The Role and Mechanism of Paeoniae Radix Alba in Tumor Therapy.

Tumors have a huge impact on human life and are now the main cause of disease-related deaths. The main means of treatment are surgery and radiotherapy, but they are more damaging to the organism and have a poor postoperative prognosis. Therefore, we urgently need safe and effective drugs to treat tumors. In recent years, Chinese herbal medicines have been widely used in tumor therapy as complementary and alternative therapies. Medicinal and edible herbs are popular and have become a hot topic of research, which not only have excellent pharmacological effects and activities, but also have almost no side effects. Therefore, as a typical medicine and food homology, some components of Paeoniae Radix Alba (PRA, called Baishao in China) have been shown to have good efficacy and safety against cancer. Numerous studies have also shown that Paeoniae Radix Alba and its active ingredients treat cancer through various pathways and are also one of the important components of many antitumor herbal compound formulas. In this paper, we reviewed the literature on the intervention of Paeoniae Radix Alba in tumors and its mechanism of action in recent years and found that there is a large amount of literature on its effect on total glucosides of paeony (TGP) and paeoniflorin (PF), as well as an in-depth discussion of the mechanism of action of Paeoniae Radix Alba and its main constituents, with a view to promote the clinical development and application of Paeoniae Radix Alba in the field of antitumor management.

Potential application of Nardostachyos Radix et Rhizoma-Rhubarb for the treatment of diabetic kidney disease based on network pharmacology and cell culture experimental verification.

BACKGROUND: Diabetic kidney disease (DKD) is one of the serious complications of diabetes mellitus, and the existing treatments cannot meet the needs of today's patients. Traditional Chinese medicine has been validated for its efficacy in DKD after many years of clinical application. However, the specific mechanism by which it works is still unclear. Elucidating the molecular mechanism of the Nardostachyos Radix et Rhizoma-rhubarb drug pair (NRDP) for the treatment of DKD will provide a new way of thinking for the research and development of new drugs. AIM: To investigate the mechanism of the NRDP in DKD by network pharmacology combined with molecular docking, and then verify the initial findings by in vitro experiments. METHODS: The Traditional Chinese Medicine Systems Pharmacology (TCMSP) database was used to screen active ingredient targets of NRDP. Targets for DKD were obtained based on the Genecards, OMIM, and TTD databases. The VENNY 2.1 database was used to obtain DKD and NRDP intersection targets and their Venn diagram, and Cytoscape 3.9.0 was used to build a "drug-component-target-disease" network. The String database was used to construct protein interaction networks. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and Gene Ontology analysis were performed based on the DAVID database. After selecting the targets and the active ingredients, Autodock software was used to perform molecular docking. In experimental validation using renal tubular epithelial cells (TCMK-1), we used the Cell Counting Kit-8 assay to detect the effect of NRDP on cell viability, with glucose solution used to mimic a hyperglycemic environment. Flow cytometry was used to detect the cell cycle progression and apoptosis. Western blot was used to detect the protein expression of STAT3, p-STAT3, BAX, BCL-2, Caspase9, and Caspase3. RESULTS: A total of 10 active ingredients and 85 targets with 111 disease-related signaling pathways were obtained for NRDP. Enrichment analysis of KEGG pathways was performed to determine advanced glycation end products (AGEs)-receptor for AGEs (RAGE) signaling as the core pathway. Molecular docking showed good binding between each active ingredient and its core targets. In vitro experiments showed that NRDP inhibited the viability of TCMK-1 cells, blocked cell cycle progression in the G0/G1 phase, and reduced apoptosis in a concentration-dependent manner. Based on the results of Western blot analysis, NRDP differentially downregulated p-STAT3, BAX, Caspase3, and Caspase9 protein levels (P < 0.01 or P < 0.05). In addition, BAX/BCL-2 and p-STAT3/STAT3 ratios were reduced, while BCL-2 and STAT3 protein expression was upregulated (P < 0.01). CONCLUSION: NRDP may upregulate BCL-2 and STAT3 protein expression, and downregulate BAX, Caspase3, and Caspase9 protein expression, thus activating the AGE-RAGE signaling pathway, inhibiting the vitality of TCMK-1 cells, reducing their apoptosis. and arresting them in the G0/G1 phase to protect them from damage by high glucose.

Oil body extraction from high-fat and high-protein soybeans by laccase cross-linked beet pectin: physicochemical and oxidation properties.

BACKGROUND: Soybean oil bodies (SOB) are droplets of natural emulsified oil. Soybean oil emulsifies well but it is easily oxidized during storage. Beet pectin is a complex anionic polysaccharide, which can be adsorbed on the surface of liposomes to improve their resistance to flocculation. Laccase can covalently cross-link ferulic acid in beet pectin, and its structure is irreversible, which can improve the stability of polysaccharides. RESULTS: At pH 2.5, laccase cross-linked beet pectin high-oil soybean oil body (HOSOB) and high-protein soybean oil body (HPSOB) emulsions showed obvious aggregation and severe stratification, and the oxidation of the emulsions was also high. The flocculation of emulsions decreased with an increase in the pH. The effect of pH on the flocculation of emulsion was confirmed by confocal laser electron microscopy. The ζ potential, emulsification, and rheological shear force increased with increasing pH whereas the particle size and surface hydrophobicity decreased with increasing pH. CONCLUSION: This experiment indicates that the physicochemical stability of the two composite emulsions was strongly affected under acidic conditions but stable under neutral and weakly alkaline conditions. Under the same acid-base conditions, the degree of oxidation of HPSOB composite emulsion changes substantially. The results of this study can provide a basis for the design of very stable emulsions to meet the demand for natural products. © 2023 Society of Chemical Industry.

Efficacy of Bushen Culuan decoction on ovarian follicle and follicular granulosa cells in mice with premature ovarian insufficiency induced by tripterygium wilfordii polyglycoside.

OBJECTIVE: To investigate the protective efficacy of Bushen Culuan decoction (BCD) on ovarian follicle and follicular granulosa cells in mice with premature ovarian insufficiency (POI) induced by tripterygium wilfordii polyglycoside, and to study the potential mechanism underlying the action. METHODS: Eighty female Balb/c mice were randomly divided into 4 groups (n = 20 each): blank group, model group, Bushen Culuan decoction intervening group (BCD group) and estradiol valerate intervening group (EV group). In the first 14 model establishing d, mice in model group, BCD group and EV group were under Tripterygium wilfordii polyglycoside (TWP) gavage to establish POI models. In the 14-day therapeutic stage, mice in BCD group were taken BCD 18.35 mg·kg-1d-1, mice in EV group were taken EV solution 0.15 mg·kg-1d-1, while mice in blank group and model group were taken normal saline. When the mice accomplished therapy, whole blood was collected for serum hormone including follicle stimulating hormone (FSH), luteal hormone (LH), estradiol (E2), antimullerian hormone (AMH) levels and vascular endothelial growth factor (VEGF), bone morphogenetic protein-7 (BMP-7) measurement. Ovarian tissues were harvested for morphologic observation, follicle counting, ovarian follicular graulosa cell apoptosis test and testing BMP-7 and caspase-3 expressions. RESULTS: The body weights of the mice kept growing stably in the process expect in TWP intervening stage. Compared with model group, BCD group had significantly higher ovarian index, serum E2, AMH, VEGF, BMP-7 levels and significantly lower FSH level (P < 0.05). Meanwhile the VEGF level in BCD group was higher than in EV group (P < 0.05). Compared with model group, the histopathological damage and GCs apoptosis were mitigated; developing follicle counting, BMP-7 expression were up-regulated, and caspase-3 expression was downregulated in BCD groups (P < 0.05). CONCLUSION: BCD treatment could attenuate pathological process in POI ovaries, suppress GC apoptosis, probably through promoting BMP-7 expression and following inhibiting caspase-3 activation.

Current trends in smart mesoporous silica-based nanovehicles for photoactivated cancer therapy.

Photoactivated therapeutic strategies (photothermal therapy and photodynamic therapy), due to the adjusted therapeutic area, time and light dosage, have prevailed for the fight against tumors. Currently, the monotherapy with limited treatment effect and undesired side effects is gradually replaced by multimodal and multifunctional nanosystems. Mesoporous silica nanoparticles (MSNs) with unique physicochemical advantages, such as huge specific surface area, controllable pore size and morphology, functionalized modification, satisfying biocompatibility and biodegradability, are considered as promising candidates for multimodal photoactivated cancer therapy. Excitingly, the innovative nanoplatforms based on the mesoporous silica nanoparticles provide more and more effective treatment strategies and display excellent antitumor potential. Given the rapid development of antitumor strategies based on MSNs, this review summarizes the current progress in MSNs-based photoactivated cancer therapy, mainly consists of (1) photothermal therapy-related theranostics; (2) photodynamic therapy-related theranostics; (3) multimodal synergistic therapy, such as chemo-photothermal-photodynamic therapy, phototherapy-immunotherapy and phototherapy-radio therapy. Based on the limited penetration of irradiation light in photoactivated therapy, the challenges faced by deep-seated tumor therapy are fully discussed, and future clinical translation of MSNs-based photoactivated cancer therapy are highlighted.

[Clinical efficacy of Bushen Huoxue Culuan Formula in treatment of infertility caused by diminished ovarian reserve due to kidney deficiency and blood stasis].

To study the clinical efficacy and safety of Bushen Huoxue Culuan Formula in treating infertility caused by diminished ovarian reserve(DOR) with kidney deficiency and blood stasis. A total of 100 DOR patients treated at Xiyuan Hospital, Acupuncture Hospital and Clinic of China Academy of Chinese Medical Sciences from 2017 to 2020 in line with the inclusion criteria were selected and randomly divided into experimental group and control group at the ratio of 1∶1. The experimental group was treated with Bushen Huoxue Culuan Formular, while the control group was treated with Climen and Clomiphene for 3 menstrual cycles. The ovulation rate, pregnancy rate, pregnancy success rate, serum hormone levels, and traditional Chinese medicine(TCM) symptom scores were observed in the 2 groups. The total effective rate was 92.00% in the experimental group and 72.00% in the control group, with a statistical difference between the two groups(P<0.01); the experimental group was superior to the control group in reducing FSH level, increasing AMH level, improving TCM symptoms, increasing pregnancy rate and pregnancy success rate, with a significant difference(P<0.05). There was no abnormal safety indicator and adverse reaction. Bushen Huoxue Culuan Formular is effective in treating infertility caused by DOR due to kidney deficiency and blood stasis, with a safety and reliability.

Polydopamine-carbon dots functionalized hollow carbon nanoplatform for fluorescence-imaging and photothermal-enhanced thermochemotherapy.

The low power photothermal therapy can reduce the tissue damage caused by laser irradiation, thus the near-infrared (NIR) absorbing vehicles with high photothermal conversion efficiency are demanded in the low power treatment. Herein, the NIR-absorbing agent polydopamine (PDA) and carbon dots (CDs) were gated on the openings of hollow mesoporous carbon (HMC) to construct a photothermal enhanced multi-functional system (HMC-SS-PDA@CDs). Interestingly, the fluorescence emission wavelength of HMC-SS-PDA@CDs was red-shifted by FRET effect between PDA and CDs, which solved the dilemma of fluorescence quenching of carbon-based materials and was more conducive to cell imaging. The modification of PDA@CDs not only acts as the gatekeepers to realize multi-responsive release of pH, GSH and NIR, but also endows the HMC vehicle with excellent photothermal generation capacity, the possibility for bio-imaging as well as the enhanced stability. Naturally, both the cytological level and the multicellular tumor sphere level demonstrate that the delivery system has good low-power synergistic therapeutic with combination index (CI) of 0.348 and imaging effects. Meanwhile, the combined treatment group showed the highest tumor inhibition rate of 92.6% at 0.75 W/cm2. Therefore, DOX/HMC-SS-PDA@CDs nano-platform had broad application prospects in low power therapy and convenient imaging of carbon-based materials.

Oridonin induces ferroptosis by inhibiting gamma-glutamyl cycle in TE1 cells.

Oridonin (Ori) is a natural tetracyclic diterpenoid active compound with excellent antitumor activity, but the mechanism of Ori on esophageal cancer cell, TE1, remains unclear. In this study, we examined the levels of intracellular iron, malondialdehyde, and reactive oxygen species after Ori treatment, while interfering with the effects of Ori with ferroptosis inhibitor, demonstrating that Ori's inhibition of TE1 cell proliferation is associated with ferroptosis. To understand the molecular mechanism of Ori, we performed UPLC-MS/MS metabolomics profiling on TE1 cells, which show that gamma-glutamyl amino acids (gamma-glutamylleucine, gamma-glutamylvaline), 5-oxoproline, glutamate, GSH, and GSSG are changed significantly after Ori treatment. Meanwhile, the activity of gamma-glutamyl transpeptidase 1 (GGT1) decreased. This revealed that Ori inhibited the gamma-glutamyl cycle in TE1 cells. Furthermore, we found that Ori can covalently bind to cysteine to form the conjugate oridonin-cysteine (Ori-Cys), resulting in the inhibition of glutathione synthesis, which is consistent with the decrease in the enzymatic activity of glutamate cysteine ligase catalytic subunit (GCLC). Eventually, the value of intracellular GSH/GSSG was reduced, and the enzymatic activity of the glutathione peroxidase 4 (GPX4) was significantly decreased. In conclusion, our experiments indicated that Ori can inhibit the gamma-glutamyl cycle, thereby inducing ferroptosis to exert anti-cancer activity.

Nanomedicine of Plant Origin for the Treatment of Metabolic Disorders.

Metabolic disorders are major clinical challenges of health that are progressing globally. A concurrence of metabolic disorders such as obesity, insulin resistance, atherogenic dyslipidemia, and systematic hypertension leads to metabolic syndrome. Over the past years, the metabolic syndrome leads to a five- and two-fold rise in diabetes mellitus type II and cardiovascular diseases. Natural products specifically plant extracts have insulin-sensitizing, anti-inflammatory, and antioxidant properties and are also considered as an alternative option due to few adverse effects. Nanotechnology is one of the promising strategies, which improves the effectiveness of treatment and limits side effects. This review mainly focuses on plant extract-based nanosystems in the management of the metabolic syndrome. Numerous nano-drug delivery systems, i.e., liposomes, hydrogel nanocomposites, nanoemulsions, micelles, solid lipid, and core-shell nanoparticles, have been designed using plant extracts. It has been found that most of the nano-formulations successfully reduced oxidative stress, insulin resistance, chronic inflammation, and lipid profile in in vitro and in vivo studies as plant extracts interfere with the pathways of metabolic syndrome. Thus, these novel plant-based nanosystems could act as a promising candidate for clinical applications.

Dingkun Pill replenishes diminished ovarian reserve through the PI3K/AKT/mTOR signaling pathway in TWP-induced mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Diminished ovarian reserve (DOR) can lead to poor fertility and shorten the reproductive lifespan of females. The Dingkun Pill (DKP), a traditional Chinese-patented medication, has been an integral part of traditional Chinese medicinal treatment for the management of gynecological diseases for centuries. Relevant clinical studies have shown that DKP is able to protect against DOR, however, its mechanism of action is not yet fully elucidated. STUDY GOALS: This study was conducted with the aim of exploring the impact of tripterygium wilfordii polyglycosidium (TWP) on the PI3K/AKT/mTOR pathway in the context of the pathophysiology of DOR and the mechanism of action of DKP. MATERIALS AND METHODS: Eighty female balb/c mice with regular estrous cycles were assigned to Blank, Model, DKP and hormone replacement therapy (HRT) groups in a random manner. With the exception of the Blank group, mice in the other groups were exposed to 40 mg/kg/d TWP suspension for 30 days to DOR induction. Following this, either DKP or hormones were orally administrated to determine their effect on disease progression. During the experiment, changes in body weight and the estrous cycles of the mice were observed. Post treatment, serum sample anti-mullerian hormone (AMH), estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were quantified using enzyme-linked immunosorbent assay (ELISA). The mice were then sacrificed in order to harvest their ovaries for hematoxylin and eosin (HE) staining. This process allowed for the assessment of ovarian morphology and follicular quantification. Apoptotic ovarian cells of the ovary were assessed using TUNEL technique, while Caspase-3 and Cytochrome C (Cyt C) expressions of the ovary were examined through immunohistochemistry (IHC). Western blotting analysis was used to quantify levels of Bax, Bcl-2, Caspase-3, Cyt C, mTOR, P-mTOR, AKT, P-AKT, P-PI3K and PI3K proteins, while mRNA levels of Bax, Bcl-2, PI3K, AKT and mTOR were measured in ovarian tissue using RT-PCR. RESULTS: The findings revealed that DKP was able to improve levels of serum hormones and promote the recovery of the estrous cycle. DKP augmented the total amount of primordial follicles while reducing the number of follicles that were atretic follicles. The apoptosis index of growing follicles and Bax, Cyt C and Caspase-3 expressions decreased, while the Bcl-2: Bax ratio increased. DKP suppressed levels of phosphorylation and the mRNA expressions of mTOR, AKT and PI3K. CONCLUSIONS: It was demonstrated that DKP was able to increase ovarian reserves through inhibition of the PI3K/AKT/mTOR signaling pathway, which lead to the suppression of primordial follicle activity and a reduction in levels of apoptosis of early growing follicles. This highlights its potentially beneficial role for the treatment of DOR.

[Establishment of premature ovarian insufficiency kidney deficiency and blood stasis pattern mouse model with Tripterygium wilfordii polyglycoside for Bushen Culuan Decoction therapy].

To establish a mouse model of premature ovarian insufficiency( POI) with kidney deficiency and blood stasis pattern by Tripterygium wilfordii polyglycoside( TWP) gavage,and to evaluate the ovarian function and fertility of the model,in order to find Bushen Culuan Decoction therapeutic mechanism. 60 SPF level Blab/c female mice with normal estrous cycle were randomly divided into 6 groups of 10 each: blank group 1( BG1),blank group 2( BG2),blank fertility group( BFG),model group( MG),model recovery group( MRG) and model fertility group( MFG). The mice in three model groups were treated by gastric gavage with TWP suspension 40 mg·kg-1 twice a day for 14 days,while the mice in three blank groups were treated by gastric gavage with same volume normal saline for 14 days. The mice in BG1 and MG were sacrificed and dissected on day 15. The mice in BG2,BFG,MRG and MFG were returned normal feeding from day 15 and were sacrificed and dissected on day 29. The mice in BFG and MFG were cohabited with male mice with a ratio of 2 ∶1( female ∶male) from day 15. The general situation and estrous cycles of all mice were observed every day. Serum sex hormone levels,ovarian index,uterine index,ovarian morphology,follicle count,ovarian VEGF and ES index were observed within the mice in BG1,BG2,MG and MRG. Pregnancy rate,litter size,survival number of newborn mice and male-female proportion were reported within the mice in BFG and MFG. In model establishing stage,the body weight of mice significantly decreased( P <0. 05) in MG and MFG. Compared with BG1,the mice in model group had irregular estrous cycle,decreased ovarian and uterine indexes,less primordial and developing follicles,more atretic follicles,increased VEGF expression and decreased ES expression( P <0. 05). Compared with blank group 2,the mice in model recovery group had irregular estrous cycle,increased FSH level,decreased ovarian indexes,less primordial and developing follicles,more atretic follicles,increased VEGF expression( P<0. 05). Compared with blank fertility group,the mice in model fertility group had smaller litter size and newborn mice survival count( P<0. 05). Gastric gavage with TWP 40 mg·kg-1 twice a day for 14 days is a feasible way to establish a POI kidney deficiency and blood stasis pattern mouse model. The mice ovarian functions didn't recovery on day 14 after stopping TWP intervening,which could suggest the effectiveness of subsequent therapeutic intervention.

[Infertility caused by salpingitis treated based on theory of kidney deficiency and blood stasis].

Infertility caused by salpingitis is one of the main causes of secondary infertility in women. In recent years,the incidence has been increasing year by year. Modern medicine believes that this disease is a complication due to incomplete or delayed treatment of acute and chronic salpingitis,with no satisfactory drug therapy at present. Clinical therapies mainly include surgical treatment,interventional treatment and assisted reproductive technology. After summarizing the experience of predecessors and the clinical practice of treating infertility for many years,the author considers that the disease location is the cell veins,and the nature is mostly mixed of deficiency and excess. Kidney deficiency and blood stasis are the main pathogenesis of infertility caused by salpingitis. Blood stasis is the pathological basis,while kidney deficiency is the fundamental pathogenesis. Long-term kidney deficiency will lead to blood stasis,and blood stasis will aggravate kidney deficiency. Both of them are cause and effect to each other. Infertility caused by salpingitis is difficult to cure. Based on the theory of kidney deficiency and blood stasis,the basic principles of clinical treatment are tonifying kidney and activating blood circulation,removing blood stasis and dredging collaterals. Oral administration with traditional Chinese medicine combined with external therapies,such as enema,external application,acupuncture and moxibustion,have been achieved a good efficacy in repairing fallopian tube function and improving pregnancy rate. Therefore,the treatment of infertility caused by salpingitis based on " kidney deficiency and blood stasis" is worthy of further discussion in both clinical and experimental aspects.

Synthesis, Characterization and In Vitro Evaluation of Dual pH/Redox Sensitive Marine Laminarin-Based Nanomedicine Carrier Biomaterial for Cancer Therapy.

In order to improve the anti-cancer therapy efficiency of hydrophobic drugs such as curcumin (Cur), a novel dual pH/redox sensitive marine laminarin-based nanomedicine carrier biomaterial with photo-dynamic therapy (PDT) was synthesized in this study. The new synthetic chemical structure, named as Hematin-Laminarin-Dithiodipropionic Acid-MGK (HLDM), was characterized by 1H-NMR and IR. The Cur-loaded micelles were then prepared via dialysis method. The HLDM could self-assemble into micelles in water with hydrodynamic diameter of 135±15 nm. The particle size, zeta potential and morphology of micelles were detected by transmission electron microscope (TEM). Interestingly, the in vitro release experiment showed that the release amount of Cur-loaded HLDM micelles could reach 80% in the pH and redox sensitive environment. Furthermore, cell study showed that the Cur-loaded HLDM micelles had stronger cellular uptake and cytotoxicity to MCF-7 cells than that of HLDM. The multifunctional marine laminarin based nanomedicine carrier biomaterial can be used for new drug delivery systems with dual pH/redox sensitivity for cancer therapy.

Effect of magnetic nanoparticles size on rheumatoid arthritis targeting and photothermal therapy.

Nanoparticles based multifunctional system exhibits great potential in diagnosis and therapy of rheumatoid arthritis (RA). The size of nanoparticles plays an essential role in biodistribution and cellular uptake, in turn affects the drug delivery efficiency and therapeutic effect. To investigate the optimal size for RA targeting, Fe3O4 nanoparticles with well-defined particle sizes (70-350 nm) and identical surface properties were developed as model nanoparticles. The synthesized Fe3O4 nanoparticles exhibited excellent biocompatibility and showed higher temperature response under irradiation of near infrared light. Size-dependent internalization was observed when incubated with inflammatory cells. Compared with large ones, small nanoparticles were more readily be phagocytized, leading to higher cytotoxicity in vitro. However, the in vivo experiment in CIA mice demonstrated a quite different result that nanoparticles with size of 220 nm exerted better accessibility to inflamed joint and resulted in higher temperature and better therapeutic effect under laser irradiation. This study not only offered a novel method for RA therapy but also a guideline for RA targeted drug carrier design.

In Vivo Evaluation of Reduction-Responsive Alendronate-Hyaluronan-Curcumin Polymer-Drug Conjugates for Targeted Therapy of Bone Metastatic Breast Cancer.

Many cancers, such as human breast cancer and lung cancer, easily metastasize to bones, leading to the formation of secondary tumors in advanced stages. On the basis of the CD44-targeted effect of oHA and the bone-targeted effect of ALN, we prepared a reduction-responsive, CD44 receptor-targeting and bone-targeting nanomicelle, called CUR-loaded ALN-oHA-S-S-CUR micelles. In this study, we aimed to evaluate the antitumor activity and bone-targeting ability of CUR-loaded ALN-oHA-S-S-CUR micelles. The in vivo experiment results showed that a larger number of micelles was gathered in the bone metastatic tumor tissue and reduced the bone destruction. The CUR-loaded ALN-oHA-S-S-CUR micelles markedly inhibited the tumor growth. So the CUR-loaded ALN-oHA-S-S-CUR micelles constitute a promising drug delivery system for bone tumor therapy.

[Clinical application evaluation and revision suggestions of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for pelvic inflammatory disease].

To evaluate the clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for pelvic inflammatory disease and provide reference for the revision of the Guideline. Questionnaire research was conducted from applicability and application evaluation. A total of 1 311 copies of valid questionnaires were obtained, including 717 questionnaires on applicability evaluation and 594 questionnaires on application evaluation. There were 83 items from 4 aspects in the applicability questionnaire. In statistical agreement rates of those items to reflect the application status of the Guideline, the rates of 8 items were all more than 95% except for rates of "content integrity", "comparison with the diagnosis and treatment scheme of his/her unit (individual)" and "economy of clinical application", 94.70%, 93.86% and 93.17% respectively. In statistical agreement rates of those items to reflect the quality of the Guideline, the rates of 3 items were all more than 97%, except the rate of "whether syndrome classification is reasonable" item was 95.26%. Among the items that reflect the local purchase difficulty and price evaluation of Chinese patent medicine recommended in the Guideline, most clinicians thought the prices were modest. There were 56 items from 6 aspects in the application evaluation questionnaire. In statistical agreement rates of those items to reflect the application rationality of the Guideline, the rates of 3 items were all more than 96%, except rate of "whether syndrome classification is reasonable" item was 91.58%. In statistical agreement rates of those items to reflect the clinical application effect of the recommended regimen in the Guideline, the traditional application of traditional Chinese medicine decoction had generally better application effect, whereas Chinese patent medicines were less effective. In statistical agreement rates of those items to reflect the overall evaluation of clinical application, the rates of "overall effect" and "overall safety" were all more than 96%, except the rates of "overall economy" item was 92.42%. It indicates that the overall effect of this Guideline is relatively well. It is suggested to improve the classification of syndrome differentiation and increase the species of Chinese medicine decoction and Chinese patent medicines, and to standardize the duration and course of medication. The next revised work should not only uptake the experiences of prominent TCM doctors and all kinds of research achievements, but also regularly update and strengthen the publicity of the Guideline.

[Effects of huqi extractum on the viability and apoptosis in mouse thymic lymphocytes against 60Co radiation].

OBJECTIVE: To explore the effects of Huqi Extractum (HQE) on the viability and apoptosis in mouse thymic lymphocytes against 60Co radiation. METHODS: Thymic lymphocytes were isolated from 4 -8 weeks healthy male Kunming mice and primarily cultured. Then they were divided into the control group, the irradiation group, the low dose HQE group, the medium dose HQE group, and the high dose HQE group. Equal volume of serum free RPMI-1640 culture solution was added in the control group and the irradiation group, while equal volume of HQE solution (at the daily dose of 25, 50, and 100 mg/mL) was respectively added in the low, medium, and high dose HQE groups. Except the control group, those in the rest groups were exposed radiation at a single dose of 5 Gy gamma-ray. Changes of the thymic lymphocytes' viability were measured by MTT colorimetric assay at 12, 24, 36, and 48 h after radiation. The early apoptosis rate was detected using flow cytometry (FCM) after 10-h radiation. The apoptosis was detected using agarose gel electrophoresis to observe the DNA injury after 24-h radiation. RESULTS: The viability level decreased more obviously in the irradiation group than in the control group at 24 -48 h after radiation (P < 0.01, P < 0.05). The average viability level was obviously higher in the low, medium, and high dose HQE groups than in the irradiation group (P < 0.05) in a dose dependent manner. The early apoptosis rate was obviously lower in the low, medium, and high dose HQE groups than in the irradiation group, with statistical difference shown in the high dose HQE group (P < 0.01). Typical DNA ladder fragments were found in the electrophoresis in all groups except the control group. But the DNA injury was comparatively milder in the low, medium, and high dose HQE groups, with more obvious effects shown in the high dose HQE group. CONCLUSION: HQE showed protection for the viability of early thymic lymphocytes exposed to the 60CO radiation, and could lower the early apoptosis level.

[Protective effects of Chinese herbal medicine Huqi extractum on salivary glands against radiation in Wistar rats].

OBJECTIVE: To explore the protective effects of Huqi extractum, a compound Chinese herbal medicine, on salivary glands against radiation in Wistar rats. METHODS: One hundred Wistar rats were randomly divided into sham-exposure group, untreated group, and low-, medium- and high-dose Huqi groups. Local irradiation of 60Co gamma-rays with a single dose of 15 Gy was applied to the salivary glands of the Wistar rats except the sham-exposure group. After 3- and 40-day treatment, saliva was collected. Colorimetric method, iodine-amylase colorimetric method and enzyme-linked immunosorbent assay were used to detect concentrations of sodium (Na+), potassium (K+) and secretory immunoglobulin A (sIgA) and activity of salivary amylase. Pathological changes of salivary gland tissues were observed by hematoxylin-eosin straining. RESULTS: After 3-day administration, radiation-induced salivary gland injuries were obvious and prevalent in irradiated rats. Comparing with the sham-exposure group, saliva concentration of sIgA and body weight were reduced in other irradiated groups, except those in the high-dose Huqi group, while salivary amylase level was increased. At 3-day phase, pathologic changes of the salivary glands were featured as swelling acinus plasm and vacuolation. At 40-day phase, atrophy of gland cells was dominant. After 40-day administration, there were no significant differences between the high-dose Huqi group and sham-exposure group in sIgA and amylase levels and body weight, and according to the histological examination, no significant difference was revealed under the optical microscope. CONCLUSION: Chinese herbal medicine is helpful for the recovery of the salivary glands from the radiation injury, morphologically and functionally in rats.

Synergistic anti-candidal activity of tetrandrine on ketoconazole: an experimental study.

With the widespread use of azoles, drug resistant Candida albicans strains are increasing. The study examined the synergism of tetrandrine (TET) on ketoconazole (KCZ) candidacidal activity. The protocol M27-A2 of the Clinical and Laboratory Standards Institute (CLSI) was adopted and the minimum inhibitory concentrations (MICs) were determined for KCZ alone and in combination with a TET level that was noncytotoxic for C. albicans strains CA-1 through CA-17, with no CA-10. Colony counting techniques were used to construct time-kill curves. CA-15 was used to build the mouse candidal vaginitis model. After randomization, drugs were administered vaginally once daily from days 3-10 (both KCZ and TET were 26 mg/kg/day and 13 mg/kg/day, respectively, administered in different combinations). Mouse vaginal lavage fluid was obtained at days 2, 6, and 11 after inoculation for fungal load analysis, and vaginal tissue was obtained for pathological examination. MICs of KCZ alone and combined with 30 microg/mL TET for the C. albicans strains were 1-32 microg/mL and 0.0038-0.2500 microg/mL, respectively ( T = 24.624, p = 0.000). Time-kill curves showed that at 48 h the viable cell counts of strains treated with KCZ + TET were at least 2 log(10) CFU/mL lower compared to strains treated with corresponding doses of KCZ (p = 0.000). At day 6, the fungal load in the KCZ 26 mg/kg/day + TET 26 mg/kg/day mice was significantly lower than the KCZ 26 mg/kg/day mice (1.17 +/- 1.17 x 10(4) CFU/mL and 9.33 +/- 3.08 x 10(4) CFU/mL, respectively, p = 0.000). Mucosal and submucosal fungal clearances were complete and vaginal mucosal edema was slight with minimal inflammatory cell infiltration. We conclude that noncytotoxic doses of TET synergistically enhance KCZ candidacidal activity in vitro and in vivo.