[Effectiveness of Xuebijing in treatment of multiple organ dysfunction syndrome: a Meta analysis].

OBJECTIVE: To systematical evaluate the effect of Xuebijing injection in the treatment of multiple organ dysfunction syndrome (MODS). METHODS: With the keywords including Xuebijing, multiple organ dysfunction syndrome, multiple organ dysfunction and multiple organ failure, PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), VIP and Wanfang Data from the database start until March 4th, 2018 were searched for relevant randomized controlled trials (RCTs) related to Xuebijing injection combined conventional treatment versus conventional treatment alone for MODS. The control group received conventional western medicine treatment, including etiological treatment, antibiotics, mechanical ventilation, nutritional support, and comprehensive treatment to maintain fluid, electrolyte, acid and alkali balance. The experimental group was given traditional western medicine combined with Xuebijing injection. The observation parameters included 7-day and 28-day mortality, acute physiology and chronic health evaluation II (APACHE II) and Marshall score, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), the number of platelets, activated partial thromboplastin time (APTT) and prothrombin time (PT). According to the inclusion and exclusion criteria, two evaluators independently screened the literature, extracted data and evaluated the methodological quality of the included studies. RevMan 5.3 software was used for Meta analysis. Funnel plot was used to analyze publication bias. RESULTS: A total of 35 RCTs and 2 131 patients were enrolled, including 1 076 in the experimental group and 1 055 in the control group. The results of Meta analysis showed that compared with control group, Xuebijing combined conventional treatment was in favor to decrease the mortality of patients with MODS [7-day mortality: odds ratio (OR) = 0.42, 99% confidence interval (99%CI) = 0.26-0.69, P < 0.000 01; 28-day mortality: OR = 0.31, 99%CI = 0.21-0.45, P < 0.000 01], also could obviously reduce critical condition degree of APACHE II score and the organ function of Marshall score [APACHE II: mean difference (MD) = 3.24, 99%CI = 2.00-4.49, P < 0.000 01; Marshall score: MD = 1.95, 99%CI = 0.50-3.40, P = 0.000 5]. Meanwhile, the results of conventional western medicine combined with Xuebijing in the removal of IL-6 and TNF-α, platelets increase and improvement of PT were better than those of conventional western medicine (IL-6: MD = 5.56, 99%CI = 1.44-9.68, P = 0.000 5; TNF-α: MD = 4.97, 99%CI = 3.44-6.50, P < 0.000 01; platelets: MD = -50.79, 99%CI = -74.84 to -26.74, P < 0.000 1; PT: MD = 4.55, 99%CI = 3.96-5.14, P < 0.000 01), however, there was no obvious advantage in improving APTT (MD = 0.96, 99%CI = -5.08-7.00, P = 0.68). The analysis of funnel map showed that the effect points of various studies were mainly centered on the amount of combined effect, and the "inverted funnel" type was generally symmetrical distribution. However, because the number of the included studies was less, the literature bias could not be completely eliminated. CONCLUSIONS: Xuebijing injection may through its strong cytokines clearance, platelet increase and blood coagulation improvement to protect the organ function in patients with MODS, so as to reduce the mortality and improve the prognosis.

The expression of ERK and JNK in patients with an endemic osteochondropathy, Kashin-Beck disease.

Kashin-Beck disease (KBD) is a chronic, endemic osteochondropathy. Its etiopathogenesis is still obscure until now. Epidemiological observation has shown that low selenium play a crucial role in the pathogenesis of KBD. Extracellular signal-regulated kinases (ERKs) and C-Jun N-terminal kinase (JNK), members of the mitogen-activated protein kinase (MAPK) superfamily, play an important role in cell proliferation and differentiation. Nuclear factor-ĸB (NF-ĸB), an important signaling mediator for inflammatory and immune responses, is involved in the regulation of osteoclastogenesis. In the present study, we investigated the expression of ERK and JNK signal molecular, as well as nuclear factor-ĸB in the pathogenesis of Kashin-Beck disease, evaluated the effect of selenium on ERK signal pathway. The expression levels of ERK and JNK signal pathway, as well as nuclear factor-ĸB were investigated for 218 patients and 209 controls by immunoblot analysis in whole blood. Evaluated the effect of selenium on ERK signal pathway by Na2SeO3 treatment. The protein levels of pRaf-1, pMek1/2 and pErk1/2 decreased significantly in KBD patients, p-JNK and NF-ĸB increased in KBD patients. Furthermore, Na2SeO3 treatment improved the reduction of proteins in ERK signal pathway. These findings indicated that ERK and JNK signaling pathways, as well as the expression level of NF-κB signaling molecular are important contributor to the pathogenesis of KBD. Selenium stimulates the phosphorylation of the ERK signaling pathway.

[Clinical research on treatment of migraine with pine needle moxibustion].

OBJECTIVE: To observe the clinical effect and mechanism of migraine treated with pine needle moxibustion. METHODS: Forty-three patients were randomly divided into 2 groups of pine needle moxibustion group (group A, 21 cases) and medicated thread moxibustion of Zhuang medicine group (group B, 22 cases). Same acu-points were selected as the main points for both groups, namely Fengchi (GB 20), Baihui (GV 20), Taiyang (EX-HN 5), Shuaigu (GB 8), Cuanzhu (BL 2), Sizhukong (TE 23), Yanglingquan (GB 34), Waiguan (TE 5) and Ashi points. Pine needle moxibustion was applied for the group A. Processed lighted pine needles were banded together with one even head to do moxibustion on acupoints or pain points. While, lighted medicated thread was adopted for the group B to do moxibustion. Therapeutic effects, the content of high-sensitivity C-reactive protein (hs-CRP), Mg2+ in the serum and the degree of pain of the two groups were compared. RESULTS: (1) In the group A, the complete remission rate was 47.6% (10/21) and the effective rate was 90.5% (19/21). In the group B, the complete remission rate was 13.6% (3/22) and the effective rate was 50.0% (11/22). The two rates in the group A were superior to those in the group B (both P < 0.01); (2) In the group A, the content of hs-CRP was decreased from (4.29 +/- 0.98) mg/L to (2.11 +/- 0.87) mg/L, and Mg2+ was increased from (0.67 +/- 0.28) mmol/L to (1.07 +/- 0.16) mmol/L. In the group B, the contents of the above mentioned indices were respectively decreased from (4.30 +/- 1.07) mg/L to (3.38 +/- 1.15) mg/L and increased from (0.68 +/- 0.21) mmol/L to (0.88 +/- 0.25) mmol/L. There were significant differences between the two groups after treatment (both P < 0.05). (3) The degree of pain in the group A after treatment was much lower than that in the group B (P < 0.05). CONCLUSION: The clinical effect of migraine treated with pine needle moxibustion is better than that with the medicated thread moxibustion of Zhuang medicine. And it has obvious regulation effect on the levels of hs-CRP and Mg2+ in the serum of patients.