Efficacy and Safety of Chinese Medicine Resuscitation Pack for Enhanced Recovery after Bronchoscopy: A Randomized, Single-Blind, Placebo-Controlled Clinical Trial.

OBJECTIVE: To evaluate the efficacy and safety of a hospital-made resuscitation pack, a Chinese medicinal herbal compound formula designed to enhance recovery in post-bronchoscopy patients. METHODS: In this randomized, single-blind, placebo-controlled clinical trial, eligible patients were randomly assigned 1:1 to either the treatment or control groups. The patients in the treatment group applied the resuscitation pack, which contained aromatic compounded Chinese herbs. The patients in the control group applied a hospital-made, single herb placebo pack. Packs were placed on the Tiantu (CV 22) acupuncture point for 4 h as soon as the bronchoscopy finished. Efficacy indicators, such as recovery time, patients' symptoms including nausea and dizziness, and adverse events (AEs) were observed and compared. The outcome indices were evaluated at baseline, 1 and 24 h after the bronchoscopy. Subgroup analysis was further performed by patients' age and depth of sedation. RESULTS: When applying generalized estimating equations (GEE) to evaluate the intensity of post-bronchoscopy nausea and vomiting, the intensity was lower in the treatment group (163 cases) compared with the control group (162 cases; 95% CI: 0.004, 0.099, P=0.03]. Also, significantly lower intensity of nausea was observed in the 60-70 years of age subgroup (95% CI: 0.029, 0.169, P=0.006) and deep sedation subgroup (95% CI: 0.002, 0.124; P=0.04). There was no significant difference in dizziness between two groups by GEE (95% CI: -0.134, 0.297; P=0.459). In addition, no serious AEs were observed in either group. CONCLUSIONS: Our study found that the resuscitation pack markedly improved patients' symptoms by reducing nausea and vomiting after bronchoscopy without AEs, compared with placebo in the perioperative period. (Trial registration No. ChiCTR2000038299).

Naru-3 inhibits inflammation, synovial hyperplasia, and neovascularization in collagen-induced arthritis in rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Naru-3 is a prescribed formulation based on the theory of Mongolian medicine for the treatment of rheumatoid arthritis (RA). Naru-3 consists of three medicinal agents: Aconitum kusnezoffii Reichb (caowu), Terminalia chebula Retz (hezi), and Piper longum L (biba). These medicinal agents are widely distributed in the Mongolian area of China and have been used to treat rheumatism for centuries. BACKGROUND: Mongolian medicine Naru-3 is commonly prescribed to treat RA, but its mechanism of action is unknown. METHODS: A rat collagen-induced arthritis (CIA) model was established to investigate the mechanism of Naru-3. Rats were treated with Naru-3, Etanercept (ETN), and sodium carboxymethylcellulose (CMC) for four weeks. After treatment was terminated, paw thickness, ankle diameter, and arthritis index (AI) were scored. Synovial hyperplasia was evaluated using hematoxylin and eosin (H&E) staining and two-dimensional ultrasonography. Synovitis and neovascularization were assayed using power Doppler imaging (PDI) and contrast-enhanced ultrasonography (CEUS). Levels of vascular endothelial growth factor (VEGF), interleukin (IL)-1, and CD31 in the serum or synovium were detected using ELISA and immunohistochemistry analyses. RESULTS: Naru-3 and ETN alleviated the symptoms of CIA as evidenced by diminished paw thickness, ankle diameter, and AI scores. Mechanistically, Naru-3 inhibited synovial hyperplasia, synovitis, and neovascularization by diminishing systemic and local inflammation, as indicated by the relative expression of CD31, VEGF and IL-1 in the serumor synovium. After four weeks of treatment, no significant neovascularization was observed in the Naru-3 group, but neovascularization and synovitis occurred in the ETN group, as demonstrated by H&E staining, PDI, and CEUS examination. CONCLUSION: Naru-3 inhibited inflammation, synovial hyperplasia, and neovascularization and alleviates RA in our CIA rat model. No symptom recurrence was observed four weeks after drug treatment.

An integrated network pharmacology and cell metabolomics approach to reveal the role of rhein, a novel PPARα agonist, against renal fibrosis by activating the PPARα-CPT1A axis.

BACKGROUND: Rhein, an anthraquinone compound, displays extensive antifibrotic effects; however, its potential mechanisms are not fully understood. In this study, we explored the underlying molecular mechanism of action of rhein. METHOD: An integrated network pharmacology and cell metabolomics approach was developed based on network pharmacology and bioinformatics method, and then successfully applied to speculate the potential targets of rhein and construct a rhein-target-metabolic enzyme-metabolite network. Thereafter, the antifibrotic mechanism of rhein was validated in TGF-ß- and oleic acid- induced HK-2 and NRK-52E cells in vitro as well as a unilateral ischemia-reperfusion injury Sprague-Dawley rat model. RESULTS: Based on the construction of the rhein-target-metabolic enzyme-metabolite network, we found that rhein played an antifibrotic role through the PPAR-α-CPT1A-l-palmitoyl-carnitine axis. In vitro experiments demonstrated that rhein effectively activated the expression of PPARα and its downstream proteins (CPT1A and ACOX1) to alleviate lipid accumulation and fibrosis development. In vivo experiments indicated that rhein attenuated renal fibrosis mainly by activating the fatty acid oxidation pathway and improving lipid metabolism. CONCLUSION: Taken together, our findings reveal that rhein is a novel agonist of PPARα, which contributes to its renoprotection through the regulation of the PPARα-CPT1A axis. Moreover, our study provides a novel insight into an integrated network pharmacology-metabolomics strategy for uncovering the pharmacological mechanisms of drugs from the system perspective.

[Research progress on Pheretima and earthworms with related origin].

Through literature analysis of Pheretima and its origin-related earthworm,this study summarized the progress on Pheretima in textual criticism of origin,origin identification,effective components,detection of harmful components,and pharmacological effects,which can lay a basis for further research on Pheretima. Through literature research,the authors found that Pheretima was first recorded in Secret Formulary for Traumatology and Fracture Taught by Immortal written by LIN Daoren in Tang Dynasty rather than the Taiping Holy Prescriptions for Universal Relief in Song Dynasty. The latest techniques for origin identification include microscopic trait identification,DNA barcoding,and HPLC. The main effective components of Pheretima are proteins,polypeptides,enzymes,nucleotides,amino acids,and trace elements. According to recent studies,Pheretima has anti-pulmonary and anti-renal interstitial fibrosis,respiratory syncytial virus-inhibiting,human hypertrophic scar fibroblast proliferation-suppressing,and mouse embryonic fibroblast proliferation-promoting effects. Moreover,Pheretima can prevent colitis-induced colon cancer by inhibiting the activation of COX-2/PGE2/ß-catenin signaling pathway. METHODS:: for detecting the harmful components and their residues( organic pollutant polychlorinated biphenyl,heavy metals) and bacteria in Pheretima,have been established. Pheretima,mainly derived from wild earthworms,has remarkable clinical efficacy. However,the wild resource is in short supply and artificial culture is expected to be a promising solution.

Development and Evaluation of a Web-Based Resource for Suicidal Thoughts: NowMattersNow.org.

BACKGROUND: Nearly half of people who die by suicide see a health care provider in the month before their death. With the release of new care guidelines, detection of suicidal patients will likely increase. Providers need access to suicide-specific resources that can be used as part of immediate, brief interventions with a suicidal patient. Web-based suicide prevention resources have the potential to address this need. OBJECTIVE: This study aimed to describe the development of the NowMattersNow.org website as a resource for individuals with suicidal thoughts and to evaluate the utility of the site via user experience surveys. METHODS: NowMattersNow.org is an online video-based free public resource that provides evidence-based teachings, examples, and resources for managing suicidal thoughts and intense emotions focused largely around skills from dialectical behavior therapy. Developed with assistance from mental health consumers, it is intended to address gaps in access to services for suicidal patients in health care systems. Visitors stay an average of a minute and a half on the website. From March 2015 to December 2017, a user experience survey measured self-reported changes on a 1 (not at all) to 5 (completely overwhelming) scale regarding intensity of suicidal thoughts and negative emotions while on the website. Longitudinal regression analyses using generalized estimating equations evaluated the magnitude and statistical significance of user-reported changes in suicidal ideation and negative emotion. In secondary analyses, user-reported changes specific to subgroups, including men aged 36 to 64 years, mental health care providers, and other health care providers were evaluated. RESULTS: During the period of analysis, there were 138,386 unique website visitors. We analyzed surveys (N=3670) collected during that time. Subsamples included men aged 36 to 64 years (n=512), mental health providers (n=460), and other health care providers (n=308). A total of 28% (1028/3670) of survey completers rated their suicidal thoughts as a 5 or "completely overwhelming" when they entered the website. We observed significant reductions in self-reported intensity of suicidal thoughts (-0.21, P<.001) and negative emotions (-0.32, P<.001), including decreases for users with the most severe suicidal thoughts (-6.4%, P<.001), most severe negative emotions (-10.9%, P<.001), and for middle-aged men (-0.13, P<001). Results remained significant after controlling for length of visit to website (before the survey) and technology type (mobile, desktop, and tablet). CONCLUSIONS: Survey respondents reported measurable reductions in intensity of suicidal thoughts and emotions, including those rating their suicidal thoughts as completely or almost completely overwhelming and among middle-aged men. Although results from this user-experience survey administered at one point in time to a convenience sample of users must be interpreted with caution, results provide preliminary support for the potential effectiveness of the NowMattersNow.org website as a tool for short-term management of suicidal thoughts and negative emotions.

[Effect of needle-implantation at "Neiguan" (PC 6) on the expression of myocardial TGF-beta3 and its mRNA in the Chinese miniswine with myocardial ischemia injury].

OBJECTIVE: To observe the effect of needle-implantation (NI) at "Neiguan" (PC 6) on the expression of myocardial transforming growth factor-beta 3 Protein(TGF-beta 3) and mRNA in Chinese miniswine with myocardial ischemia (MI) injury. METHODS: A total of 32 Chinese Guizhou miniswine were randomly and equally divided into Sham-operation group, model group, NI-PC 6 group and NI-Geshu (BL17, NI-BL17) group. MI injury model was established by occlusion of the descending anterior branch of the left coronary artery. Two acupuncture needles (veterinary use) were separately and subcutaneously implanted into "Neiguan" (PC 6) and "Geshu" (BL17) areas for 7 days. TGF-beta 3 protein and mRNA expressions were determined by Western blot and real-time PCR techniques, separately. RESULTS: In comparison with the sham-operation (sham) group, TGF-beta 3 protein and mRNA expressions in model group were upregulated significantly (P < 0.05). While compared with the model group, myocardial TGF-beta3 mRNA expression was upregulated considerably in NI-PC 6 group (P < 0.01), rather than in NI-BL17 group (P > 0.05), and myocardial TGF-beta 3 expression in both NI-PC 6 and NI-BL17 groups was upregulated obviously (P < 0.01). Comparison between NI-PC 6 and NI-BL17 groups showed that the expression levels of myocardial TGF-beta 3 protein and mRNA were significantly higher in NI-PC 6 group than in NI-BL17 group (P < 0.05). CONCLUSION: Needle-implantation of "Neiguan" (PC 6) can upregulate myocardial TGF-beta 3 protein and mRNA expression in MI Chinese miniswine, which may contribute to its effect in improving the ischemic myocardial injury by way of enhancing the angiopoiesis.

[A study on differences of curative effects of acupuncture and nCPAP for treatment of OSAHS].

OBJECTIVE: To compare curative effects of acupuncture and nasal continuous positive airway pressure (nCPAP) on obstructive sleep apnea-hypopnea syndrome(OSAHS), and to explore the characteristics and advantages of acupuncture in treatment of this disease. METHODS: Sixty-six cases of OSAHS were randomly divided into an acupuncture group (n = 44) treated by acupuncture at Lianquan (CV 23) and Tianrong (SI 17) etc., and a nCPAP group (n = 22) treated by nCPAP. Indexes of respiration, blood oxygen and sleep were monitored before, during and after treatment. RESULTS: Compared with those before treatment, no significant differences of these indexes were found in the acupuncture group during treatment (P > 0.05), but hypopnea index (HI), apnea-hypopnea index (AHI), the maximal apnea duration, the maximal hypopnea duration, sleep time spent when SaO2 was below 90% (SaO2 < 90%T) and the microarousal index improved significantly at the end of treatment (P < 0.05 or P < 0.01); while all the indexes improved significantly in the nCPAP group during treatment (P < 0. 01), but the therapeutic effect was not maintained at the end of treatment with no significant difference as compared with those before treatment. The therapeutic effect in the nCPAP group was better than that in the acupuncture group during the treatment (P < 0.05 or P < 0.01), but no significant difference of the therapeutic effect was found between the two groups at the end of treatment (P > 0.05). CONCLUSION: The therapeutic effect of nCPAP on OSAHS produces during treatment and the therapeutic effect of acupuncture produces after treatment, indicating they possibly have different mechanisms.

[Headspace solid-phase microextraction-gas chromatography-mass spectrometry for analysis of volatile components from pollen pini].

Headspace solid-phase microextraction HS-SPME) technique was employed to extract the volatile compounds from Pollen Pini. The volatile components were isolated and identified successfully by gas chromatography-mass spectrometry (GC-MS). The volatiles were collected using several SPME parameters (including extraction time and temperature). The best response was obtained using a PA fiber by when the extraction temperature was 70 degrees C, extraction time was 30 minutes and desorption time was 10 time. Analysis was performed by GC-MS. Seventy components were identified by HS-SPME. The main components were fatty compounds. The results showed that the HS-SPME technique could be used to extract the volatile components from HS-SPME-GC-MS.