Liang-Ge Decoction Ameliorates Coagulation Dysfunction in Cecal Ligation and Puncture-Induced Sepsis Model Rats through Inhibiting PAD4-Dependent Neutrophil Extracellular Trap Formation.

Liang-Ge (LG) decoction could ameliorate coagulation dysfunction in septic model rats. However, the mechanism of LG in treating sepsis still needs to be clarified. Our current study established a septic rat model to evaluate the effect of LG on coagulation dysfunction in septic rats first. Second, we investigated the effect of LG on NET formation in septic rats. Finally, NETs and PAD4 inhibitors were further used to clarify if LG could improve the mechanism of sepsis coagulation dysfunction by inhibiting NET formation. Our findings indicated that treatment with LG improved the survival rate, reduced inflammatory factor levels, enhanced hepatic and renal function, and reduced pathological changes in rats with sepsis. LG could also alleviate coagulation dysfunction in septic model rats. Besides, LG treatment reduced NETs formation and decreased PAD4 expression in neutrophiles. In addition, LG treatment showed a similar result in comparison to the treatment with either NET inhibitors or PAD4 inhibitors alone. In conclusion, this study confirmed that LG has therapeutic effects on septic rats. Furthermore, the improvement of coagulation dysfunction in septic rats by LG was achieved through inhibiting PAD4-mediated NET formation.

Effect of Electroacupuncture Combined with Guizhi Gegen Decoction on Cervical Vertigo and Its Influence on TCD of Vertebrobasilar Artery, Blood Rheology Indexes, and Quality of Life.

Cervical vertigo is a common clinical disease. In this study, we investigated the clinical efficacy of adding the treatment protocol of Gui Zhi Ge Gen Tang and electroacupuncture to the Western medical treatment in cervical vertigo. The results showed that the total effective rate of the study group was higher than that of the control group (P < 0.05). After treatment, the vertigo, headache, neck and shoulder pain, daily life and work, and psychological and social adjustment scores were higher in the study group than in the control group (P < 0.05). LVA, RVA, and VB were higher in the study group than in the control group after treatment (P < 0.05). The whole blood viscosity high cut, whole blood viscosity low cut, and plasma viscosity levels were lower in the study group than in the control group after treatment (P < 0.05). After treatment, PF, RF, RE, BP, GH, VT, SF, MH, and HT were higher in the study group than those before treatment (P < 0.05). The incidence of adverse reactions was not statistically significant in the study group compared with the control group (P > 0.05). This means that electroacupuncture combined with Gui Zhi Ge Gen Tang can effectively increase the blood flow velocity of the vertebrobasilar artery in patients with cervical vertigo and improve their blood rheology and quality of life with definite efficacy and high safety.

[Expert consensus on diagnosis and treatment of septic shock with integrated traditional Chinese and Western medicine].

OBJECTIVE: Septic shock is a pathological stage during the progress of sepsis. The mortality rate is high, and timely, standardized and comprehensive treatment is of great significance in reducing the mortality rate. At present, there are many domestic and international guidelines for the diagnosis and treatment of sepsis and septic shock. On this basis, China Association of Integrative Medicine Emergency Medicine Committee organized experts to collect evidence-based medical evidence and expert experience in the diagnosis and treatment by integrated Chinese and Western medicine, and referred to the Expert consensus on diagnosis and treatment of sepsis with integrated traditional Chinese and Western medicine published by China Association of Integrative Medicine Emergency Medicine Committee in 2013, developed Expert consensus on diagnosis and treatment of septic shock with integrated traditional Chinese and Western medicine. The consensus provided a "China approach" for the resolution of this worldwide problem. In the "China approach", the staging of septic shock is "longitude", and the "four syndromes and four methods" treatment thought is "latitude". Under the framework of interlaced latitude and longitude, we recommend a series of effective integrated Chinese and Western medicine treatment. The method embodies the wisdom of China and has certain guiding significance for the clinical treatment of septic shock.

Cupping regulates local immunomodulation to activate neural-endocrine-immune worknet.

Research on cupping therapy is lacking at home and abroad. However, cupping and acupuncture therapy are both surface stimulation therapies. This paper suggests the mechanism of cupping therapy and proposes that the same mechanism underlies both cupping and acupuncture therapy. The microenvironment is changed when stimulating the surface of the skin, and physical signals transform into biological signals, which also interact with each other in the body. These signalling cascades activate the neuroendocrine-immune system, which produces the therapeutic effect.

A Randomized Controlled Trial of Puncturing and Bloodletting at Twelve Hand Jing Points to Treat Acute Carbon Monoxide Poisoning as Adjunct to First Aid Treatment: A Study Protocol.

Background. Acute carbon monoxide poisoning (ACOP) is a significant cause of morbidity and mortality in many countries. Twelve Hand Jing Points (THJP) have been believed to be effective to treat all kinds of emergency calls in traditional Chinese medicine (TCM) for more than 3000 years. This randomized controlled trial (RCT) is designed to evaluate the effectiveness of THJP in curing acute carbon monoxide poisoning in first aid treatment. This paper reports the protocol of the trial. Methods/Design. This RCT is a multicenter, randomized, controlled study undergoing in China. The compliant patients are divided into the bloodletting group and standard of care group. With first aid treatments given to both of the groups, the bloodletting group is bleeding at THJP upon being hospitalized. Primary outcomes and secondary outcomes will be measured and compared between these two groups. Before treatment, immediately after treatment, and 30 minutes, 1 hour, and 4 hours after treatment, patients' basic vital signs and state of consciousness were observed. Before treatment and 1 and 4 hours after treatment, carboxyhemoglobin concentration in venous blood samples was detected. Discussion. The objective of this study is to provide convincing evidence to clarify the efficacy and safety of THJP for early treatment of acute carbon monoxide poisoning.

[Study of traditional Chinese medicine syndrome on multiple organ dysfunction syndrome in the elderly].

OBJECTIVE: To statistically analyze the clinical data from patients with multiple organ dysfunction syndrome in the elderly (MODSE), and to investigate the distribution pattern of traditional Chinese medicine (TCM) syndromes. METHODS: TCM data of 200 patients with MODSE was collected on 1, 3 and 7 days after diagnosis. Using 134 symptoms as observation indexes, clustering analysis was used to analyze the TCM symptoms and syndromes of these patients. RESULTS: In accordance with Diagnostic efficacy of standard TCM Syndrome, Diagnostics of TCM, State Standard of the People's Republic of China: clinical diagnose and treat Terminology of TCM, expert group differentiate on the professional knowledge and clinical manifestation and 7 types of TCM syndrome were selected. Among all syndrome types, there were 134 (22.3%) cases of phlegm stagnation with the largest population, 113 cases (18.8%) of toxic heat flourishing, 97 cases (16.2%) of damp-heat accumulation, 85 cases (14.2%) of qi-deficiency, 67 cases (11.2%) of both yin and yang deficiency, 55 cases (9.2%) of fu being filled and substances could not pass through, and 48 cases (8.1%) of qi stagnation and blood stasis. CONCLUSIONS: This preliminary study found 7 primary types of TCM syndrome in patients with MODSE, including syndrome of phlegm stagnation, toxic heat flourishing, accumulation of damp-heat, qi-deficiency, both yin and yang deficiency, fu being filled and substances could not pass through and qi stagnation and blood stasis. The most common syndrome is phlegm stagnation and deficiency, phlegm, blood stasis, toxic are the main etiology and pathology of the disease.

[Effects of Xue-Bi-Jing combined with forsythia suspension on the liver gene expression levels of rats with sepsis model].

OBJECTIVE: To study the effects of "XUE BI JING plus LIANQIAO" injection on gene expression levels of rats with sepsis model. METHODS: One hundred and twenty rats were randomly divided into sham operation group, sepsis model group, Te-neng group and "XUE BI JING plus forsythia suspension" group. The sepsis model of rats was prepared by "CLP" method. Tai neng group was treated by peritoneal injection Imipenem/ Cilastatin (0.18 g/kg); "XUE BI JING plus LIANQIAO" group was treated by peritoneal injection Imipenem/ Cilastatin (0.18 g/kg) plus "xue-bi-jing" (10 ml/kg) and "liang ge san" (18 g/200 g) by intragastric administration 2 times a day; the sham operation group and model group were treated by peritoneal injection of normal saline (10 ml/kg). The survival rates at 48h and 72h were observed for all groups. The gene expression levels of livers in all groups were detected by BiostarR-40s chip. The NCBI database was used to inquest Gene function and class. RESULTS: The survival rates at 48h and 72h in "XUE BI JING+ forsythia suspension" group were 83.3% and 76.7% which were significantly higher than those (30.0% and 16.7%) in sepsis model group and those (60.0% and 33.3%) in Te-neng group (P < 0.01). Model group/control group have 305 differential expression genes with 159 up-regulation genes and 146 down-regulation genes. Tai-neng group/model group have 386 differential expression genes with 206 up-regulation genes and 180 down-regulation genes. "XUE BI JING plus forsythia suspension" group/model group have 342 differential expression genes with 102 up-regulation genes and 240 downregulation genes. The genes with up-regulation in model group/ control group and with down-regulation in"XUE BI JING plus forsythia suspension" group/model group were 24. The genes with down-regulation in the model group/ sham operation group and with up-regulation in "XUE BI JING plus forsythia suspension"group/model group were 16. CONCLUSION: "XUE BI JING plus forsythia suspension" can reduce the mortality of rats with sepsis, which could be due to the expression of relative regulation genes.

[A gene chip study of "Jun Du Yan Bingzhi" on liver in a sepsis model of rat].

OBJECTIVE: To study the effect of "Jun Du Yan Bingzhi" on genic change in liver of a sepsis rat model by gene chip technique, in order to study the mechanism of the action of the drug on the gene level. METHODS: Ninety rats were randomly divided into normal control group, model group and "Jun Du Yan Bingzhi" group, with 30 rats in each group. Sepsis was reproduced by cecal ligation and puncture (CLP) method. In "Jun Du Yan Bingzhi" group the rats were treated with intraperitoneal injection of imipenem/cilastatin (0.18 g/kg), Xuebijing injection (10 ml/kg) and gavage of "Liangge San" (15 ml/kg). In the control group and model group intraperitoneal physiological saline (10 ml/kg) was given; Survival time, and 48-hour and 72-hour survival rates of every group were observed, and changes in liver genes were examined with BiostarR-40 s chip. The ratio of Cy3/Cy5 > or =2.0 or < or =0.5 was used to screen differential genes, and NCBI database was used to identity the function of differential genes. RESULTS: The 48-hour and 72-hour survival rate of "Jun Du Yan Bingzhi" group was significantly higher than that of model group (83.3% vs. 30.0%, 76.7% vs. 17.7%, both P<0.01), 305 differential genes were found in model/control groups, with up-regulation in 159, down-regulation in 146, 500 differential genes were found in "Jun Du Yan Bingzhi" group/model group, with up-regulation in 292, down-regulation in 208, model group/control group up-regulation and "Jun Du Yan Bingzhi" group/model group down-regulation were 48, model group/control group down-regulation and "Jun Du Yan Bingzhi" group/model group up-regulation were 63. CONCLUSION: "Jun Du Yan Bingzhi" can degrade the 48-hour and 72-hour death rate of sepsis rat, through control immunization related, inflammation, signal transduction transcription regulation, cell cycle, apoptosis, substance metabolism, translation/processing/modify/degradation of protein, differentiation/proliferation/growth of cell related gene, promote multisystem function of sepsis rat to recover normal.