Effects of heat exposure and vitamin C intervention on oxidative stress and blood pressure changes in treadmill rats / 中华劳动卫生职业病杂志

Objective: To investigate the effect of oxidative stress caused by heat exposure on the blood pressure increase of treadmill rats and the intervention of antioxidants. Methods: In June 2021, Twenty-four healthy SD male rats were randomly divided into four groups: normal temperature feeding, normal temperature treadmill, high temperature treadmill and high temperature treadmill supplementation with vitamin C groups, 6 rats in each group. The rats run on the platform in normal temperature or heat exposure environment for 30 min in the morning and in the afternoon daily, 6 days per week. The daily vitamin C supplement dose of high temperature treadmill supplementation with vitamin C group was 10 mg/kg. BP recordings were done at the end of the week. The rat vascular lipofuscin (LF) was detected by ELISA, the rat serum nitric oxide (NO) was detected by nitrate reductase method, the serum malondialdehyde (MDA) was detected by thibabituric acid method, the serum glutathione peroxidase (GPx) and superoxide dismutase (SOD) were detected by chemiluminescence method, and the serum catalase (CAT) was detected by ammonium molybdate method. The total antioxidant capacity (T-AOC) of serum was measured by iron reduction/antioxidant capacity method, and the content of nuclear erythroid 2-related factor 2 (Nrf2) in vascular tissue was measured by Western blot. The intra-group mean was compared by repeated measurement analysis of variance, and the inter-group mean was compared by single-factor analysis of variance and post-event LSD-t test. Results: Compared with the previous time point, the systolic BP and diastolic BP of the high temperature treadmill group were significantly increased at 7, 14 and 21 d, and decreased at 28 d which were higher than the initial level (P<0.05), and the systolic BP and diastolic BP values at each experimental time point were significantly higher than those of normal temperature treadmill group (P<0.001). The changes of thickening of the artery wall, no smoothing of the endodermis and irregular arrangement of muscle cells in high temperature treadmill group were observed. Compared with the normal temperature treadmill group, the content of MDA in serum, and LF in vascular tissue were significantly increased, the activities of SOD, CAT, T-AOC, the content of NO in serum, and the expression of Nrf2 in vascular tissue were significantly decreased in high temperature treadmill group (P<0.05). Compared with the high temperature treadmill group, the systolic BP and diastolic BP values at 7, 14, 21 and 28 d, the content of serum MDA and LF in vascular tissue were significantly decreased, the activities of CAT and T-AOC, and the expression of Nrf2 in vascular tissue significantly increased (P<0.05), the histopathological changes of the artery wall improved in high temperature treadmill supplementation with vitamin C group. Conclusion: Heat exposure has effect on oxidative stress, which may be related to the increase of BP. Vitamin C as an anti-oxidative enhancer can prevent those negative effects, which could alleviate the pathological changes of vessel intima in heat-exposed rats. And the Nrf2 may be a regulated factor to vascular protection.

Review of the in vitro inhibitory effects of traditional Chinese medicine and its components on CYP450 enzymes in liver microsomes / 药学学报

Cytochrome P450s (CYP450) is a superfamily of phase I metabolic enzymes, which participates in more than 90% of drug oxidation. The induction or inhibition of CYP450s is the main mechanism of drug-drug interaction. In recent years, in vitro metabolism studies conducted through isolated organs, cells, or enzyme systems have developed rapidly, due to their precision and simplicity. Therefore, profiles of the in vitro metabolism studies of traditional Chinese medicines can infer the possible metabolic pathways of drugs, predict the potential drug interactions, and may enhance the rational use of drugs in clinic. This article reviews the in vitro inhibitory effects of traditional Chinese medicine, ingredients, and extracts on the activities of CYP450 enzymes in the liver microsomes, which can provide a reference for further researches on the interaction between Chinese medicine and chemical medicine.

Varieties and standards of Corydalis medicinal plants / 中国中药杂志

Through literature research and standard retrieval, Corydalis-derived medicinal materials, the origins, and related standards were summarized. Finally, 27 medicinal materials were screened out, involving 71 species(varieties). Among them, only 11 are recorded in Chinese Pharmacopoeia(2020), National Standard for Chinese Patent Drugs·Tibetan Medicine, Tibetan Medicine Standards, and other local standards, including Corydalis Bungeanae Herba and Corydalis Herba. The names and original plants of the medicinal materials are different in different standards, and the phenomena of "same medicinal material with different names" and "same name for different medicinal materials" are prominent. Most standards only include the traits, microscopic identification, and physico-chemical property identification, with unsound quality criteria. Thus, efforts should be made to strengthen the sorting of Corydalis medicinal plants, herbal textual research, and investigation of the resources and utilization. Moreover, via modern techniques, the chemical components and medicinal material basis of different original plants should be explored and sound quality standards should be established to improve the safety and quality of Corydalis-derived medicinal materials. Summarizing Corydalis medicinal plants, Corydalis-derived medicinal materials, and related standards, this study is expected to provide a reference for the standard formulation, quality evaluation, expansion of drug sources, and rational development and utilization of Corydalis resources.

Clinical observation of pediatric Tuina plus oral Chinese medication for pediatric anorexia due to spleen failing in transportation / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of pediatric Tuina (Chinese therapeutic massage) plus oral administration of Chinese medication for pediatric anorexia due to spleen failing in transportation. Methods: A total of 94 children with anorexia due to spleen failing in transportation were randomized into an observation group and a control group by the random number table method at a ratio of 1:1, with 47 cases in each group. The control group was treated with modified Bu Huan Jin Zheng Qi San, and the observation group was treated with additional Tuina manipulation of Yun Shui Ru Tu based on the treatment in the control group. After 4 weeks of treatment, the clinical efficacy of the two groups was observed, and the traditional Chinese medicine (TCM) symptom score, serum leptin, neuropeptide Y, and serum zinc and calcium levels were compared. Results: After 4 weeks of treatment, the total effective rate of the observation group was 87.2％, and that of the control group was 74.5％. The difference between the two groups was statistically significant (P<0.05). After treatment, the TCM symptom scores in both groups decreased significantly (P<0.05), and the scores in the observation group were lower than those in the control group (P<0.05). After treatment, the serum leptin level in both groups decreased, and the level in the observation group was lower than that in the control group (P<0.05). The serum neuropeptide Y, zinc, and calcium levels in both groups increased after treatment, and the levels in the observation group were higher than those in the control group (P<0.05). Conclusion: Tuina manipulation of Yun Shui Ru Tu plus oral administration of Chinese medication is significantly effective in treating pediatric anorexia due to spleen failing in transportation, which can improve the appetite of children and improve the symptoms of anorexia, and the curative effect is better than that of oral administration of Chinese medication alone.

Preliminary Investigation of Resources and Medicinal Use of Codonopsis canescens / 中国实验方剂学杂志

Objective:To study the resources and medicinal use of Tibetan medicine Codonopsis canescens，analyze its suitable habitat，and protect its wild resources，in order to provide an important reference basis for further rational development and utilization. Method:Combined investigation methods of literature textual research，visiting investigation and on-the-spot investigation were adopted. Result:In this paper，we investigated the resources and medicinal use of C. canescens in 27 cities and counties of Sichuan，Qinghai and Tibet. Compared with historical records of C. canescens，the results showed that there was no obvious change in the distribution range，and the distribution was uneven in different places. Ganzi Prefecture， Sichuan， boasts rich resources； in particular， Luhuo county has as high as 90-120 plants/100 m2， it is estimated that the reserves per unit area of root C. canescens in this area were 3 445.32 g·m-2，which totaled 1 279.18 ton（1 ton=1 000 kg）. In history，the root is the main medicinal part. However， in recent years，in order to protect resources，the aboveground part is frequently used. The clinical efficacy of Tibetan medicine is mainly to tonify Qi and activate blood circulation. It can be combined with other drugs to treat rheumatism，sores，furuncle，carbuncle and other diseases. However，the plants of Codonopsis are mixed with C. canescens in each Tibetan area，and the mixed varieties are determined according to the growing varieties of the same genus in this area. Conclusion:The reserves of wild resources of C. canescens are decreasing with the increase of clinical use and market demand of Tibetan medicine. There is serious mixture of Codonopsis plants in Tibetan areas. It is suggested paying attention to resource protection，carrying out artificial planting，establishing the standard for the medicinal use of Tibetan medicine，and promote rational and sustainable utilization of resources.

Clinical value of integrated traditional Chinese and Western medicine based on the concept of enhanced recovery after surgery in the perioperative period of total knee arthroplasty / 中国基层医药

Objective:To investigate the clinical value of integrated traditional Chinese and Western medicine based on the concept of enhanced recovery after surgery (ERAS) in the perioperative period of total knee arthroplasty.Methods:Sixty patients who underwent primary unilateral total knee arthroplasty in Tonglu Hospital of Traditional Chinese Medicine from July 2018 to June 2019 were included in this study. They were randomized as odd numbers to the control group ( n = 30) and even numbers to the observation group ( n = 30). The control group was treated with conventional rehabilitation treatment, while the observation group was subjected to integrated traditional Chinese and Western medicine based on the concept of ERAS in the perioperative period of total knee arthroplasty. The perioperative pain, related complications, hospitalization expenses and length of hospital stay were recorded in each group. The Visual Analogue Scale (VAS) was used to evaluate the degree of pain and range of motion of the knee joint. The Hospital for Special Surgery (HSS) knee score was also measured to evaluate the curative effects. Results:At 3 and 7 days, 2 and 6 weeks after surgery, knee range of motion score was (63.40 ± 2.80) points, (86.20 ± 4.40) points, (90.30 ± 6.48) points, (100.5 ± 3.39) points, respectively, and at 6 weeks after surgery, HSS knee score was (89.40 ± 5.18) points, in the observation group, which were significantly higher those in the control group [(48.50 ± 4.20) points, (55.40 ± 3.58) points, (77.50 ± 4.38) points, (87.60 ± 4.58) points, (70.50 ± 6.44) points, t = 0.029, 0.013, 0.032, 0.039, 0.042, all P < 0.05]. In the observation group, the VAS score in resting state at 6, 12, 24 and 48 hours after surgery were (3.62 ± 0.40) points, (2.41± 0.52) points, (2.05 ± 0.62) points, (1.93 ± 0.28) points respectively, and the VAS score in active state at 24 and 48 hours were (2.15 ± 0.21) points and (1.71 ± 0.39) points, respectively, which were significantly lower than those in the control group [(5.71 ± 0.63) points, (4.60 ± 0.31) points, (3.84 ± 0.22) points, (3.30 ± 0.21) points, (5.50 ± 0.49) points, (4.80 ± 0.21) points, t = 0.040, 0.035, 0.046, 0.042, 0.027, 0.024, all P < 0.05]. The proportions of patients experiencing postoperative urinary retention, mental disorder, or blood transfusion, length of hospital stay, and hospitalization expenses in the observation group were lower or shorter than those in the control group ( χ2 = 0.003, 0.005, 0.017, t = 0.040, 0.048, all P < 0.05). Conclusion:Integrated traditional Chinese and Western medicine based on the concept of ERAS can mitigate postoperative pain, reduce perioperative complications, and promote the recovery of knee joint function, and thereby deserves clinical application.

Herbal Textual Research on Local Varieties of Codonopsis Radix / 中国实验方剂学杂志

Codonopsis Radix， one of the bulk commodities， has been commonly used for tonification in clinical practice. Apart from the medicinal purpose， it can also be utilized as food. Among the multiple local varieties， the ones called "Luduiduoji" in Tibetan medicine cannot be neglected， which have frequently been adopted for diminishing inflammation and swelling， invigorating spleen and stomach， and tonifying Qi， etc. Considering its complex origins and frequent substitution by or confusion with other medicinal materials， this paper reviewed the Si Bu Yi Dian， Jingzhu Bencao， ministerial and local standards， modern literature on Tibetan medicine， and the results of field investigation in major Tibetan medicine hospitals and medicinal material markets of Sichuan， Qinghai and Tibet to figure out the name， original plants， medicinal parts， effects， and local varieties of Codonopsis Radix in Tibetan medicine. The results showed that the names of local varieties were diverse， many of which were transliterated into Tibetan， with "Luduiduoji" being most well-known. It was derived from 14 species in genus Codonopsis and one in Adenophora of family Campanulaceae， with Codonopsis foetens subsp. nervosa， C. thalictrifolia var. mollis， C. canescens， C. alpina， and C. pilosula being the main species. According to literature records， the roots， aerial parts， and whole plants could all be employed as medicine， but there were certain differences in their clinical applications. At present， in order to protect the medicinal resources， Tibetan medical workers mostly collect the aerial parts， which are applicable to patients with yellow water， rheumatism， Gamba disease， and leprosy. This literature review of local varieties for Codonopsis Radix and textual research on their original plants are of great significance for elevating the standard， accelerating the pharmacodynamic research， expanding the sources and promoting the rational use of Codonopsis Radix.

[Product improvement and secondary development of Pudilan Xiaoyan Oral Liquid based on clinical medication].

Pudilan Xiaoyan Oral Liquid is widely used in clinical applications, with safe and effective results. Its coverage rate in the national first, second and third grade hospitals is as high as 71%. In this study, we analyzed and summarized the research progress on the material basis, quality control, production process and clinical medication of Pudilan Xiaoyan Oral Liquid based on the clinical diseases(parotitis, tonsillitis, pharyngitis), and deeply explored the intrinsic quality improvement and secondary development of Pudilan product. Pharmacodynamic material basis of Pudilan Xiaoyan Oral Liquid was explored through the network pharmacology technology and quality control indicators of the production process were optimized by cell anti-inflammatory experiments. Through these techno-logies, it would be more specific, scientific and effective to carry out process optimization of each link and multidimensional quality control of the whole process. The dosage and oral compliance for special patients(children) were explored, providing a reference for clinical pediatric medication of Pudilan Xiaoyan Oral Liquid. Simultaneously, it is helpful to expand the application market by developing Pudilan daily chemical products, and promote the traditional Chinese medicine products in terms of curative effect and daily life.

[Investigation of active components and mechanism of Pudilan Xiaoyan Oral Liquid based on network pharmacology].

To investigate the active components/ingredients of Pudilan Xiaoyan Oral Liquid based on the network pharmacology technology, and analyze the network data of its potential targets and mechanisms. The active ingredient screening, protein interaction analysis and pathway annotation were used to further optimize its active components and potential targets, and clarify the pharmacodynamic substance basis and mechanism of Pudilan Xiaoyan Oral Liquid. Through this technique, we screened out 41 active ingredients in Pudilan Xiaoyan Oral Liquid, mainly including 16 alkaloid components, 13 organic acid components, 11 flavonoid components and 1 coumarin component such as chicoric acid, chlorogenic acid, oroxindin, rutin, corynoline, and esculetin. In addition, 6 targets for parotitis, 48 targets for tonsillitis, and 22 targets for pharyngitis were screened. A total of 22 disease signaling pathways are involved, including 4 pathways closely related to inflammation. The IL-17 signaling pathway had the highest D(degree) value and may be most closely related to inflammatory diseases. Through network data excavating, we initially explored the main active components/ingredients of Pudilan Xiaoyan Oral Liquid, clarified the pharmacodynamic basis of Pudilan Xiaoyan Oral Liquid treatment-related diseases and its key mechanism of action in this study, hoping to provide a theoretical basis for clinical research, and at the same time, lay the foundation for deep research and promotion of Pudilan Xiaoyan Oral Liquid product.

[Identification of quality markers for Pudilan Xiaoyan Oral Liquid].

On the basis of anti-inflammatory activity, combined with multiple indicators, the quality markers of Pudilan Xiaoyan Oral Liquid were screened and determined for quality control. Lipopolysaccharide(LPS) was used to induce normal human bronchial epithelial cell(NHBE) inflammation model. The anti-inflammatory effects of the main chemical components in Pudilan Xiaoyan Oral Liquid were examined one by one, and the pharmacodynamic basis for the overall anti-inflammatory efficacy of Pudilan Xiaoyan Oral Liquid was clarified to identify the quality markers of Pudilan Xiaoyan Oral Liquid and the contents of the quality markers were determined by high performance liquid chromatography(HPLC). The results showed that adenosine, epigoitrin, chlorogenic acid, caffeic acid, cichoric acid, corynoline, baicalin, wogonoside, wogonin and oroxylin A had a certain regulatory effect on inflammatory factor tumor necrosis factor(TNF-α), interleukin(IL-1ß) and IL-6 at specific concentrations in a dose-dependent manner. Considering the factors such as the IC_(50) value of each monomer component and the comprehensiveness of the quality control components, we proposed to use adenosine, cichoric acid, corynoline, baicalin and wogonin as quality markers of Pudilan Xiaoyan Oral Liquid. The contents of the five components were determined by HPLC, and the results showed that they were relatively stable in three batches of Pudilan Xiaoyan Oral Liquid. In this study, the quality control components selected by the anti-inflammatory activity test have a clear material basis, covering all four active pharmaceutical ingredients, which can fully reflect the quality of Pudilan Xiaoyan Oral Liquid, and effectively improve the quality control standard of Pudilan Xiaoyan Oral Liquid.

[Improvement of compliance of Pudilan Xiaoyan Oral Liquid based on comprehensive analysis of bad taste of traditional Chinese medicine oral liquid preparation].

From "good efficacy with a bad taste" to "good efficacy with no bitterness" and then to "good efficacy with a good taste" is the only way to develop oral liquid preparations of traditional Chinese medicine, and "good medicine is beneficial to disease" is the only way for the development of oral liquid preparations of traditional Chinese medicine. Based on the analysis of the causes, the sources of bitterness, the formation principles and their solutions of traditional Chinese medicine oral liquid preparations, we explored the causes of the bad taste and the material basis of bitterness of Pudilan Xiaoyan Oral Liquid, and applied the solutions in improving the taste of Pudilan products. The overall taste of Pudilan Xiaoyan Oral Liquid was improved by modifying the original product taste, enhancing the process and changing the dosage form, which improves the compliance of the patients who take the medicine, and better serve the clinical medication.

[Source control of Pudilan Xiaoyan Oral Liquid--research on quality of Taraxaci Herba based on ultra high performance liquid chromatography fingerprint].

Pudilan Xiaoyan Oral Liquid has been widely used in the clinical treatment of inflammatory diseases such as upper respiratory tract infections. Taraxaci Herba, as the monarch medicine in Pudilan Xiaoyan Oral Liquid, due to its multi-source, multi-origin characteristics, and the difference in the content of active ingredients in different medicinal parts, has become a potential factor for the unstable quality among different batches of Pudilan Xiaoyan Oral Liquid. In this paper, Thermo Scientific Vanquish ultra-high-performance liquid chromatography(UPLC) system was used, and the Chinese Medicine Chromatographic Fingerprint Similarity Evaluation System(2012 Edition) issued by National Pharmacopoeia Commission was used for processing and analysis. The main common peaks were identified and contents were determined by comparison with reference substances. Fingerprints of Taraxaci Herba medicinal materials from different origins were established. 13 common peaks were identified, and 29 batches of samples from five origins had similarities above 0.90. At the same time, an ultra-high performance liquid chromatography method was developed for the determination of monocaffeoyl tartaric acid, chlorogenic acid, caffeic acid, chicoic acid, and luteolin in Taraxaci Herba. The quantitative analysis conditions were verified by methodology, and the average sample recovery was 97.30%-101.8%. The results showed that the content of the same ingredient in Taraxaci Herba from different origins and different medicinal parts was obviously different, and the fluctua-tion range was also different for different ingredients. The establishment of UPLC fingerprints for Taraxaci Herba from different regions combined with multi-component content determination methods provides a reference for improving the quality control of Taraxaci Herba medicinal materials, and also provides a source guarantee for the quality improvement of Pudilan Xiaoyan Oral Liquid.

UPLC-Q-TOF-MS Analysis of Chemical Constituents of Paederiae Herba for Folk Use / 中国实验方剂学杂志

Objective:The chemical constituents of ethanol extracts from Paederia scandens，P. scandens var.tomentosa，P. stenophylla and P. foetida used in folk were identified. And the differences of chemical constituents among the four kinds of ethanol extracts were compared. Method:The chemical constituents of four species of Paederia were qualitatively and rapidly analyzed by UPLC-Q-TOF-MS. The data were analyzed manually and matched through databases to determine the differences among the chemical constituents of four species of Paederia. Result:Twenty-three compounds were identified from four species, including 12 iridoid glycosides，such as paederoside，paederosidic acid，asperuloside，asperulosidic acid，paederosidic acid methyl ester and monotropein.5 quinic acid derivatives, such as 1-O-caffeoylquinic acid，chlorogenic acid，cryptochlorogenic acid,and 5 flavonoid glycosides，such as quercetin-3-O-rutinoside-7-O-glucoside,quercetin-3-O-rutinoside-7-O-xyloside，rutin and simple compoundkinsenoside. Conclusion:Based on the UPLC-Q-TOF-MS analysis of the chemical components of four kinds of Paederia，the four peaks with the highest response intensity were paederoside，paederosidic acid，asperuloside and asperulosidic acid，all of which were iridoid glycosides.

Nutritional and Metabolic Support and the Treatment Strategy of Severe Corona Virus Disease 2019 (COVID-19) / 中华急诊医学杂志

The digestive tract is a target organ attacked by COVID-19. It is also the earliest affected organ other than the lung and must bear side effects from the anti-virus chemotherapy such as LPV/r. In this article, we aim to provide practical recommendations for a nutritional and metabolic management strategy for severe corona virus disease-19 (COVID-19) patients. These recommendations are based on the newest pathophysiological findings on the risk factors of malnutrition for COVID-19. We also systematically retrieve literatures on nutritional therapy for acute lung injuries from international and Chinese databases according to evidence-based principles. Our suggestions are: 1) Physicians should be mindful of gut injury when they focus on respiratory support, by monitoring and managing the nutritional status; 2) Periodical and dynamic nutritional risk evaluation is needed; 3) For severe patients, the feeding target of calorie and protein should be down-regulated; 4)The using of ω-3 fatty acids products should be in accordance with pharmacological indications; the forms and dosage should be determined individually.

A Meta-analysis of Qingre Jiedu and Liangxue Sanyu method in the treatment of sepsis / 中华危重病急救医学

Objective To systematically review the effect of Qingre Jiedu and Liangxue Sanyu method in patients with sepsis,and to discuss its effect in the treatment of sepsis.Methods The randomized controlled trials (RCTs) on the treatment of Qingre Jiedu and Liangxue Sanyu method for sepsis published on PubMed,Embase,Web of Science,CNKI and Wanfang database from the construction to December 31st,2017 were searched by electronical way.Conventional treatment measures for sepsis,such as fluid resuscitation,maintenance of hemodynamic stability,anti-infection,improvement of tissue perfusion,maintenance of organ function and nutritional support were used in the control group.While traditional Chinese medicine treatment based on Qingre Jiedu and Liangxue Sanyu method were applied in the experimental group besides the conventional treatment,including Chinese patent medicine or Chinese herbal medicine.The main outcome was 28-day mortality,and the second outcome was acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ),coagulation function,inflammatory mediators,procalcitonin (PCT),lactic acid (Lac),and the length of intensive care unit (ICU) stay.Two researchers independently searched literatures,collected data and evaluated risk bias.The statistical analysis was completed by RevMan 5.3 and STATA 13.0 software.The funnel plot and Egger test were used to evaluate the potential publication bias of the main outcomes.Results A total of 20 RCTs were enrolled in this Meta-analysis,including 1 347 patients,with 667 patients in the control group and 680 patients in the experimental group.Comprehensive risk bias assessment showed that the risk bias of 11 RCT items was unknown,and the risk bias of 9 RCT items was high.Meta-analysis results showed that compared with the control group,the 28-day mortality of the experimental group was significantly lowered [relative risk (RR) =0.54,95％ confidence interval (95％CI) =0.45-0.65,P ＜ 0.00001],the 7-day APACHE Ⅱ score was significantly lowered [mean difference (MD) =-3.86,95％CI =-4.82 to-2.90,P ＜ 0.00001],the 7-day prothrombin time (PT) and activated partial thromboplastin time (APTT) were significantly shortened (PT:MD =-1.72,95％CI =-2.29 to-1.14,P ＜ 0.00001;APTT:MD =-4.36,95％CI =-5.81 to-2.91,P ＜ 0.000 01),the 7-day D-dimer was slightly improved (MD =-0.13,95％CI =-0.37-0.11,P =0.29),the 10-day interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were significantly decreased (IL-6:MD =-40.33,95％CI =-59.55 to-21.11,P ＜ 0.000 1;TNF-α:MD =-7.26,95％CI =-11.31 to-3.21,P =0.000 4),the 7-day Lac was significantly declined (MD =-1.30,95％CI =-1.91 to-0.68,P ＜ 0.000 1),but no significance in PCT (MD =-1.57,95％CI =-3.25-0.11,P =0.07) or the length of ICU stay (MD =-4.02,95％CI =-8.60-0.56,P =0.09)was found.The results of publication bias assessment showed that 19 studies reported 28-day mortality were basically "funnel-shaped" distribution without potential publication bias (P =0.336).Conclusion The Meta-analysis showed that Qingre Jiedu and Liangxue Sanyu method may reduce the release of inflammatory mediators,improve the coagulation function,and reduce the 28-day mortality in patients with sepsis.

Research Progress of Astragali Radix and Salviae Miltiorrhizae Radix on Improving Renal Damage in Hypertension / 中国实验方剂学杂志

Hypertensive renal damage is one of the most serious complications of hypertension, and it is also the main cause of end-stage renal disease. Renal damage can further promote the rise of blood pressure and difficult to control, forming a vicious circle. Traditional Chinese medicine (TCM) considers that deficiency of the original and excess of the standard is its basic pathogenesis, and insufficient kidney-Qi and blood stasis are one of the most common syndromes of hypertensive kidney damage. Astragali Radix membranaceus is praised as the most important medicine for invigorating Qi, and Salviae Miltiorrhizae Radix is likened to "four things with the same function". Based on the theory of invigorating Qi and activating blood circulation, the effective ingredients of Astragali Radix membranaceus-Salviae Miltiorrhizae Radix are mainly astragaloside, Astragali Radix polysaccharide, mulberry isoflavone, salvianolic acid and tanshinone. Many studies have shown that in the process of hypertensive kidney damage, Astragali Radix membranaceu Its active ingredients, whether effective monomers, monomer compatibility or direct compatibility of drug pairs, can regulate blood pressure, reduce urinary protein, protect renal tubules, protect glomerular filtration barrier, improve renal hemodynamics and protect renal function by regulating multiple signal transduction pathways related to hypertensive renal damage. Lowering blood pressure and protecting renal function are two pronged functions. Based on the theory of Invigorating Qi and activating blood circulation, this paper reviews the research progress of Astragali Radix-Salviae Miltiorrhizae Radix in the treatment of hypertensive renal damage, with a view to providing scientific basis for the further study and clinical application of Radix astragali-Salviae Miltiorrhizae Radix in hypertensive renal damage.

Research on contents of anthraquinones,dianthrones and tannins in Rheum tanguticum on PCA and CA / 中国中药杂志

Anthraquinones,dianthrones and tannins are the main active ingredients of Rheum tanguticum. In this study the three components were determined by HPLC,and the results were analyzed by multiple comparisons,principal components analysis(PCA)and correspondence analysis(CA). The results showed that the contents of components in different growing areas and types(wild and cultivated) reached a significant level(P<0. 05). Baiyu county,Xiaojin county and Ruoergai county had obvious advantages in the accumulation of catechin hydrate,rhien and sensenoside A respectively. The principal component was different in two growing type and the wild environment was conducive to combined anthraquinones accumulation. For active components,normalized planting was better than retail cultivating. Therefore,the effect on the accumulation of chemical components in Rh. tangusticum,should be taken into full account in the selection of the cultural base of Rh. tanguticum. The standardized cultivating is superior to retail cultivating in terms of the accumulation of active ingredients,and standardized planting is inferior to the wild.

Effects of Prevention and Treatment by Integrated Traditional Chinese and Western Medicine on TCM Constitutions of Community Diabetic Patients / 中国中医药信息杂志

Objective To analyze the improved the effects of prevention and treatment by integrated tradition Chinese and Western medicine on TCM constitutions and relevant indexes of community diabetic patients; To provide a reference for the comprehensive prevention and treatment of community diabetes.Methods By using cluster sampling method, 700 patients with diabetes aged 45 to 65 in healthcare service center in Minhang District in Shanghai were chosen randomly and divided into intervention group and control group, with 350 cases in each group. The control group used information platform, and was treated with standardized management and treatment of diabetes. On the basis of the treatment of the control group, the intervention group was identified TCM constitutions once a month, developed personalized community diabetes prevention and treatment of TCM norms, and gave guidance and intervention for health preserving and disease prevention for a year. The TCM constitution improvement was observed. Diabetic symptoms grading scale and anxiety self-rating scale, depression self-rating scale were assessed, and the complications were observed.Results Before intervention: TCM constitution of yin-yang harmony (51.43％) > yin asthenia (18.29％) > qi asthenia (11.71％) > yang asthenia (9.71％) > damp-heat (1.57％). After intervention: TCM constitution of yin-yang harmony (63.71％) > yin asthenia (8.71％) > qi asthenia (6.57％), yang asthenia (6.29％) > damp-heat (1.71％). There was difference in constitutions of yin-yang harmony, yang asthenia, and damp-heat before and after and through intervention and group interaction (P<0.05). There was statistical significance in diabetes symptoms curative effect index between the two groups (P=0.021). There was statistical significance in ophthalmoscopy results before and after and through intervention and group interaction (P=0.002).Conclusion The prevention and treatment by intervention of integrated traditional Chinese and Western medicine can improve the TCM constitutions of diabetic patients in community and influence the symptoms of diabetes.

Early acupuncture for traumatic intracerebral hematoma: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect of early acupuncture intervention on brain edema in patients with traumatic intracerebral hematoma and explore its mechanism on the basis of conventional western medicine.</p><p><b>METHODS</b>With stratified block randomization, sixty-four patients with glasgow coma scale (GCS) of 6 to 12 were divided into an acupuncture combined with medicine group (a combination group) and a western medication group, 32 cases in each one. In the western medication group, dehydration to reduce intracranial pressure and nutritional nerves were given as the basic treatment. In the combination group, on the basis of the treatment as the western medication group, acupuncture was applied at Xuehai (SP 10), Taixi (KI 3), Fenglong (ST 40), Yinlingquan (SP 9), Zusanli (ST 36), etc. The treatment was given once every day, for 6 times as one course; there was an interval of 1 day between two courses; a total of 4 courses were required. GCS score and recovery time were recored before treatment and on the 7 th, 14 th and 28 th days. 90 days follow-up after treatment, the GOS was observed, and the mortality and effective survival rate were calculated. The Barthel index (BI) score was evaluated before treatment and on the 14th, 21st, 28th days and 90 days follow-up after treatment. Before treatment and 3rd, 7th, 14th, 21st, 28th days, cranial CT or MR scan was performed to calculate the brain edema index (BEI); Plasma interleukin-6 (6IL-6), neuropeptide Y (NPY) and nitric oxide (NO) were measured before treatment and on the 3rd, 7th and 14th days after treatment.</p><p><b>RESULTS</b>(1) The GCS scores increased gradually in the two groups during treatment, and there was significant difference between the 28th days and before treatment (both <0.05). There were no significant difference between the two groups about GCS score and average recovery time on the 28th days treatment (all >0.05). (2) The mortality rate of the combination group was 6.3% (2/32) on 90 days follow-up, 9.4% (3/32) in the western medication group (>0.05). The effective survival rate was 81.3% (26/32) in the combination group, which was higher than 59.4% (19/32) in the western medication group (<0.05). (3) The BI score was significantly higher than that before treatment on the 28th days and 90 days follow-up in the two groups (all <0.05), and the result in the combination group was superior to that in the western medication group (both <0.05). (4) The BEI decreased on the 14th, 21st and 28th days in the two groups (all <0.05), and on the 14th day, the BEI decreased more significantly in the combination group than that in the western medication group (<0.05). (5) The levels of IL-6, NPY and NO decreased on the 7th and 14th days in the two groups (all <0.05), and decreased more significantly in the combination group than that in the western medication group on the 7th day (<0.05).</p><p><b>CONCLUSION</b>On the basis of conventional western medicine, early acupuncture can reduce cerebral edema and improve the prognosis of patients, and acupuncture combined with medicine are superior to western medicine alone. Acupuncture mechanism may be related to reducing the expression of inflammatory response.</p>

Enhancement of oral bioavailability and immune response of Ginsenoside Rh2 by co-administration with piperine / 中国天然药物

Ginsenoside Rh2 (Rh2) is one of the major bioactive ginsenosides in Panax ginseng. However, the oral bioavailability of Rh2 is low, with P-glycoprotein (P-gp) and CYP3A4 being reported to be the main factors. The purpose of the present study was to determine the enhancing effect of piperine on the oral bioavailability as well as bioactivity of Rh2. The inhibitory effect of piperine on P-gp and CYP3A4 was determined using a Caco-2 monolayer model and a recombinant CYP3A4 metabolic system, respectively. The pharmacokinetics of oral Rh2 (10 mg·kg) administered alone or in combination with piperine (10 and 20 mg·kg) was performed in rats. The immune boosting effect of Rh2 was assessed in rats by measuring IL-12 level after treated by Rh2 alone or co-administered with piperine. The results indicated that piperine significantly increased the permeability of Rh2 and inhibited the metabolism of Rh2. The pharmacokinetic study results showed that the AUC of Rh2 was significantly increased in combination with piperine at high dose (20 mg·kg) when compared to the control group, with relative bioavailability of 196.8%. The increase of Rh2 exposure led to increased serum levels of IL-12. In conclusion, piperine may be used as a bioenhancer to improve pharmacological effect of Rh2 when given orally.