Effectiveness and safety of traditional Chinese medicine for diabetic retinopathy: A systematic review and network meta-analysis of randomized clinical trials.

BACKGROUND: Diabetic retinopathy (DR) is currently recognized as one of the most serious diabetic microangiopathies and a major cause of adult blindness. Commonly used clinical approaches include etiological control, microvascular improvement, and surgical intervention, but they are ineffective and have many side effects. Oral Chinese medicine (OCM) has been used for thousands of years to treat DR and is still widely used today, but it is unclear which OCM is more effective for DR. AIM: To estimate relative effectiveness and safety profiles for different classes of OCMs for DR, and provide rankings of the available OCMs. METHODS: The search time frame was from the creation of the database to January 2023. RevMan 5.3 and Stata 14.0 software were used to perform the systematic review and Network meta-analyses (NMA). RESULTS: A total of 107 studies and 9710 patients were included, including 4767 cases in the test group and 4973 cases in the control group. Based on previous studies and clinical reports, and combined with the recommendations of Chinese guidelines for the prevention and treatment of DR, 9 OCMs were finally included in this study, namely Compound Xueshuantong Capsules, Qiming Granules, Compound Danshen Dripping Pills, Hexue Mingmu Tablets (HXMM), Qiju Dihuang Pills (QJDH), Shuangdan Mingmu Capsules (SDMM), Danggui Buxue Decoction (DGBX), Xuefu Zhuyu Decoction and Buyang Huanwu Decoction. When these nine OCMs were analyzed in combination with conventional western medicine treatment (CT) compared with CT alone, the NMA results showed that HXMM + CT has better intervention effect on the overall efficacy of DR patients, HXMM + CT has better effect on improving patients' visual acuity, SDMM + CT has better effect on inhibiting vascular endothelial growth factor, DGBX + CT has better effect on reducing fundus hemorrhage area, HXMM + CT has better effect on reducing fasting blood glucose, and QJDH + CT has better effect on reducing glycated hemoglobin. When there are not enough clinical indicators for reference, SDMM + CT or HXMM + CT treatments can be chosen because they are effective for more indicators and demonstrate multidimensional efficacy. CONCLUSION: This study provides evidence that combining OCMs with CT leads to better outcomes in all aspects of DR compared to using CT alone. Based on the findings, we highly recommend the use of SDMM or HXMM for the treatment of DR. These two OCMs have demonstrated outstanding efficacy across multiple indicators.

Effects of Rosa roxburghii Tratt on Ulcerative Colitis: An Integrated Analysis of Network Pharmacology and Experimental Validation.

Rosa roxburghii Tratt is a traditional Chinese plant that has been used to treat different inflammatory diseases. The purpose of this study was to investigate the mechanism of action of Rosa roxburghii Tratt extract (RRTE) against ulcerative colitis (UC) using network pharmacology and experimental validation. HPLC-Q/Orbitrap MS was used to rapidly identify the substances contained in RRTE after extracting the active components from the fruit. Then, network pharmacology combined with molecular docking was used to explore the critical target and potential mechanism of RRTE against UC using the active ingredients in RRTE as the research object. Data are presented in a visual manner. Finally, the pharmacological effects of RRTE in alleviating UC were further verified using a DSS-induced UC model of NCM460. The results showed that 25 components in RRTE were identified. A total of 250 targets of the active components and 5376 targets associated with UC were collected. Furthermore, a systematic analysis of the Protein-Protein Interaction (PPI) networks suggests that epidermal growth factor receptor (EGFR), phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1), and serine/threonine kinase 1 (AKT1) are critical targets for RRTE in the treatment of UC. A comprehensive regulatory network analysis showed that RRTE alleviated UC through the EGFR-mediated PI3K/Akt pathway, and molecular docking showed that active components could strongly bind to EGFR, PIK3R1, and AKT1. In addition, RRTE alleviated dextran sulfate sodium salt (DSS)-induced cell injury and significantly decreased the protein expression levels of EGFR, PIK3R1, and p-AKT in NCM460 cells in vitro. Furthermore, RRTE significantly regulated the expression of the apoptosis-related proteins Apoptotic protease-activating factor 1 (Apaf1), cleaved caspase-3, B-cell lymphoma-2 (Bcl2), and Bcl2 associated X protein (Bax). In conclusion, the components of RRTE are complex, and RRTE can relieve UC through the EGFR-mediated PI3K/Akt pathway.

Nonthermal plasma-irradiated polyvalent ferromanganese binary hydro(oxide) for the removal of uranyl ions from wastewater.

Nonthermal plasma (NTP) irradiation was employed to adjust the morphological structures and valence distribution of ferromanganese (Fe-Mn)-based binary hydro (oxide) to enhance the heterogeneous adsorption of uranyl ions. The output voltage and the liquid-plate distance played a more vital role among the NTP factors in the irradiation system in influencing the polyvalent Fe-Mn binary hydro (oxide) (poly-Fe-Mn). The formation of plates, flakes, and nanoscale nodules was specifically observed, which caused more pores and fractures in the poly-Fe-Mn binary hydro (oxide). The poly-Fe-Mn performed explicitly better in the adsorption of uranium ions in comparison with the counterpart of the Fe-Mn, which was appropriately fitted by the pseudofirst-order kinetic and Elovich models. Maximum equilibrium adsorption capacities of 663.92 and 923.45 mg/g were obtained for the Fe-Mn and poly-Fe-Mn binary hydro (oxides) toward U ions in the orthogonal design, respectively. The maximum monolayer adsorption capacity achieved by the fitting of the Langmuir model was 1091.10 mg/g. Both physisorption and chemisorption contributed to the heterogeneous process of the poly-Fe-Mn toward uranium ions. The employment of NTP irradiation changed the monolayer adsorption of the traditional Fe-Mn materials and diversified the reaction mechanisms between the interface of the Fe-Mn materials and uranium ions. The elements, including O, N, and U exhibited higher compatibility and overlapped in the samples. The highly effective capture of uranium ions from the solution by the poly-Fe-Mn binary hydro (oxide) was mainly related to the chemical deposition of O and N radicals.

A green rust-coated expanded perlite particle electrode-based adsorption coupling with the three-dimensional electrokinetics that enhances hexavalent chromium removal.

A green rust-coated expanded perlite (GR-coated Exp-p) microelectrode was synthesized and incorporated into a column-mode three-dimensional electrokinetic (3D-EK) platform to effectively pursue a continuous Cr(VI) removal from the aqueous solution. Brucite-like layers of GR were decorated onto the Exp-p material. The molar ratio of Fe(II) to Fe(III) played a most vital role among the three synthesis factors in influencing the performance of the particle electrode. For the equilibrium adsorption experiments, the target maximum adsorption capacity of 122 mg/g was predicted by a target optimizer and desirability function at the conditions following the pH of 4.7, the initial concentration of 172.4 mg/L, the dosage of 0.28 g/L, and the temperature of 28.96 °C, respectively. SO42-, Cl-, and NO3- fiercely competed with Cr(VI) anions in the acidic conditions for the locally positive sites. A low concentration and a slow flow were favored in the column-mode 3D-EK platform. The pseudo-first-order and Langmuir models were suitable for describing the kinetics and isotherms of the adsorption process, respectively. Cr(VI) anions were electrostatically attracted to the silanol groups and GR surface of the adsorbent, subsequently reduced in both heterogeneity and homogeneity, and finally immobilized by coordinating with silanediol groups and silanetriol groups.

Efficacy and safety of Tongfu powder in acute pancreatitis patients with gastrointestinal dysfunction: a clinical trial.

OBJECTIVE: To evaluate the efficacy and safety of Tongfu powder for external application on Shénquè (the umbilicus, hereafter, Tongfu powder) versus mosapride in acute pancreatitis (AP) patients with gastrointestinal dysfunction. METHODS: A total of 102 AP patients were diagnosed using the latest Atlanta Criterion and recruited at the Department of Infectious Disease, Beijing Friendship Hospital (Beijing, People's Republic of China) from August 2014 to December 2016. Patients were randomized into the Tongfu powder group and mosapride group using the random table. Information on scores (eg, the gastrointestinal function score) on days 1 and 7 of hospitalization, biochemical indicators (eg, interleukin [IL]-2 and IL-6), indicators for curative effects (eg, first defecation time, bowel sound recovery time, hospitalization costs, and duration) were collected and compared between the 2 groups. RESULTS: The gastrointestinal function score decreased significantly after treatment, and the changes were significantly different between the Tongfu powder group and the mosapride group (P<0.05). Significantly shorter time to first defecation and bowel sound recovery was observed in the Tongfu powder group versus the mosapride group (P<0.05). The improvements of IL-2, IL-4, intestinal fatty acid binding protein, motilin, and vasoactive intestinal peptide in the Tongfu powder group were higher than those in the mosapride group (P<0.05). There were no significant differences in hospital cost and length of hospital stay between the 2 groups. CONCLUSION: This study suggested that Tongfu powder for external application may improve gastrointestinal function for AP patients compared with mosapride.

Antidiabetic Effect of High-Chromium Yeast Against Type 2 Diabetic KK-Ay Mice.

High chromium yeast has attracted many researchers for its high efficiency and high safety among chromium supplements. The preventive effect of oral high-chromium yeast on diabetes was assessed using KK-AY mice. Sixteen-wk-old type 2 diabetic KK-AY mice were divided into five groups and orally administered with two types of drying processed high-chromium yeast, chromium picolinate at 1000 µg Cr/kg/d, metformin (positive control), and normal yeast (negative control) for 13 weeks. The spray-dried high-chromium yeast significantly delayed the onset of hyperglycemia in type 2 diabetic KK-AY mice (P < 0.05) and significantly improved fasting blood glucose, TG(triglyceride), and TCHO(total cholesterol) . Histopathological analysis showed that the spray-dried high-chromium yeast led to high affinities for the stains to the ß-cells in the islets of Langerhans and alleviated hepatic steatosis. High-chromium yeast could be a potential candidate for nutritional supplement to ameliorate diabetes. PRACTICAL APPLICATION: Chromium plays an important role in fat and carbohydrate metabolism. The result show that spray-dried high chromium yeast significantly delayed the onset of hyperglycemia in type 2 diabetic KK-AY mice. As one of chromium supplements, the purpose of this study is to examine the efficacy of high chromium yeast on the type 2 diabetes and drying method on its bioactivity, which will be useful for research and development of high-chromium yeast and improvement of pharmacological activity-based quality control.

[Effect of Compound Qingre Granule on the Expression of Peripheral Blood Lymphocyte Subsets of Acute Virus Infection Patients].

OBJECTIVE: To observe interventional effects of anti-viral therapy and Compound Qin-gre Granule (CQG) on host cellular immune functions of acute virus infection patients. METHODS: Thirty acute virus infection patients were recruited to detect peripheral lymphocyte subsets. They were randomly assigned to two groups, the Western medicine treatment group (treated with anti-virus Western medicine) and the integrative medicine treatment group (treated with anti-virus Western medicine plus CQG). T-cell subsets were re-examined 7 days later. Changes between before and after treatment were observed. Effect on host cellular immune functions and efficacy were compared between the Western medicine treatment and the integrative medicine treatment. RESULTS: Compared with the normal control group, the percentage of peripheral T cells increased, and the percentage of B/NK cells decreased in acute virus infection patients (P < 0.01). Meanwhile, in T cell subsets, the percentage of CD8+ T cells and CD8+ CD38+ T cells increased (P < 0.05, P < 0.01); and percentages of CD4+ T cells, CD4+ CD28 + T cells, and CD8+ CD28+ T cells decreased (P < 0.05, P < 0.01). After one-week treatment, percentages of CD4+ T cells, CD4+ CD28+ T cells, and CD8+ CD28+ T cells increased (P < 0.05, P < 0.01), while the percentage of CD8+ CD38+ T cells decreased (P < 0.01). More significantly, these changes were greater in the integrative medicine treatment group than in the Western medicine treatment group (P < 0.05). CONCLUSIONS: Disarranged cellular immune functions existed in acute virus infection patients. CQG could significantly improve viral infection induced immunologic derangement and immunologic injury.

Isolation of antifungal compound from Paeonia suffruticosa and its antifungal mechanism.

OBJECTIVE: To isolate antifungal compound from Paeonia suffruticosa, and to find the antifungal mechanisms by observing the ultrastructural modifications of yeasts in growth phase produced by 1,2,3,4,6-penta-O-galloyl-beta-D-glucose (PGG). METHODS: Peony (Paeonia suffruticosa) root bark (PRB) was separated by solvent extraction and purified by high performance liquid chromatography (HPLC) method using analytical and preparative reversed phase C18 column on the basis of bio-assay method. In order to investigate the antifungal mechanism of PGG, Yeasts were submitted to different concentrations [3 × minimum inhibition concentration (MIC), 0.3 × MIC] for 1 h under constant stirring at 30 °C, and transmission electron microscopy was performed. RESULTS: Based on the antifungal activity of PRB on Candida glabrata CBS138, the antifungal compound were isolated in ethyl acetate layer of PRB and identified as PGG by mass spectrometry, 1H nuclear magnetic resonance (NMR) analyses, with molecular weight of 940 and molecular formular as C41H32O26. Transmission electron microscopy showed that PGG degraded the cell wall envelope. CONCLUSION: The results suggest that PGG may be responsible for the antifungal activity of PRB by disrupting the structure of cell wall directly.

Correlation between different Chinese medicine syndromes and changes in microcirculation in septic shock patients.

OBJECTIVE: To investigate the correlation between different Chinese medicine (CM) syndromes and variations in microcirculation in septic shock patients. METHODS: seventy Septic shock patients were divided into four groups: heat damaging qi-yin group (HDQY, 23 cases); yin exhaustion and yang collapse group (YEYC, 26 cases); excessive heat in Fu organ group (EHFO, 10 cases); and heat damaging nutrient-blood group (HDNB, 11 cases). Sublingual microcirculation parameters were observed by sidestream dark-field (SDF) imaging and scored by Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Sequential Organ Failure Assessment (SOFA), and parameters of microcirculation perfusion variations and prognoses were analyzed. RESULTS: Compared with those with qi-yin heat damage, perfused vessel density (PVD) in other groups decreased dramatically (P<0.05), and APACHE II scores increased significantly (P<0.05). In addition, the recovery time was prolonged substantially (P<0.05), and the mixed venous oxygen saturation (SVO2) decreased (P<0.05). Blood lactic acid increased significantly (P<0.05), and the mixed SVO decreased (P<0.05), in the YEYC group. Compared with the thermal injury camp blood group, sublingual microcirculation parameter variations showed no obvious difference in the YEYC and EHFO groups (P>0.05). There were significant positive correlations between CM syndromes and APACHE II scoring in different groups (r=0.512, P<0.05). There were negative correlations between PVD and APACHE II scoring (r=-0.378, P=0.043), the proportion of perfused vessels (PPV) and APACHE II scoring (r=-0.472, P=0.008), as well as between the microvascular flow index (MFI) and APACHE II scoring (r=-0.424, P=0.023) in different patients. CONCLUSION: Sublingual microcirculation may serve as a clinical diagnostic parameter of the patient condition, as well as being a prognostic indicator.

Salvianolic acid B protects from pulmonary microcirculation disturbance induced by lipopolysaccharide in rat.

The aim of the present study was to examine the effect and possible mechanism of salvianolic acid B (SalB) on pulmonary microcirculation disturbance induced by lipopolysaccharide (LPS) in rat. Male Sprague-Dawley rats were subjected to thoracotomy under continuous anesthesia and mechanical ventilation. Albumin leakage from pulmonary capillary and the numbers of leukocytes adherent to the pulmonary capillary wall were determined for 60 min by an upright microscope upon LPS (2 mg · kg(-1) · h(-1)) infusion with or without administration of SalB (5 mg · kg(-1) · h(-1)). Pulmonary tissue wet-to-dry weight ratio, tumor necrosis factor α, and interleukin 8 in plasma and bronchoalveolar lavage fluid were measured. In addition, the expressions of E-selectin, intercellular adhesion molecule 1, and myeloperoxidase in pulmonary tissue were assessed by immunohistochemistry. The expressions of aquaporin 1 (AQP-1), AQP-5, metalloproteinase 2 (MMP-2), and MMP-9 were assessed by Western blot assay. Pretreatment with SalB significantly attenuated LPS-induced pulmonary microcirculatory disturbance, including the increase in leukocyte adhesion and albumin leakage. In addition, LPS increased pulmonary tissue wet-to-dry weight ratio and tumor necrosis factor α and interleukin 8 levels in plasma and bronchoalveolar lavage fluid enhanced the expression of E-selectin, intercellular adhesion molecule 1, myeloperoxidase, MMP-2, and MMP-9, whereas it decreased the expression of AQP-1 and AQP-5 in pulmonary tissue, all of which were attenuated by SalB pretreatment. Salvianolic acid B pretreatment improves pulmonary microcirculation disturbance and lung injury on LPS exposure. More studies are required to evaluate the potential of SalB as an option for protecting lung from endotoxemia.

The effect of Astragaloside IV on immune function of regulatory T cell mediated by high mobility group box 1 protein in vitro.

High mobility group box 1 protein (HMGB1), a potent pro-inflammatory cytokine, contributes to the pathogenesis of diverse inflammatory and infectious disorders. Some studies have illustrated the potential effect of HMGB1 on regulatory T cells (Tregs). Astragaloside IV (AST IV) isolated from a Chinese herb, Astragalus mongholicus, is known to have a variety of immunomodulatory activities. However, it is not yet clear whether AST IV possesses potential regulatory effect on the pro-inflammatory ability of HMGB1 with subsequent activation of Tregs. This study was carried out to investigate the antagonistic effects of different doses of AST IV on the immune function of Tregs mediated by HMGB1 in vitro. Tregs isolated from the spleens of mice were co-cultured with HMGB1 and/or AST IV. Cell phenotypes of Tregs were analyzed, and the contents of various cytokines in the cell supernatants as a result of co-culture and the proliferation of CD4(+)CD25(-) T cells were determined. Results showed that HMGB1 stimulation resulted in significantly down-regulation of expressions of Tregs cell phenotypes. However, AST IV can rival the suppressing effect of HMGB1 on immune function of Tregs with a dose-dependent in vitro. These results indicate that AST IV has the potential therapeutic action on inflammation augmented by HMGB1.

Research on the relationship between thick greasy tongue fur formation and vascular endothelial cell permeability with the protein expression of zonula occludens-1.

OBJECTIVE: To determine the relationship of thick greasy tongue fur formation and permeability of vascular endothelial cells (ECs) with the protein expression of zonula occludens-1 (ZO-1). METHODS: Sprague Dawley rats were randomly divided into a model group of severe acute pancreatitis (SAP) and a sham-operated (SO) group. The SAP rats were further divided into two subgroups on the basis of tongue-coating status: a thick greasy tongue fur group (SAP-TGF) and a normal tongue fur group (SAP-NF). Six rats were chosen randomly from every group mentioned above for an Evans blue assay 5 days after model establishment. For the histomorphology analysis, the expressions of ZO-1 protein and mRNA were studied by hematoxylin-eosin (H&E) staining, transmission electron microscope, Western blot, and Q-PCR using blood and tongue tissues, which were collected from 8 rats randomly chosen from each group. RESULTS: The papillae density of the rat tongue surface and the caryocinesis frequency of the basal layer were significantly increased in the SAP-TGF group compared with the SO group (P<0.05). Evans blue levels in the tongue tissue of the SAP-TGF group were significantly higher than that of the SO and SAP-NF groups (P<0.05). Vascular ECs were wider and obviously fissured in the SAP-TGF group under transmission electron microscope observation. The protein and mRNA expression of ZO-1 in the SAP-TGF group were lower than those in the SAP-NF (P<0.05). CONCLUSIONS: Reproductive activity enhancement of glossal epithelial cells was one of the main characteristics of thick greasy tongue fur formation. An increase in vasopermeability was closely associated with thick greasy tongue fur formation. Tight junction structural variation of vascular ECs might play an important role in the pathological and physiological process of thick greasy tongue fur formation.

Attenuating effect of pretreatment with Yiqifumai on lipopolysaccharide-induced intestine injury and survival rate in rat.

BACKGROUND: Yiqifumai is a traditional Chinese medicine compound preparation used for treatment of microcirculatory disturbance-related diseases in China. We have previous reported that pretreatment with Yiqifumai could improve the lipopolysaccharide (LPS) -induced microcirculatory disturbance in rat mesentery. The present study intended to investigate the effect of pretreatment with Yiqifumai on intestine injury and survival rate of the rats subjected to LPS challenge. METHODS: Male Wistar rats were continuously infused with LPS (5 mg kg-1 body weight h-1) via the left jugular vein for 90 min. In some rats, Yiqifumai 80 (mg/kg) was administrated through the left jugular vein 10 min before LPS infusion. The mean arterial pressure (MAP), heart rate (HR), rectal temperature (RT), respiratory rate (RR) and survival rate were measured at 24 h, 48 h and 72 h after LPS infusion. At 72 h after exposure to LPS, the intestine morphology was observed under a stereomicroscope and the immunohistochemistry staining of intestine was conducted to evaluate the expression of intercellular adhesion molecule 1 (ICAM-1) and the number of myeloperoxidase (MPO) positive cells in tissue. After observation of intestine microcirculation, blood was collected from the abdominal aorta of each animal to analyze the level of inflammatory markers in plasma, including TNF-α and MCP-1. RESULTS: Compared to the control, LPS infusion significantly decreased MAP and the survival rate and increased the HR, RT and RR, as well as elicited leukocyte infiltration, intestine hemorrhage, enhanced expression of ICAM-1 and raised level of inflammatory markers. All of indicators, except for the RT, were significantly attenuated by Yiqifumai, in contrast to the LPS group. CONCLUSIONS: The results demonstrated the potential of pretreatment with Yiqifumai to ameliorate rat intestine injury, inflammatory response to LPS and the decrease in survival rate caused by LPS challenge.

[Effect of Tongfu granules and its constituents on barrier function of small intestine in rats with sepsis].

OBJECTIVE: To investigate the effects of Tongfu granules and its constituents on barrier function of small intestine in rats with sepsis. METHODS: The male rats were divided into model group, Tongfu granules group, Rhubarb group and Magnoliae cortex group by random digits table, normal rats as control group. Intraperitoneal injection of lipopolysaccharide (LPS, 6 mg/kg) was used to reproduce sepsis model. After establishment of model, rats in Tongfu granules group were given Tongfu granules 28 g×kg(-1)×d(-1) by gavage, and Rhubarb group and Magnoliae cortex group rats were given Rhubarb or Magnoliae cortex 5 g×kg(-1)×d(-1) by gavage, while the model group was given normal saline in same quantity, once a day. Blood samples of rats were collected at 24, 48, 72 hours for measuring tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) with enzyme linked immunosorbent assay (ELISA). The pathological changes in intestinal mucosa were observed, and the pathological scores was estimated at 72 hours. RESULTS: The levels of TNF-α and IL-8 were significantly higher in model group than those in control group at different time points. The serum levels of TNF-α and IL-8 were significantly lower in treatment groups than those in model group, and the level of TNF-α (ng/L) in Tongfu granules group was significantly lower than that in Rhubarb and Magnoliae cortex groups at different time points (24 hours: 44.64±1.48 vs. 47.18±1.83 and 46.96±2.23, 48 hours: 51.38±1.36 vs. 57.17±2.23 and 59.41±2.01, 72 hours: 55.54±2.58 vs. 64.34±1.02 and 65.96±3.45, all P<0.05), and IL-8 (ng/L) level at 72 hours was significantly lower than that in Magnoliae cortex group (65.53±4.52 vs. 69.14±2.82,P<0.05). The scores of the lesions were significantly higher in model group than that in control group (3.90±0.17 vs. 0). The scores of Rhubarb group, Magnoliae cortex group and Tongfu granules group were 3.15±0.28, 3.18±0.08, and 2.95±0.15, respectively, which were lower than those of the model group (all P<0.01), and the Tongfu granules group descended obviously than other groups. In control group, the intercellular tight junctions were normal, and the morphology of microvilli and mitochondria was also normal. In model group, the microvilli of intestinal mucosa of the small intestine were absent or disintegrated. The intercellular tight junctions were seen to be blurred in Rhubarb and Magnoliae cortex groups, and they were close to normal state in Tongfu granules group. Their integrity was better preserved compared with that of the model group. CONCLUSION: Injury of barrier function of the small intestine was found in septic rat. It was found that traditional Chinese medicine Tongfu granules, Rhubarb and Magnoliae cortex could protect the barrier function of the small intestine by decreasing the TNF-α and IL-8 levels in septic rats. Above-mentioned effects of Tongfu granules were better than Rhubarb and Magnoliae cortex.

Astragalus polysaccharides regulate T cell-mediated immunity via CD11c(high)CD45RB(low) DCs in vitro.

ETHNOPHARMACOLOGICAL RELEVANCE: Astragalus polysaccharides (APS) isolated from one of the Chinese herbs, Astragalus mongholicus, are known to have a variety of immunomodulatory activities. However, it is not yet clear whether APS can induce the activation and differentiation of dendritic cells (DCs) and subsequently activate T cells. AIM OF THE STUDY: This study was carried out to investigate the effect of APS on the differentiation of splenic DCs and its influence on T cell-mediated immunity through interleukin (IL)-12-producing CD11c(high)CD45RB(low) DCs in vitro. METHODOLOGY: MACS microbeads were used to isolate splenic DCs, CD11c(high)CD45RB(low) DCs, CD11c(low)CD45RB(high) DCs and CD4(+) T cells. Phenotypes were analyzed by flow cytometry, and cytokine levels were determined with cytometric bead array or ELISA. RESULT: The percentage of CD11c(high)CD45RB(low) DCs was significantly increased after treatment with APS compared to their counterparts. The cytokine secretion pattern of CD11c(high)CD45RB(low) DCs and CD11c(low)CD45RB(high) DCs was detected, and it was found that unlike the stable IL-10 secretion pattern of CD11c(low)CD45RB(high) DCs induced by APS, CD11c(high)CD45RB(low) DCs showed a dose-dependent relationship between IL-12 production and APS stimulation. In order to verify whether the activation of CD4(+) T was associated with the differentiation of splenic DCs mediated by APS to CD11c(high)CD45RB(low) DCs, anti-IL-12 receptor (IL-12R) as well as anti-IL-10R monoclonal antibody was used to inhibit the effect of CD11c(high)CD45RB(low) DCs and CD11c(low)CD45RB(high) DCs in CD4(+) T mixed lymphocyte reaction culture. After treatment with anti-IL-12R or anti-IL-10 monoclonal antibody in CD4(+) T+CD11c(high)CD45RB(low) DCs or CD11c(low)CD45RB(high) DCs mixed lymphocyte reaction, the inductions of these DCs on T cells were inhibited dramatically. CONCLUSION: APS might induce the differentiation of splenic DCs to CD11c(high)CD45RB(low) DCs followed by shifting of Th2 to Th1 with enhancement of T lymphocyte immune function in vitro. Also, the effect of APS on T-cell differentiation to Th1 was not associated with the inhibition of IL-10 production in CD11c(low)CD45RB(high) DCs.

[Effects of Tongfu Granule on intestinal dysfunction in patients with multiple organ dysfunction syndrome].

OBJECTIVE: To study the mutual influences between intra-abdominal hypertension (IAH) and intestinal dysfunction, and to observe the efficacy of Tongfu Granule (TFG) in treating IAH of patients with multiorgan dysfunction syndrome (MODS). METHODS: Adopting randomized, double-blinded, controlled method, 60 MODS patients hospitalized in authors' ICU wards from August 2007 to January 2008 were equally assigned to two groups: A and B, that is, the TFG group and the placebo group, all were treated by conventional treatment but different in the administration of TFG and placebo, respectively 1 bag, three times per day, for 7 days via oral intake or gastric infusion. On the 1st, 3rd and 7th day or before death, patients were monitored in terms of symptoms (abdominal distention, defecation, borborygmus, abdominal circumference, intra-abdominal pressure, and occult blood in stool), gastrointestinal function score, APACHE II score, and 28-day outcome. The blind outcome was shown up by specified tester by the end of the observation of 60 cases, A is the TFG group, B is the placebo group. RESULTS: As compared with the placebo group, intestinal peristalsis and borborygmus were increased, the intra-abdominal pressure and circumference were decreased in the TFG group significantly, which could reduce the possibility of gastrointestinal hemorrhage. Moreover, the gastrointestinal function score and APACHE II score were improved and the 28-day mortality was reduced to a certain degree in the TFG group. CONCLUSION: TFG could promote the recovering of gastrointestinal function and relieve the heightened intra-abdominal pressure in patients with MODS so as to improve patients' prognosis to some extents.

Inhibition of methicillin-resistant Staphylococcus aureus by the compound Qingre granules.

BACKGROUND: The infection rate of methicillin-resistant Staphylococcus aureus (MRSA) is increasing yearly due to the overprescription of antibiotics. Traditional Chinese compound medicines are less inclined to induce bacterial resistance in the clinical setting because of their multi-acting mechanisms. However, most current research is limited to bacteriostasis in vitro using single extracts or formulations. Plasma pharmacology is an in vitro method, using what is called "medicine serum". The aim of this study was to investigate whether the medicine serum of compound Qingre granules (QRKL) alone or in combination with antibiotics may treat MRSA infection in the clinic. METHODS: An animal model of MRSA resistance was created by injecting rabbits with the standard strain of MRSA ATCC43300. Infected rabbits were treated with QRKL by intragastric administration. Sixty minutes after the last intragastric administration, serum was obtained from the rabbits by heart puncture to obtain what is termed "medicine serum". The minimum inhibitory concentration (MIC) of QRKL, medicine serum alone, or serum combined with antibiotics was assessed by agar dilution. RESULTS: were compared with the growth of sixteen isolates of MRSA. RESULTS: The MIC of QRKL to the standard strain ATCC43300 was 10.00 mg/ml. The MIC(90) of vancomycin was 1.00 microg/ml, which, when combined with QRKL, dropped to 0.50 microg/ml. The MIC(90) of cefuroxime alone was 512.00 microg/ml. This level also decreased to 256.00 microg/ml when combined with QRKL. The addition of QRKL thus significantly reduced the MIC of both cefuroxime and vancomycin compared with antibiotics alone (P < 0.01). The MIC(90) of vancomycin with medicine serum decreased to 0.50 microg/ml, and the MIC of vancomycin with medicine serum also descended compared with using vancomycin alone (P < 0.01). CONCLUSIONS: The growth of MRSA can be inhibited by QRKL or medicine serum of QRKL in vitro. The addition of QRKL results in increased sensitivity of MRSA to vancomycin and this may provide a novel treatment for patients with MRSA infection.

Improving effect of pretreatment with yiqifumai on LPS-induced microcirculatory disturbance in rat mesentery.

Yiqifumai is a traditional Chinese medicine compound preparation used for the treatment of various vascular diseases in China. However, little is known regarding its role in microcirculation. The present study investigated the effect of pretreatment of yiqifumai on rat mesentery microcirculatory disturbance induced by LPS. Male Wistar rats were continuously infused with LPS (5 mg kg(-1) h(-1)). The parameters evaluated included diameter of and red blood cell velocity in venules, leukocyte adhesion to venular wall, dihydrorhodamine 123 (DHR) fluorescence in the venular walls, fluorescein isothiocyanate-albumin leakage, and mast cell degranulation, which were observed by an inverted intravital microscope. CD11b/CD18 expression on neutrophils was examined using flow cytometry. In some rats, yiqifumai (5, 30, or 80 mg kg(-1)) was given in one shot 10 min before LPS infusion. After infusion of LPS, the number of leukocytes adherent to venular wall, the intensity of DHR fluorescence in the venular walls, albumin leakage from venules, and degranulated mast cells were significantly increased, whereas the red blood cell velocity in venule was decreased. Pretreatment with high-dose yiqifumai (80 mg kg(-1)) significantly reduced the number of adherent leukocytes, the intensity of DHR fluorescence, degranulation of mast cell, albumin leakage, and the expression of CD11b/CD18, whereas the yiqifumai of medium dose (30 mg kg(-1)) only inhibited leukocyte adhesion to the venular wall. The results suggested that pretreatment with yiqifumai attenuated microcirculatory disturbance induced by LPS. This effect may be associated with yiqifumai's inhibition effect on reactive oxygen species production, leukocyte adhesion, and mast cell degranulation.

[Effect of qishen huoxue granule combined with fluconazole on survival rate of mice with systemic C. albaicans infection].

OBJECTIVE: To observe the effect of Qishen Huoxue Granule (QHG) combined with Fluconazole on the survival rate of mice with systemic C. albaicans (CA) infection. METHODS: Deep CA infection model mice, with normal and low immunity, were established separately by injecting standard strain of CA via caudal vein, and were divided into 4 groups at random, treated by gastrogavage with normal saline (Group A), QHG (Group B) Fluconazole (FCZ, Group C) and QHG + FCZ (Group D) respectively, and a blank group was set up with normal mice for control. The survival time and the total survival rate in 30 days in various groups were recorded. RESULTS: For mice with normal immunity, the survival rate in Group D and C was 79% and 78% respectively, showing no difference between them (P > 0.05). But for those with low immunity, it was 36% and 7% respectively, and the survival rate significantly higher in Group D than in Group C (P < 0.05). CONCLUSION: As compared with those treated with FCZ alone, QHG combined with FCZ can raise the survival rate of the immuno-suppressed mice with systemic CA infection.

[Effect of Qishen Huoxue Granule in treating severe sepsis].

OBJECTIVE: To study the anti-inflammatory effect and the therapeutic efficacy of Qishen Huoxue Granule (QHG) in treating severe sepsis. METHODS: One hundred and sixty-seven patients with severe sepsis were enrolled and randomly assigned to two groups, the 85 patients in the control group treated with conventional Western medicine and the 82 in the QHG group treated with conventional Western medicine plus QHG. Changes of tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), interleukin-10 (IL-10), procalcitonin (PCT), Marshall score, APACHE II score, ICU stay time and 28-day mortality were monitored and compared. RESULTS: Compared with the control group, IL-6 and TNF-alpha levels, the ICU stay time and 28-day mortality were significantly lower in the QHG group (all P < 0.05). During the QHG treatment, no severe adverse event was observed. CONCLUSION: The integrative treatment could reduce the blood levels of IL-6 and TNF-alpha, shorten the ICU stay time and decrease the 28-day mortality of patients with sepsis, showing a favor therapeutic prospect.