Efficacy of integrated Traditional Chinese Medicine and anti-retroviral therapy on immunological nonresponse in patients with human immunodeficiency virus/acquired immunodeficiency syndrome: a Meta-analysis of randomized controlled trial.

OBJECTIVE: To explore the efficacy of integrating Traditional Chinese Medicine (TCM) and anti-retroviral therapy (ART), a customized combination of different classes of medications which was also called cock-tail treatment, on the immunological nonresponse (INR) in people living with human immunodeficiency virus (HIV) (PLWH). METHODS: Relevant literature in databases such as China National Knowledge Infrastructure Database (CNKI), Wanfang Digital Journal, Chinese Medical Journal Database (CMJD), Chinese Biomedical Literature Database (CBM), PubMed, Cochrane, and Embase was reviewed by two independent investigators. Data were extracted from the studies according to the eligible criteria and analyzed using Review Manager 5.3. RESULTS: Nine randomized controlled trials (RCTs) with 1078 patients were analyzed. Our analyses showed that CD4 T cell counts in the treatment group improved compared with that in the control group [mean difference (MD) = 13.51, 95% confidence interval (CI): 7.42-19.60, P < 0.0001]. There was no significant difference between the treated and control groups after 3 months (MD = 25.31, 95% CI: ?2.78 to 53.41, P = 0.08). However, after 6 and 12 months, the response of the treatment group was superior to the control group (MD = 27.45, 95% CI: 7.09-47.81, P = 0.008 and MD = 27.34, 95% CI: 6.31-48.37, P = 0.01, respectively). The clinical efficacy of the treatment group was also higher than that of the control group (RR = 1.75, 95% CI: 1.16-2.65, P = 0.007). However, CD45RO and CD45RA T cell counts did not differ significantly between the two groups (MD = 12.37, 95% CI: ?6.71 to 31.45, P = 0.20 and MD = 5.67, 95% CI: ?3.00 to14.35, P = 0.20, respectively). CONCLUSION: The combined treatment strategy of integrated TCM and Western Medicine promotes long-term reconstitution of the immune system and thus, is beneficial and has potential use for improving INR in PLWH. However, large-scale RCTs are required to provide evidence for optimal intervention strategies.

[Auricular electroacupuncture improves depression possibly by promoting hippocampal Raf/ERK/RSK/CREB signaling in chronic unpredictable mild stress induced depression rats].

OBJECTIVE: To observe the effect of auricular electroacupuncture (EA) on intracellular Raf/ extracellular signal-regulated kinase (ERK)/ ribosomal S6 kinase (RSK)/ cAMP response element-binding protein (CREB) signal pathway in the hippocampus of depression model rats, so as to explore its anti-depressive mechanism. METHODS: A total of 60 male SD rats were randomly divided into control, model, auricular EA, PD98059(ERK inhibitor), DMSO (Dimethylsulfoxide), PD98059+EA groups (n=10 in each group). The rats in the control group were fed with normal diet without any treatment. The depression model was induced by chronic unpredictable mild stress (CUMS) for consecutive 21 days. EA (20 Hz, 2 mA) was applied to bilateral auricular "Xin"(Heart) and "Shenmen" for 30 min, once daily for 28 days. Rats of the PD98059, DMSO and PD98059+EA groups received intracerebroventricular injection of PD98059(100 µmol/L), DMSO and PD98059 (dissolved by DMSO) solutions (5 µL/d), respectively, once daily for 28 days. Sucrose preference test (sucrose consumption) was conducted at the baseline, before and after the intervention. The expression of hippocampal Raf, phosphorylated (p)-Raf, ERK, p-ERK, RSK, CREB and p-CREB proteins were detected by Western blot after EA intervention. RESULTS: Following modeling, the sucrose consumption volume, and the expression levels of hippocampal Raf, p-Raf, ERK, p-ERK, RSK, CREB, p-CREB proteins were significantly lower in the model group than those in the control group (P<0.01). Following the treatment, the sucrose consumption and the expression levels of Raf, p-Raf, ERK, p-ERK, RSK, CREB, p-CREB in the auricular EA group and those of p-Raf, ERK and CREB in the PD98059+EA group were obviously increased in comparison with the model group (P<0.05, P<0.01), the expression level of p-ERK in the PD98059 group was obviously decreased in comparison with the model group (P<0.05), suggesting an improvement of depression after auricular EA. Compared with auricular EA group, the expression level of p-ERK, p-CREB and RSK in the PD98059+EA group were significantly decreased (P<0.05). CONCLUSION: EA of auricular "Xin" and "Shenmen" is able to improve depression in depression rats, which is probably related to its effect in promoting activities of hippocampal Raf/ERK/RSK/CREB signaling.

[Advances in studies on bear bile powder].

In this paper, a detailed analysis was made on relevant literatures about bear bile powder in terms of chemical component, pharmacological effect and clinical efficacy, indicating bear bile powder's significant pharmacological effects and clinical application in treating various diseases. Due to the complex composition, bear bile powder is relatively toxic. Therefore, efforts shall be made to study bear bile powder's pharmacological effects, clinical application, chemical composition and toxic side-effects, with the aim to provide a scientific basis for widespread reasonable clinical application of bear bile powder.

[Research of Chinese herbal compound on promoting HIV immune reconstitution].

This article reviews the research reports of Chinese herbal compound on AIDS immune reconstitution for nearly 20 years, found that Chinese herbal compound has exact clinical efficacy for AIDS immune reconstitution. Therefore, we should give full play to the unique advantages of Chinese herbal compound in improving immunity, thus improving symptoms and improve quality of life, to achieve optimal clinical treatment of AIDS.

[Research progress of Chinese medicine treatment of HAART-related toxic and side effect].

Highly active antiretroviral therapy (HAART) have made great progress in rapid inhibition of HIV, reduce the morbidity and mortality, etc; while it exists many limits, such as viruses rebound after discontinuation of drug, side effects, drug-resistant. With the emergence of these problems, researchers explored therapies by traditional Chinese medicine, so as to achieve target of lower antiviral drug side effect, raising antiviral treatment adherence. Through a large number of clinical tests, we achieved encouraging effects in treating HAART related side effects by Chinese medicine.

[Research development of HIV drug resistance].

Highly active antiretroviral combination therapy significantly reduced the mortality, but in the high-speed copying, high genetic variation and drug selection pressure under the effect of the increasingly serious problem of drug resistance greatly weakened the role of HAART inhibit viral replication and reduce antiviral treatment. This paper reports the latest trends in HIV drug-resistance in order to develop anti-HIV drugs in clinical programs, research and development of new guidance anti-HIV-1 strategy to bring guidance.