Traditional Chinese medicine shenhuang granule in patients with severe/critical COVID-19: A randomized controlled multicenter trial.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is still a pandemic, with a high mortality rate in severe/critical cases. Therapies based on the Shenghuang Granule have proved helpful in viral infection and septic shock. HYPOTHESIS/PURPOSE: The objective of the current study was to compare the efficacy and safety of the traditional Chinese medicine, Shenhuang Granule, with standard care in hospitalized patients with severe/critical COVID-19. STUDY DESIGN AND METHODS: This was an open-label, multicenter, randomized, controlled clinical trial. At 4 medical centers, a total of 111 severe/critical patients were randomly assigned to receive Shenhuang Granule (SHG group) twice a day for 14 days, in addition to standard care, or to receive standard care alone (Control group). The maximal follow up time was 75 days. The clinical endpoint was clinical improvement and mortality. RESULTS: 54 patients were assigned to the control group and 57 to the SHG group. The overall mortality was 75.9% (41/54) in the control group, and 38.6% (22/57) in the SHG group (p < 0.01 vs. control). The post hoc analysis showed that in the severe category, the mortality of the control group vs. the SHG group was 58.8% (10/17) vs. 5.3% (1/19) (p < 0.01); while in the critical category, it was 83.8% (31/37) vs. 55.3% (21/38) (p < 0.05). In the severe category, the mortality of patients who eventually received an invasive ventilator in the control vs. the SHG group was 58.8% (10/17) vs. 0 (0/19) (p < 0.01). Administration of SHG was associated with increased lymphocytes and decreased adverse events. CONCLUSION: Shenhuang Granule is a promising integrative therapy for severe and critical COVID-19.

Quantitative trait locus analysis of neointimal formation in an intercross between C57BL/6 and C3H/HeJ apolipoprotein E-deficient mice.

BACKGROUND: Inbred mouse strains C57BL/6J (B6) and C3H/HeJ (C3H) exhibit marked differences in neointimal formation after arterial injury when deficient in apolipoprotein E (apoE(-/-)) and fed a Western diet. Quantitative trait locus (QTL) analysis was performed on an intercross between B6.apoE(-/-) and C3H.apoE(-/-) mice to determine genetic factors contributing to the phenotype. METHODS AND RESULTS: Female B6.apoE(-/-) mice were crossed with male C3H.apoE(-/-) mice to generate F(1)s, which were intercrossed to generate 204 male F(2) progeny. At 10 weeks of age, F(2)s underwent endothelium denudation injury to the left common carotid artery. Mice were fed a Western diet for 1 week before and 4 weeks after injury and analyzed for neointimal lesion size, plasma lipid and MCP-1 levels. One significant QTL, named Nih1 (61cM, LOD score: 5.02), on chromosome 12 and a suggestive locus on chromosome 13 (35cM, LOD: 2.67) were identified to influence lesion size. One significant QTL on distal chromosome 1 accounted for major variations in plasma non-HDL cholesterol and triglyceride levels. Four suggestive QTLs on chromosomes 1, 2, and 3 were detected for circulating MCP-1 levels. No correlations were observed between neointimal lesion size and plasma lipid levels or between lesion size and plasma MCP-1 levels. CONCLUSIONS: Neointimal formation is controlled by genetic factors independent of those affecting plasma lipid levels and circulating MCP-1 levels in the B6 and C3H mouse model.

[Effects of Shengqing Capsules on cholelithiasis-related genes in guinea pigs].

OBJECTIVE: To explore the molecular mechanisms of Shengqing Capsules in treating cholelithiasis. METHODS: Sixty female guinea pigs were randomized into 3 groups: group I (fed with normal diet), group II (fed with low-protein diet) and group III (fed with low-protein diet and Shengqing Capsules). After six-week feeding, the gallstone formation and the expressions of bilirubin UDP-glucuronosyltransferase (B-UGT) mRNA and cholesterol 7alpha-hydroxylase (CYP7A1) mRNA were observed. RESULTS: The proportions of stone-formed in groups I, II and III were 2/14, 9/12 and 4/14, respectively. There were significant differences among the three groups (P<0.05). The expressions of B-UGT and CYP7A1 mRNAs were higher in both group I and group III as compared with those in the group II (P<0.05). CONCLUSION: Shengqing Capsules can reduce the rate of stone-formation, which may be due to its interference of metabolism of bilirubin and cholesterol and up-regulation of the expressions of B-UGT and CYP7A1 mRNAs.

[Experimental study on effects of herbs for nourishing and smoothing the liver in reversing bile lithogenicity of guinea pig].

OBJECTIVE: To further probe the mechanisms of herbs for nourishing and smoothing the liver in reversing bile lithogenicity of guinea pig. METHODS: Sixty guinea pigs were divided randomly into control group (fed with normal diet, n=20), model group (fed with lithogenic diet, n=20) and treatment group (fed with lithogenic diet plus herbal medicine, n=20). After four-week feeding, the animals were sacrificed and sampled, the rates of gallstone formation in each group were estimated, and the total bile acid (TBA), total bilirubin (TBIL), conjugated bilirubin (CB), unconjugated bilirubin (UCB), and calcium ion in the bile were determined, and the different bilirubins were analyzed by HPLC. RESULTS: (1) The rate of gallstone formation was 5% in normal group, 81.25% in model group and 31.25% in treatment group (P<0.05). (2) The bile TBIL, CB, UCB and Ca(2+) were higher and the bile TBA was lower significantly in model group than that in the other two groups (P<0.05). (3) HPLC analysis revealed that MCB was higher and DCB was lower significantly in model group (P<0.01), and there were no significant differences of UCB and IPA among the three groups. (4) The percentages of MCB and UCB were much higher and the percentage of DCB was remarkably lower in model group (P<0.05). CONCLUSION: Herbs for nourishing and smoothing the liver can significantly reduce the rate of gallstone formation and has effect of reversing lithogenicity of bile in guinea pigs fed with lithogenic diet.