Experts consensus statement on Xiyanping Injection in clinical practice(children) / 中国中药杂志

Xiyanping Injection is a commonly used medicine in clinical treatment,which is recommended by many pediatric disease guidelines/consensus. However,the instraction is relatively simple and lack of guidance for clinical application,which affects the efficacy and brings safety risks. Therefore,more detailed clinical guidance is urgently needed. This consensus is formulated by clinical experts of traditional Chinese medicine and Western medicine in pediatrics. This consensus follows Manual for the clinical experts consensus of Chinese patent medicine which published by China Association of Chinese Medicine. The study identified clinical problems using clinical investigation,searched the literature based on PICO clinical problems,using GRADE system to carry out evidences evaluation,classification and recommendation,and adopted the nominal grouping method to reach expert consensus. The consensus combines evidence-based evidence with expert experience,sufficient evidence of clinical problems would lead to " recommendations",and clinical problems with insufficient evidence will lead to " consensus suggestions". This expert consensus recommends the indications,intervention time for treatment,route of drug administration,dose conversion,the indications of being used alone,suitability and taboos of medicine combination,and introduces the safety and clinical application,to provide reference for clinical using.

Efficacy and safety of Choudongning capsule (CDN)in children with Tourette's syndrome of spleen deficiency and phlegm accumulation / 中国中药杂志

To evaluate the efficacy and safety of Choudongning (CDN)capsule in children with Tourette's syndrome of spleen deficiency and phlegm accumulation through a randomized double-blind three-arm controlled phase Ⅲ study in 588 patients from 8 hospitals. The included patients were randomly divided into test group, positive control group and placebo group at the ratio of 3∶1∶1. Patients in the test group orally took CDN capsules and simulated Tiapridal tablets; the patients in positive control group took Tiapridal tablets and simulated CDN capsules; whereas the patients in placebo group orally took the simulated agents of the above two drugs. The treatment course was 6 weeks for three groups. The global grading rates, YGTSS scores and its factor scores, the degree of social function damage, as well as traditional Chinese medicine syndrome efficacy were evaluated as the outcome measures on efficacy. The AEs/ADRs, vital signs and laboratory testing were observed as outcome measures on safety. The total effective rate of YGTSS was 75.92% in the test group, 72.65% in the positive control group, and 37.29% in the placebo group. Non inferiority test stands between the test group and the positive control group, and they were superior to placebo group in efficacy with statistical difference. Significant difference had also been found among the 3 groups in YGTSS tics score, motor tics score, vocal tics, degree of social function damage and traditional Chinese medicine syndrome efficacy. During the study, there were 5 (1.42%)ADRs in the test group, 10 (8.55%)in the positive control group and 3 (2.54%)in the placebo group. The incidence of ADRs in the test group was lower than that in the positive control group, with statistical difference. It is clear to say that CDN capsule can effectively treat the Tourette's syndrome of spleen deficiency and phlegm accumulation. Its efficacy is not inferior to the commonly used Tiapridal tablets, with even less adverse reactions, so it has clinical application value.

Xifeng zhidong tablet and the placebo control treatment of tic disorder children patients of internal disturbance of Gan-wind with phlegm syndrome: a clinical study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To assess the efficacy and safety of Xifeng Zhidong Tablet (XZT) in treating tic disorder children patients of internal disturbance of Gan-wind with phlegm syndrome (IDGWPS).</p><p><b>METHODS</b>A stratified randomized, double-blinded, parallel control of placebo, multi-center trial was conducted in 160 subjects from 5 hospitals in China. They were randomly assigned to 2 groups, the test group and the control group, 80 in each group. Those in the test group were treated with XZT, while those in the control group were treated with placebos. The therapeutic course was 4 weeks for all. The effectiveness indicators covered main indicators and secondary indicators. Yale global tic severity scale (YGTSS) was taken as the main indicators. The amelioration of social function impairment, efficacy, single index of Chinese medical syndromes, Chinese medical syndrome efficacy as well as disappearance rate of single Chinese medical symptoms were evaluated as secondary indicators. The safety indicators included clinical adverse events, vital signs, blood/urine/stool routines, renal and liver functions, and electrocardiogram (ECG).</p><p><b>RESULTS</b>As for main indicators, the score of YGTSS decreased from 22.10 +/- 6.38 to 11.34 +/- 6.58 in the test group, while it decreased from 22.65 +/- 6.70 to 16.82 +/- 6.53 in the control group, showing statistical difference when compared with the same group before treatment (P < 0.01). Besides, the decrement was more significant in the test group after treatment (P < 0.05). As for secondary indicators, the total effective rate was 83.54% in the test group and 34.18% in the controlled group, showing statistical difference between the two groups (P < 0.05). As for social function impairment, 20,38, 16, 3, 1 case(s) in the test group were ranked as normal, minimal, mild, moderate, obvious degree, while 1, 24, 45, 7, and 0 case(s) in the control group were ranked as normal, minimal, mild, moderate, obvious degree. Better effect was obtained in the test group (P < 0.05).As for Chinese medical syndrome efficacy, it was 87.34% in the test group and 64.56% in the control group (P < 0.05). As for single index of Chinese medical syndromes, the disappearance rate of motor tics, irritability, dreaminess, abnormal tongue proper,abnormal tongue fur, and abnormal tongue pulse condition was 78.67%, 34.72%, 62.26%, 34.62%, 58.97%, and 39.74%, respectively in the test group, while they were 34.67%, 13.11%, 21.82%, 15.58%, 25.97%, and 19.48%, respectively in the control group. Better results were shown in the test group (P < 0.05). Totally 5 adverse events occurred. The incidence of adverse events was 3.75% in the test group and 2.53% in the control group.</p><p><b>CONCLUSIONS</b>After 4 weeks of XZT treatment, the integral of YGTSS could be obviously reduced, the degree of social function impairment ameliorated, and Chinese medical syndromes improved. In addition, no adverse reaction occurred in this study.</p>

Experimental study on anti-influenza virus infection with yinqiao-decoction by orthogonal design / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate composition principle of Yinqiao-decoction through experiment of anti-influenza.</p><p><b>METHODS</b>The effects of different compositions of Yinqiao-decoction on the index of hemagglutinin titre of virus in the lung tissue of mice infected with virus from nose were investigated by orthogonal design.</p><p><b>RESULTS</b>According to the hemagglutinin titre of virus in the lung tissue of mice, the necessary effective drugs of Yinqiao-decoction are forsythia suspense, flos lonicerae, fructus arctii, schizonepeta tenuifolia, folium phyllostach lophatheri, glycyrrhiza uralensis, platycodon grandiflorum and mentha haplocalyx, and semen sojae preparatum isn't necessary. There is interaction between forsythia suspense and flos lonicerae, forsythia suspense and fructus arctii, forsythia suspense and schizonepeta tenuifolia, fructus arctii and mentha haplocalyx, schizonepeta tenuifolia and platycodon grandiflorum.</p><p><b>CONCLUSION</b>The optimal combination of Yinqiao-decoction is flos lonicerae, forsythia suspense, fructus arctii, folium phyllostach lophatheri, glycyrrhiza uralensis, mentha haplocalyx of the second level and schizonepeta tenuifolia, platycodon grandiflorum, semen sojae preparatum of the first level.</p>

Thinking and methods concerning applying data-mining technique in clinical efficacy evaluation of TCM treatment for child's pneumonia / 中国中西医结合杂志

TCM syndrome differentiation system (TCM-SDS) possesses a complex nonlinear characteristic, which determines the falt that the evaluation of TCM efficacy should not be simplified to a causal or linear relationship. Previous selected indexes and methods for evaluating curative effect of Child's pneumonia have their limitations. This paper mainly introduces several thoughts and methods formed in the exploratory researches, employing data mining technology in this field. We believe that efficacy evaluation research of Child's pneumonia on the basis of standardized study of TCM-SDS is a scientific work. Applying data mining method in processing enormous and multilayer information of TCM differentiation has strong advantages in screening evaluating indexes of Child's pneumonia. Meanwhile, some major concerning technical categorizations and implementing strategies for the research are also introduced.

Effect of L-arginine on human coagulant factor VIII gene expression / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of L-arginine on expression of human FVIII gene.</p><p><b>METHODS</b>Plasmid pcDNA6/V5-HisA-BDDhF VIII containing B domain deleted human coagulant factor VIII cDNA (BDDhF VIII cDNA) was constructed and transfected into human umbilical vein endothelial cells (HUVEC). After 72 h incubation with L-arginine (final concentration was 10 mmol/L) , the supernatant was collected for determining the antigen and clotting activity of human FVIII (FVIII: Ag and FVIII: C ) with ELISA and one stage clotting assay respectively. HUVECs were harvested for detecting human FVIII mRNA by Northern blot analysis. The five functional domains of BDDhFVIII cDNA including A1, A2, A3, C1 and C2 were amplified with PCR and inserted into pcDNA6/V5-HisA to construct the expression plasmids pcDNA6/V5-Hi-sA-BDDhFVIII-A1, pcDNA6/V5-HisA-BDDhFVIII-A2, pcDNA6/V5-HisA-BDDhFVIII-A3, pcDNA6/V5-HisA-BDDhFVIII-C1 and pcDNA6/V5-HisA-BDDhFVIII-C2, respectively. HUVEC were transfected with the five plasmids respectively and incubated with L-arginine (at the final concentration of 10 mmol/L) for 72 h. Nucleoli were then isolated and underwent run-on assay.</p><p><b>RESULTS</b>After 24 h incubation with L-arginine, FVIII: Ag and FVIII: C were increased markedly in the supernatant of HUVEC [FVIII: Ag was (146.08 +/- 4.78) ng/ ml, and FVIII: C (0.752 +/- 0.009) U/ml/10(6) cells x 24 h, while in control supernatant without L-arginine, FVIII: Ag was (34.66 +/- 3.98) ng/ml, and FVIII: C (0.171 +/- 0.006) U/ml/10(6) cell x 24 h, P < 0.01]. Northern blot analysis indicated that, after adding L-arginine, the transcription of human FVIII mRNA was intensified remarkably in HUVEC transfected with pcDNA6/V5-HisA-BDDhFVIII, but no any transcription in those transfected with pcDNA6/V5-HisA. Run-on assay demonstrated that with L-arginine induction, A1 and A2 domains transcription was increased obviously, while no change in A3, C1 and C2 domains transcription.</p><p><b>CONCLUSION</b>L-arginine increases expression of human FVIII gene in HUVEC through enhancing its transcription, particularly, domain A1 and A2 within FVIII gene.</p>

Dingchuantang decoction restores the imbalance of TH2/TH1 in mice infected by respiratory syncytial virus / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Dingchuantang is a traditional Chinese medicine decoction which has the Qing, Xuan and Jiang components which have the ability to dispel (Xuan), depress (Jiang) and heat clear or febrigugal (Qing). It has been used for asthma and respiratory syncytial virus (RSV) infection. However, the therapeutic mechanisms of the decoction have not been identified. To understand the mechanism of the anti-RSV property of Dingchuantang, this study investigated the effects of Dingchuantang and its three components on the levels of interleukin-4 (IL-4) and interferon-gamma (gamma-IFN) in mice infected by RSV.</p><p><b>METHODS</b>One hundred and twenty mice were randomly assigned into Normal, Infected, Dingchuantang-treated, Qing component-treated, Xuan component-treated and Jiang component-treated groups (n=20 each). The RSV infection model was prepared in the rats from the last 5 groups. The 4 treatment groups were administered with Dingchuantang, Qing component, Xuan component and Jiang component by gastric lavage respectively 2 hrs after RSV innoculation. The contents of RSV in the lungs were tested by reverse transcription polymerase chain reaction (RT-PCR). The levels of IL-4 and gamma-IFN in broncho-alveolar lavage fluid (BALF) were measured by enzyme linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>The contents of RSV of lungs in the Dingchuantang-treated group, and Qing and Xuan component-treated groups were significantly lower than those in the untreated Infected group. There was no significant difference between the Jiang component-treated and the Infected group. Dingchuantang treatment decreased the IL-4 level and increased the gamma-IFN level. The Xuan and Jiang component treatment decreased the IL-4 level but had no effect on the gamma-IFN level, while the Qing component treatment increased the gamma-IFN level but had no effect on the IL-4 level.</p><p><b>CONCLUSIONS</b>Dingchuantang can inhibit RSV reproduction and this effect works by Qing and Xuan components. Dingchuantang can also restore the imbalance TH2/TH1 by depressing IL-4 levels, worked by Xuan and Jiang components, and increasing gamma-IFN levels, worked by Qing component.</p>

Comparison and analysis on therapeutic effects of acupuncture plus massage therapy and drug on infantile diarrhea / 中国针灸

<p><b>OBJECTIVE</b>To compare therapeutic effects of acupuncture plus massage therapy and western medicine on infantile diarrhea.</p><p><b>METHODS</b>A total of 120 cases of infantile diarrhea were randomly divided into a treatment group of 80 cases and a control group of 40 cases. The treatment group were treated by acupuncture and massage therapy, and the control group by smecta.</p><p><b>RESULTS</b>The cured rate of 55.0% in the treatment group was better than 35.0% in the control group (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture plus massage therapy has obvious therapeutic effect on infantile diarrhea.</p>

Evaluation on clinical efficacy of treatment of children pneumonia by combined internal-external therapy of TCM / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of combined internal-external therapy of TCM on children pneumonia. Adopting multi-center, randomized, controlled, double blinded principle, children with pneumonia were divided into 2 groups. Besides the basic treatment of western medicine, to the 406 children in the treated group internal administering of Chinese recipe prescribed according to syndrome differentiation and external applying of Fuxiong plaster were given additionally, while to the 411 children in the control group simulative placeboes were given for instead. The clinical efficacy of treatment on disease and syndrome, improvement of TCM syndrome and physical signs of lung between the two groups were compared after treatment.</p><p><b>RESULTS</b>The cured-markedly effective rate of treatment on disease and syndrome was 97.3%, 95.1% in the treated group and 89.8%, 86.6% in the control group, respectively, the differences of the two indexes between the two groups were significant (P < 0.05). The improvements on physical signs of lung, symptoms as cough, dyspnea and sputum expectorating in the treated group were significantly better than those in the control group (P < 0.05).</p><p><b>CONCLUSION</b>It was showed that the combined internal-external TCM treatment, which could significantly enhance the clinical efficacy, is an effective therapy for children pneumonia.</p>

Clinical observation on acupuncture combined with medicine for treatment of oral ulcer in premenstrual period / 中国针灸

<p><b>OBJECTIVE</b>To find out an effective method for treatment of oral ulcer in the premenstrual period.</p><p><b>METHODS</b>Seventy-nine cases were randomly divided into a treatment group (n=48) and a control group (n=31). They were treated by acupuncture and moxibustion plus Chinese medicine and simple Chinese medicine, respectively. Their therapeutic effects were observed.</p><p><b>RESULTS</b>The effective rate was 91.7% in the treatment group and 64.5% in the control group with a significant difference between the two groups (P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture and moxibustion combined with Chinese medicine has a better therapeutic effect on oral ulcer in the premenstrual period.</p>

Effect of radix bupleuri extract on cardiomyocyte apoptosis related genes expression in mouse infected with coxsackie virus B3m / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the mechanism of Radix Bupleuri (RB) extract in regulating cardiomyocyte apoptosis. Methods The BALB/c mouse inoculated with the cardiomyocytophilic strain Coxsackie virus B3m (CVB3m) by peritoneal injection was adopted as viral myocarditis model. The experimental mice were divided into the normal control (A), the model (B) and the RB (C) groups. Mice in Group C were given 0.2 ml / 10 g of RB extract, 2 mg/ml in concentration by gastrogavage once daily, while equal volume of normal saline was given by gastrogavage to mice in Group A and B. All the mice were sacrificed on the 10th day after modeling. The cardiomyocyte apoptosis was detected by TDT/Dutp nick end labelling (TUNEL). The expression of Fas Bcl-2, and Caspase3 protein in myocardium was determined by immunohistochemistry and reverse-transcription polymerse chain reaction (RT-PCR).</p><p><b>RESULTS</b>The apoptotic cell was not found in Group A, but Fas, Bcl-2 and Caspase3 were expressed in different degree. In Group B, a lot of apoptotic cells could be seen, with expression of Fas, Bcl-2 and Caspase3 stronger than those in Group A (P < 0.01). Compared with Group B, the apoptotic cardiomyocyte in Group C was significantly reduced (P < 0.01), with the expression of Fas and Caspase3 significantly lowered but expression of Bcl-2 increased slightly.</p><p><b>CONCLUSION</b>RB extract could inhibit the cardiomyocyte apoptosis in animal with viral myocarditis, obviously down-regulate the expression of Fas and Caspase3, and slightly up-regulate Bcl-2 expression.</p>

Effect of Astragalus polysaccharides and berberine on carbohydrate metabolism and cell differentiation in 3T3-L1 adipocytes / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To compare the effects of Astragalus polysaccharides (AP) and berberine (BB) on the adipocyte's carbohydrate metabolism and cell differentiation, for assessing the possible mechanism of them in improving carbohydrate metabolism.</p><p><b>METHODS</b>Adipocytes were treated with AP or BE, the 3H-glucose up-take rate in them was investigated, those of differentiation phase were stained by oil red O to analyze the degree of cell differentiation by spectrophotography quantitatively. The adipocyte differentiation related expression of PPARgamma mRNA and C/EBPalpha mRNA were determined by RT-PCR.</p><p><b>RESULTS</b>The 3H-glucose up-take rate in the AP group and BE group were 109.3% and 182.7% of that in the blank control group respectively. AP obviously promoted the cell differentiation and up-regulated expression of PPARgamma mRNA, while BE suppressed the differentiation and expression of PPARgamma and C/EBPalpha mRNA distinctly, all showing significant difference as compared with that in the blank control (P<0.01).</p><p><b>CONCLUSION</b>AP could promote glucose up-take, cell differentiation and PPARgamma mRNA expression, BB also promote glucose up-take, but suppress the cell differentiation, and inhibit expressions of PPARgamma and C/EBPalpha mRNA in 3T3-L1 adipocytes.</p>