , Ratas , Embarazo , Animales , Femenino , Ratas Sprague-Dawley , ToxicocinéticaRESUMEN
As arsenic widely exists in nature and has been used in the pharmaceutical preparations, the traditional Chinese medicine(TCM) with arsenic include realgar(As_2S_2 or As_4S_4), orpiment(As_2S_3), and white arsenic(As_2O_3). Among the above representative medicine, the TCM compound formulas with realgar are utilized extensively. Just in Chinese Pharmacopoeia(2020 edition), there are 37 Chinese patent medicines including realgar. The traditional element analysis focuses on the detection of the total amount of elements, which neglects the study on the speciation and valence of elements. The activity, toxicity, bioavailability, and metabolic pathways of arsenic in vivo are closely related to the existence of its form, and different forms of arsenic have different effects on organisms. Therefore, the study on the speciation and valence of arsenic is of great importance for arsenic-containing TCMs and their compound formulas. This paper reviewed four aspects of the speciation and valence of arsenic, including property, absorption and metabolism, toxicity, and analytical assay.
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Arsénico/análisis , Arsenicales/análisis , Sulfuros , Trióxido de Arsénico , Medicina Tradicional China , Medicamentos Herbarios Chinos/análisis , Productos BiológicosRESUMEN
Ketone bodies have beneficial metabolic activities, and the induction of plasma ketone bodies is a health promotion strategy. Dietary supplementation of sodium butyrate (SB) is an effective approach in the induction of plasma ketone bodies. However, the cellular and molecular mechanisms are unknown. In this study, SB was found to enhance the catalytic activity of 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2), a rate-limiting enzyme in ketogenesis, to promote ketone body production in hepatocytes. SB administrated by gavage or intraperitoneal injection significantly induced blood ß-hydroxybutyrate (BHB) in mice. BHB production was induced in the primary hepatocytes by SB. Protein succinylation was altered by SB in the liver tissues with down-regulation in 58 proteins and up-regulation in 26 proteins in the proteomics analysis. However, the alteration was mostly observed in mitochondrial proteins with 41% down- and 65% up-regulation, respectively. Succinylation status of HMGCS2 protein was altered by a reduction at two sites (K221 and K358) without a change in the protein level. The SB effect was significantly reduced by a SIRT5 inhibitor and in Sirt5-KO mice. The data suggests that SB activated HMGCS2 through SIRT5-mediated desuccinylation for ketone body production by the liver. The effect was not associated with an elevation in NAD+/NADH ratio according to our metabolomics analysis. The data provide a novel molecular mechanism for SB activity in the induction of ketone body production.
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Ratones , Animales , Ácido Butírico/metabolismo , Cuerpos Cetónicos/metabolismo , Hígado/metabolismo , Hidroxibutiratos/metabolismo , Regulación hacia Abajo , Sirtuinas/metabolismo , Hidroximetilglutaril-CoA Sintasa/metabolismoRESUMEN
Chronic pain, a common symptom of people with rheumatoid arthritis, usually behaves as persistent polyarthralgia pain and causes serious damage to patients' physical and mental health. Opioid analgesics can lead to a series of side effects like drug tolerance and addiction. Thus, seeking an alternative therapy and screening out the corresponding analgesic drugs is the key to solving the current dilemma. Traditional Chinese Medicine (TCM) therapy has been recognized internationally for its unique guiding theory and definite curative effect. In this study, we used the Apriori Algorithm to screen out potential analgesics from 311 cases that were treated with compounded medication prescription and collected from "Second Affiliated Hospital of Zhejiang Chinese Medical University" in Hangzhou, China. Data on 18 kinds of clinical symptoms and 16 kinds of Chinese herbs were extracted based on this data mining. We also found 17 association rules and screened out four potential analgesic drugs-"Jinyinhua," "Wugong," "Yiyiren," and "Qingfengteng," which were promised to help in the clinical treatment. Besides, combined with System Cluster Analysis, we provided several different herbal combinations for clinical references.
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ETHNOPHARMACOLOGICAL RELEVANCE: The existence of the blood-brain barrier/blood tumor barrier (BBB/BTB) severely restricts the effectiveness of anti-tumor drugs, thus glioma is still an incurable disease with a high fatality rate. Chuanxiong (Ligusticum chuanxiong Hort., Umbelliferae) was used as a messenger drug to increase the distribution of drugs in brain tissue, and its application in Chinese herbal formula for treating glioma was also the highest. AIM OF THE STUDY: Our previous researches showed that essential oil (EO) of chuanxiong could promote temozolomide (TMZ) entry into glioma cells in vitro and enhance TMZ-induced anticancer efficiency in vivo, and therefore, the aim of this study was to investigate whether EO could increase the concentration accumulation of TMZ in brain or tumor of C6 glioma rats and the related mechanisms. MATERIALS AND METHODS: The pharmacokinetics were conducted in C6 glioma rats by administering either TMZ alone or combined with EO through oral routes. TMZ concentration in blood, brain and tumor was detected using liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) and then pharmacokinetic parameters were calculated. The changed expressions of P-gp protein, tight junction occludin, claudin-5 and zonula occludens-1 (ZO-1) in brain of glioma rats were studied by Western blot to clarify the mechanism. Finally, the chemical composition of EO was analyzed by gas chromatography-massspectrometry (GC-MS). RESULTS: The results showed that EO significantly affected the pharmacokinetic parameters such as Tmax, Cmax and CL (p < 0.01), but did not significantly change the AUC(0â∞) of TMZ in blood (p > 0.05). However, EO markedly improved the AUC(0â∞)of TMZ in brain and tumor (p < 0.01). The calculate drug targeting index was greater than 1, indicating that EO could promote the distribution of TMZ to the brain and tumor. Western blot analysis showed that EO significantly inhibited the expression of P-gp, tight junction protein claudin-5, occludin and ZO-1. And meanwhile, the expressions of P-gp, claudin-5 and occludin also markedly down-regulated in EO-TMZ co-administration treatment. GC-MS analysis of the TIC component of EO was (E)-Ligustilide (36.93%), Terpinolene (7.245%), gamma-terpinene (7.225%) etc. CONCLUSION: EO could promote the distribution of TMZ in the brain and tumor of C6 glioma rats, which may attribute to down-regulate the expression of P-gp, claudin-5 and occludin.
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Neoplasias Encefálicas , Glioma , Ligusticum , Aceites Volátiles , Animales , Barrera Hematoencefálica/metabolismo , Neoplasias Encefálicas/patología , Cromatografía Liquida , Claudina-5/metabolismo , Cromatografía de Gases y Espectrometría de Masas , Glioma/metabolismo , Ocludina/metabolismo , Aceites Volátiles/química , Ratas , Espectrometría de Masas en Tándem , Temozolomida/farmacología , Temozolomida/uso terapéutico , Proteínas de Uniones Estrechas/metabolismoRESUMEN
Follicular helper T (Tfh) cells are a newly discovered subset of CD4+ T cells. As reported, abnormalities in their development, differentiation, and function are closely related to the occurrence of autoimmune diseases. Psoriasis is an autoimmune skin disease and it is intractable with a prolonged course. At present, it is generally believed that immune imbalance mediated by T cells is the core mechanism of the pathogenesis of psoriasis. In the context of this mechanism, Tfh cells are associated with psoriasis, and their cellular level and abnormal expression of related candidates can promote the occurrence of psoriasis. In terms of treatment, Chinese medicine, by virtue of the characteristics of wide application and low price, serves as a good complementary and alternative treatment option for psoriasis. As confirmed by previous findings, some active ingredients or preparations of Chinese medicine used in the treatment of psoriasis can also intervene in and regulate the immune response mediated by Tfh cells and the related candidates. Based on the research reports and experimental data, the present study reviewed the research progress from the differentiation of Tfh cells, the relationship between Tfh cells and psoriasis, and the intervention and regulation of Tfh cells and related molecules by Chinese medicine, which is expected to provide certain theoretical support and references for the determination of new strategies for psoriasis treatment and research in related fields.
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The incidence of psoriasis which is characterized by dryness, scaling and itching of the skin has been on the rise. It can have a profound psychological impact on patients' quality of life. Accumulating research has been conducted on the mechanisms of psoriasis in western medicine, from the difference of pathological manifestations of terminal keratinocytes, the disorder of expression of related factors and cells, to the immune imbalance of T lymphocytes and their subsets, or the abnormal transcription dominated by genetic genes. As a result, a complex and huge mechanism network has formed and many hypotheses have emerged. In recent years, with the in-depth research on non-coding genes, it has been clarified that microRNA-modified multi-pathway effect interferes with the occurrence and development of psoriasis and affects the proliferation, apoptosis, and differentiation of keratinocytes. The research on microRNA involves both genetics and immunology, which can help improve the key links in the micro pathway of psoriasis. Thus, it is a key part in the pathogenesis of psoriasis and has also become the hotspot and difficulty of modern research on psoriasis. At the same time, we should give full play to the advantages of traditional Chinese medicine (TCM) in syndrome differentiation and treatment. To be specific, microRNA targets of compound Chinese medicine preparations with the functions of clearing heat, cooling blood, detoxifying and removing blood stasis or effective medicinal monomers such as paeonol, tripterygium glycosides, shikonin, curcumin, total glucosides of paeony and indirubin should be explored, and microRNA can be used as the basis for blood syndrome differentiation of psoriasis. Thereby, the syndrome differentiation theory of TCM and micro indicators of western medicine are integrated, to make full use of characteristics of TCM and guide the clinical syndrome differentiation and treatment. At present, the intervention on microRNA in TCM is rarely studied, and available studies mainly focus on several targets such as microRNA-155, microRNA-210, microRNA-21, microRNA-203, microRNA-320, microRNA-124, microRNA-330, microRNA-146a, and microRNA-15a-5p. This paper summarizes the research on compound Chinese medicine prescriptions and monomers in the treatment and syndrome differentiation of psoriasis through the intervention of microRNA, which is expected to provide a reference for the research on psoriasis in TCM and western medicine and the establishment of microRNA-based database.
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BACKGROUND: Stroke is a global disease that compromises human health. Considering the side effects of Western medicine, alternative medicine, such as Chinese medicine, is widely used. Concurrently, the research and development on the microbiota-gut-brain axis in recent years have made intestinal microflora the new target of treatment. We aim to scientifically evaluate the advantages and clinical guidance of using Buyang-Huanwu (BYHW) decoction combined with probiotics in the intestinal microflora. METHODS: The search will focus on published Randomized Controlled Trial (RCTs) that used BYHW decoction, probiotics, prebiotics, synbiotics, or similar microecological preparations to treat stroke. We will search for relevant studies in six databases: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and Chongqing VIP Information. The retrieval date will be limited to the period from inception to June 2021 and will not be restricted by language. The extracted data will be subjected to systematic review and meta-analysis to evaluate its clinical advantages and efficacy. Patient-centred and most responsive outcomes will be selected as major outcomes, including the Fugl-Meyer (FMA) and Barthel scales. Secondary outcomes will be clinically assessed factors, including inflammatory factors in serum, platelet aggregation, other laboratory parameters, and the number and distribution of flora in the gut. We will evaluate the bias of each included study using the latest version of the Cochrane Handbook and the RoB tool. The analysis of all data and the drawing of forest maps will be performed using STAT 15.1 SE software. Regardless of the I2 values generated between the studies, we will perform a subgroup analysis. The grouping method will be based on all included research characteristics and factors that may cause heterogeneity, and may depend on differences in intervention methods, sources of subjects, and other relevant factors. RESULTS: We plan to present the results of this systematic review in a peer-reviewed scientific journal, conferences, and popular press. CONCLUSION: The efficacy and safety of Buyang-Huanwu decoction combined with probiotics for the treatment of stroke will be evaluated, and the conclusion will be published to provide medical evidence for a better clinical decision of patients with stroke.
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Medicamentos Herbarios Chinos/uso terapéutico , Probióticos/uso terapéutico , Accidente Cerebrovascular/tratamiento farmacológico , Eje Cerebro-Intestino , Medicamentos Herbarios Chinos/administración & dosificación , Humanos , Metaanálisis como Asunto , Prebióticos/administración & dosificación , Probióticos/administración & dosificación , Revisiones Sistemáticas como AsuntoRESUMEN
Severe Coronavirus Disease 2019 (COVID-19) is characterized by numerous complications, complex disease, and high mortality, making its treatment a top priority in the treatment of COVID-19. Integrated traditional Chinese medicine (TCM) and western medicine played an important role in the prevention, treatment, and rehabilitation of COVID-19 during the epidemic. However, currently there are no evidence-based guidelines for the integrated treatment of severe COVID-19 with TCM and western medicine. Therefore, it is important to develop an evidence-based guideline on the treatment of severe COVID-19 with integrated TCM and western medicine, in order to provide clinical guidance and decision basis for healthcare professionals, public health personnel, and scientific researchers involved in the diagnosis, treatment, and care of COVID-19 patients. We developed and completed the guideline by referring to the standardization process of the "WHO handbook for guideline development", the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, and the Reporting Items for Practice Guidelines in Healthcare (RIGHT).
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Antivirales/uso terapéutico , Tratamiento Farmacológico de COVID-19 , Medicamentos Herbarios Chinos/uso terapéutico , Infectología/tendencias , Medicina Tradicional China/tendencias , SARS-CoV-2/efectos de los fármacos , Antivirales/efectos adversos , COVID-19/diagnóstico , COVID-19/virología , Consenso , Técnica Delphi , Medicamentos Herbarios Chinos/efectos adversos , Medicina Basada en la Evidencia/tendencias , Interacciones Huésped-Patógeno , Humanos , Gravedad del Paciente , SARS-CoV-2/patogenicidad , Resultado del TratamientoRESUMEN
A novel three-stage integrated biofilter (TSIBF) composed of acidophilic bacteria reaction segment (ABRS), fungal reaction segment (FRS) and heterotrophic bacteria reaction segment (HBRS) was constructed for the treatment of odors and volatile organic compounds (VOCs)from municipal solid waste (MSW) comprehensive treatment plants. The performance, counts of predominant microorganisms, and bioaerosol emissions of a full-scale TSIBF system were studied. High and stable removal efficiencies of hydrogen sulfide, ammonia and VOCs could be achieved with the TSIBF system, and the emissions of culturable heterotrophic bacteria, fungi and acidophilic sulfur bacteria were relatively low. The removal efficiencies of different odors and VOCs, emissions of culturable microorganisms, and types of predominant microorganisms were different in the ABRS, FRS and HBRS due to the differences in reaction conditions and mass transfer in each segment. The emissions of bioaerosols from the TSIBF depended on the capture of microorganisms and their volatilization from the packing. The rational segmentation, filling of high-density packings and the accumulation of the predominant functional microorganisms in each segment enhanced the capture effect of the bioaerosols, thus reducing the emissions of microorganisms from the bioreactor.
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Recently, various studies have shown that angiotensin-converting enzyme 2 (ACE2) acts as the "doorknob" that can be bound by the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which conduces to its entrance to the host cells, and plays an important role in corona virus disease 2019 (COVID-19). This paper aims to collect and sorts out the existing drugs, which exert the ability to block the binding of S protein and ACE2 so as to provide directions for the later drug development. By reviewing the existing literature, we expound the pathogenesis of SARS-CoV-2 from the perspective of S protein and ACE2 binding, and summarize the drugs and compounds that can interfere with the interaction of spike protein and ACE2 receptor from different ways. We summarized five kinds of substances, including peptide P6, griffithsin, hr2p analogs, EK1, vaccine, monoclonal antibody, cholesterol-depleting agents, and extracts from traditional Chinese medicine. They can fight SARS-CoV-2 by specifically binding to ACE2 receptor, S protein, or blocking membrane fusion between the host and virus. ACE2 is the key point for SARS-CoV-2 to enter the cells, and it is also the focus of drug intervention. Our drug summary on this pathomechanism is expected to provide ideas for the drug research on SARS-CoV-2 and help to develop anti-coronavirus drugs of broad spectrum for future epidemics.
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Enzima Convertidora de Angiotensina 2/antagonistas & inhibidores , Tratamiento Farmacológico de COVID-19 , SARS-CoV-2/metabolismo , Glicoproteína de la Espiga del Coronavirus/antagonistas & inhibidores , Evaluación Preclínica de Medicamentos , Humanos , Receptores de Coronavirus/antagonistas & inhibidoresRESUMEN
Biological control of odors and bioaerosols in wastewater treatment plants (WWTPs) have gained more attention in recent years. The simultaneous removal of odors, volatile organic compounds (VOCs) and bioaerosols in each unit of a full-scale integrated-reactor (FIR) in a sludge dewatering room was investigated. The average removal efficiencies (REs) of odors, VOCs and bioaerosols were recorded as 98.5 %, 94.7 % and 86.4 %, respectively, at an inlet flow rate of 5760 m3/h. The RE of each unit decreased, and the activated carbon adsorption zone (AZ) played a more important role as the inlet flow rate increased. The REs of hydrophilic compounds were higher than those of hydrophobic compounds. For bioaerosols, roughly 35 % of airborne heterotrophic bacteria (HB) was removed in the low-pH zone (LPZ) while over 30 % of total fungi (TF) was removed in the neutral-pH zone (NPZ). Most bioaerosols removed by the biofilter (BF) had a particle size larger than 4.7 µm while bioaerosols with small particle size were apt to be adsorbed by AZ. The microbial community in the BF changed significantly at different units. Health risks were found to be associated with H2S rather than with bioaerosols at the FIR outlet.
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Certain natural products, derived from medicinal plants, exhibit anti-inflammatory properties, but the mechanism of action of many remains unclear. Borrelia burgdorferi spirochetes are responsible for causing Lyme arthritis through activation of the Toll-like receptor (TLR) signaling pathway. In this study, we investigated the mechanisms by which Isoforskolin (ISOF) and Cucurbitacin IIa (CuIIa), compounds derived from Chinese herbs, can exert anti-inflammatory effects by modulating single immunoglobulin interleukin-1 receptor-related receptor (SIGIRR; also known as Toll/interleukin-1 receptor 8, TIR8) and thereby inhibiting B. burgdorferi basic membrane protein A (BmpA)-induced TLR signaling in human macrophages, specifically the THP-1 human monocytic cell line. After THP-1 cells were exposed in vitro to: i) recombinant (r)BmpA, ii) rBmpA and ISOF or iii) rBmpA and CuIIa, Cytotoxicity assay (Cell Counting Kit-8, CCK-8) are used to measure the effects of ISOF and CuIIa on cell viability. Meanwhile, real-time polymerase chain reaction and Western blotting were used to quantify SIGIRR mRNA and protein levels, respectively, at 6, 12, 24 and 48 h time points post-stimulation. In addition, proinflammatory cytokine tumor necrosis factor-α (TNF-α) was determined by ELISA analysis. Our study showed that rBmpA stimulation of THP-1 cells resulted in a drop in SIGIRR levels in THP-1 cells. More importantly, SIGIRR levels increased significantly in rBmpA-stimulated THP-1 cells following ISOF or CuIIa administration, and the results of ELISA analysis suggested that ISOF or CuIIa reduced the secretion of the proinflammatory cytokine TNF-α. In conclusion, These results reveal new possibilities for the treatment of Lyme arthritis.
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Antiinflamatorios/farmacología , Proteínas Bacterianas/farmacología , Borrelia burgdorferi , Colforsina/análogos & derivados , Colforsina/farmacología , Cucurbitacinas/farmacología , Macrófagos/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Humanos , Macrófagos/metabolismo , Receptores de Interleucina-1/genética , Receptores de Interleucina-1/metabolismo , Células THP-1 , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
BACKGROUND: Fire needle therapy is a characteristic treatment in traditional Chinese medicine (TCM). An increasing number of studies have indicated that fire needle treatment for psoriasis provides satisfactory results with few side effects and a low recurrence rate. We herein describe the protocol for a multicenter, randomized, single-blind, placebo-controlled trial that will provide high-quality evidence on the efficacy and safety of fire needle therapy for plaque psoriasis. METHODS: Ninety-two patients with blood stasis syndrome (BSS) of plaque psoriasis will be enrolled and randomly assigned to receive fire needle therapy (intervention group) or fire needle control therapy (control group) once a week for 4 weeks. The Psoriasis Area and Severity Index (PASI) score will serve as the major efficacy index, while the body surface area (BSA), Physician Global Assessment (PGA) score, Dermatology Life Quality Index (DLQI) score, patient-reported quality of life (PRQoL), visual analog scale (VAS) score for itching, TCM symptom score, and relapse rate will be assessed as secondary outcomes. The PASI score, BSA, PGA score, and VAS score for itching will be evaluated at baseline and during the 4-week treatment and follow-up periods. DLQI score, PRQoL, and TCM symptom score will be assessed at baseline and during the treatment period. Recurrence will be evaluated during the follow-up period. Safety assessments include vital sign monitoring, routine blood tests, blood biochemistry, routine urine tests, pregnancy tests, physical examinations, and adverse-event recording. SAS software will be used for data analysis. The data network platform will be designed by the data management center of Nanjing Ningqi Medical Technology Co., Ltd. DISCUSSION: It is believed that fire needle therapy can activate the meridians, promote blood circulation, and regulate skin immunity. BSS of plaque psoriasis is related to not only immune dysfunction but also poor or stagnant blood flow. We anticipate that the results of the trial described in this protocol will provide strong evidence for the safety and efficacy of fire needle therapy for BSS of plaque psoriasis. TRIAL REGISTRATION: Clinicaltrials.gov NCT03953885 . Registered on May 15, 2019. Name: Fire Needle Therapy on Plaque Psoriasis with Blood Stasis Syndrome.
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Terapia por Acupuntura/métodos , Agujas , Psoriasis , Método Doble Ciego , Humanos , Medicina Tradicional China , Microcirculación , Estudios Multicéntricos como Asunto , Psoriasis/diagnóstico , Psoriasis/terapia , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Índice de Severidad de la Enfermedad , Método Simple Ciego , Resultado del TratamientoRESUMEN
BACKGROUND: Psoriasis is a common chronic inflammatory skin disease with high recurrence rates and increasing incidence. Patients require long-term medication to reduce symptoms and prevent disease progression. Therefore, the development of treatments with high efficiency and low rate of adverse events is of utmost importance. Traditional Chinese medicine (TCM) plays an outstanding role in reducing disease symptoms and improving quality of life. The aim of this trial is to clarify the treatment efficacy, safety, and control of disease recurrence in patients with psoriasis with blood-stasis syndrome treated with Taodan granules (TDKL). METHODS: This trial is a five-center, randomized, double-blind, placebo-controlled study planned to transpire between September 1, 2019, and December 31, 2021. A sample size of 216 participants (108 per group) with mild-to-moderate psoriasis will be randomly assigned to receive TDKL or placebo twice per day, 7 days per week, for 8 weeks. The study duration will be 17 weeks, including a 1-week screening period, 8 weeks of intervention, and another 8 weeks of follow-up. The primary outcomes are improvement in the Psoriasis Area and Severity Index score and recurrence rate after 8 weeks of treatment. Secondary outcomes include body surface area affected and the scores for the Physician Global Assessment, Dermatology Life Quality Index, pain-related quality of life, pain on the visual analogue scale, and TCM syndromes. The number, nature, and severity of adverse events will be carefully recorded. DISCUSSION: The study results will help clarify the safety and efficacy of TDKL as treatment for psoriasis with respect to both disease regression and recurrence rate. We expect that this study will provide high-quality evidence with important public health implications that may alter the approach to psoriasis management in China. TRIAL REGISTRATION: The trial has been registered at ClinicalTrials.gov (ID: NCT03942198).
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Ginkgo biloba (a herbal product) has long been used in traditional Chinese medicine to treat cerebrovascular and cardiovascular diseases. Ginkgolide B is one of the important pharmacologically active components of Ginkgo biloba. Dimethylaminoethyl ginkgolide B (a novel ginkgolide B derivative) has been developed to overcome the poor water-solubility of natural drugs and to achieve higher bioavailability. This study investigated the potential effects of dimethylaminoethyl ginkgolide B on pregnant dams and embryo-fetal development in Sprague-Dawley rats and New Zealand white rabbits following maternal exposure on gestational day (GD) 6-15 and GD 6-18, respectively. Dimethylaminoethyl ginkgolide B was administered by intravenous injection to pregnant rats (0, 10, 30 and 100 mg kg-1 d-1) and rabbits (0, 6, 18 and 60 mg kg-1 d-1). Maternal toxicity signs, such as lower maternal body weight gain and food consumption, were observed at 100 mg kg-1 d-1 in rats and 60 mg kg-1 d-1 in rabbits. The developmental toxic effects included a decrease in fetal and placental weights, increased incidences of skeletal variations and delay in fetal ossification. Fetal growth and development were affected by dimethylaminoethyl ginkgolide B in the high-dose group in rabbits. The no-observed-adverse-effect level of dimethylaminoethyl ginkgolide B is considered to be 30 mg kg-1 d-1 for rats and 18 mg kg-1 d-1 for rabbits.
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In this retrospective study, we investigated the effect of neuromuscular electrical stimulation (NMES) in patients with postpartum low back pain (PPLBP).We included 67 patients with PPLBP in this study. All patients received NMES, each session 30âminutes, 1 session weekly for a total of 4 weeks. The primary outcome was measured by the reduction in pain intensity, based on the visual analogue scale (VAS). The secondary outcomes included functional status, measured by the Roland-Morris disability questionnaire (RMDQ), and quality of life, measured by the World Health Organization Quality of Life questionnaire (WHOQOL-BREF), as well as the adverse events related to the treatment. The outcome data were evaluated at baseline and at the end of 4-week treatment.After 4-week treatment, NMES did not exert better outcomes in pain relief, measured by VAS, and functional status, measured by RMDQ compared with those before the treatment. In addition, no significant improvement in quality of life, measured by WHOQOL-BREF, compared to it before the treatment.The results of our study did not find that NMES is effective in patients with PPLBP after 4-week treatment.
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Terapia por Estimulación Eléctrica/métodos , Dolor de la Región Lumbar/terapia , Adolescente , Adulto , Evaluación de la Discapacidad , Femenino , Humanos , Dimensión del Dolor , Periodo Posparto , Calidad de Vida/psicología , Estudios Retrospectivos , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto JovenRESUMEN
The quality uniformity of traditional Chinese medicine (TCM) preparation is the base for guaranteeing the safety and effectiveness of clinical medication. At present, the quality of TCM preparation is uneven. At present, the same TCM preparation in different manufacturers, TCM preparations in the same manufacturer, and even different batches of a same TCM preparation in the same manufacturer have great differences in quality, which can not reach stability and uniformity. This paper would discuss the possible factors that influence the uniformity of quality in the whole process of pharmacy by means of consulting relevant literature on quality control of Chinese herbal preparations and analyzing the present situation and problems of the quality of TCM preparation. In addition, some strategies such as standardization of cultivation of TCM, processing standardization, standardization of pharmaceutical equipment, mixed batch feeding, and Quality by Design would be also put forward to provide references for the quality uniformity of TCM preparation.
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Medicamentos Herbarios Chinos/normas , Medicina Tradicional China , Preparaciones de Plantas/normas , Control de CalidadRESUMEN
The dry quality of traditional Chinese medicine pills is the hot spot of pills research, because their quality has a crucial effect on the efficacy and development of dosage forms. Through literature research and statistical analysis, we would review the current problems on the drying of traditional Chinese medicine pills in this paper, and surrounding the evaluation system for traditional Chinese medicine pills, analyze the characteristics of common drying equipment and processes as well as their effect on quality of pills, discuss the problems in drying equipment and process as well as quality, and put forward the corresponding strategies, hoping to provide new ideas and new methods for the quality improvement of traditional Chinese medicine pills and quality standards.
Asunto(s)
Desecación , Medicamentos Herbarios Chinos/normas , Medicina Tradicional China , Control de Calidad , Estándares de ReferenciaRESUMEN
ETHNOPHARMACOLOGICAL RELEVANCE: Da Chuan Xiong Decoction Compound preparation (DCXDCP) is a classic TCM formula of an aqueous extract made from Chuanxiong Rhizoma (Ligusticum chuanxiong Hort., umbelliferae) and Tianma Rhizoma (Gastrodia elata Bl., Orchidaceae). Gastrodin (GAS), a bioactive component of tianma, its pharmacokinetic (PK) behavior significantly changed after oral administration of DCXDCP compared with the extract of tianma. However, little is known about how the ingredients of chuanxiong influenced on the PK of GAS. AIM OF THE STUDY: To study the possible PK behavior differences of GAS after individually oral administration of tianma extract and tianma extract mixed with different active ingredients of chuanxiong to rats, as well as explore whether there were some herb-herb interactions. MATERIALS AND METHODS: Different DCXDCP suspensions were prepared by mixing tianma extract with different active ingredients of chuanxiong. The rats were randomly assigned to six groups and were orally treated with different DCXDCP. At different predetermined time points after administration, the concentrations of GAS in the rat plasma were determined using HPLC, and the main PK parameters were investigated. RESULTS: The results showed that tetramethylpyrazine had no significant effects on the PK parameters of GAS (p>0.05), whereas ferulic acid (FA), total phenolic acids and total alkaloids significantly increased AUC0-∞ (p<0.05). In general the observed changes in the PK parameters of GAS in DCXDCP could be closely related to the total phenolic acids and total alkaloids. CONCLUSION: It could be shown that total phenolic acids and total alkaloids present in Ligusticum chuanxiong in addition to other components not tested yet play an important role in affecting the PK of gastrodin in DCXDCP.