[Toxicity mechanism of Rhododendri Mollis Flos: based on serum metabolomics and network toxicology].

This study aims to explore the toxicity mechanism of Rhododendri Mollis Flos(RMF) based on serum metabolomics and network toxicology. The toxic effect of RMF on normal rats was evaluated according to the symptoms, serum biochemical indexes, and histopathology. Serum metabolomics was combined with multivariate statistical analysis to search endogenous differential metabolites and related metabolic pathways. The toxic components, targets, and signaling pathways of RMF were screened by network toxicology technique, and the component-target-metabolite-metabolic pathway network was established with the help of serum metabolomics. The result suggested the neurotoxicity, hepatotoxicity, and cardiotoxicity of RMF. A total of 31 differential metabolites and 10 main metabolic pathways were identified by serum metabolomics, and 11 toxic components, 332 related target genes and 141 main signaling pathways were screened out by network toxicology. Further analysis yielded 7 key toxic components: grayanotoxin Ⅲ,grayanotoxinⅠ, rhodojaponin Ⅱ, rhodojaponin Ⅴ, rhodojaponin Ⅵ, rhodojaponin Ⅶ, and kalmanol, which acted on the following 12 key targets: androgen receptor(AR), albumin(ALB), estrogen receptor ß(ESR2), sex-hormone binding globulin(SHBG), type 11 hydroxysteroid(17-beta) dehydrogenase(HSD17 B11), estrogen receptor α(ESR1), retinoic X receptor-gamma(RXRG), lactate dehydrogenase type C(LDHC), Aldo-keto reductase(AKR) 1 C family member 3(AKR1 C3), ATP binding cassette subfamily B member 1(ABCB1), UDP-glucuronosyltransferase 2 B7(UGT2 B7), and glutamate-ammonia ligase(GLUL). These targets interfered with the metabolism of gamma-aminobutyric acid, estriol, testosterone, retinoic acid, 2-oxobutyric acid, and affected 4 key metabolic pathways of alanine, aspartate and glutamate metabolism, cysteine and methionine metabolism, steroid hormone biosynthesis, and retinol metabolism. RMF exerts toxic effect on multiple systems through multiple components, targets, and pathways. Through the analysis of key toxic components, target genes, metabolites, and metabolic pathways, this study unveiled the mechanism of potential neurotoxicity, cardiotoxicity, and hepatotoxicity of RMF, which is expected to provide a clue for the basic research on toxic Chinese medicinals.

Xuesaitong injection treating acute myocardial infarction: A systematic review and meta-analysis.

BACKGROUND: Although the incidence of acute myocardial infarction (AMI) is decreasing, the mortality in AMI patients remains substantial. Traditional Chinese medicine has shown its role in the prevention and management of AMI. The purpose of this study is to evaluate the clinical efficacy of Xuesaitong injection (XST) for the treatment of AMI by a meta-analysis. METHODS: A literature search was performed in 5 medical databases up to June 1, 2020. Randomized controlled trials involving XST combined with conventional treatment versus conventional treatment were included. A meta-analysis of clinical efficacy, left ventricular function and other objective parameters was performed to evaluate the effects of XST on AMI. RESULTS: Five randomized controlled trials involving 539 participants were eventually included. Meta-analysis showed that the combination of XST and conventional treatment could achieve significantly better effect on improving clinical efficacy (risk ratio: 1.09 [1.01, 1.17]; P = .04), left ventricular ejection fraction (mean difference [MD]: 3.18 [1.69, 4.67]; P < .0001), hypersensitive C-reactive protein (MD: -2.58 [-5.04, -0.12]; P = .04), interleukin 6 (MD: -26.00 [-38.85, -13.16]; P < .0001), cardiac troponin T (MD: -15.85 [-18.09, -13.61]; P < .00001) and creatine kinase myocardial isoenzyme (MD: -73.06 [-79.74, -66.37]; P < .00001). CONCLUSION: XST combined with conventional treatment can achieve better efficacy on clinical performance and some of the AMI related parameters. However the interpretation of the results should be cautious, due to the relatively low quality of included trials. More rigorously designed, large-scaled, randomized controlled trials are warranted to support its clinical use in the future.

Traditional Chinese medicine for acute coronary syndrome: A meta-analysis of clinical manifestations and objective indicators.

BACKGROUND: Modern clinical trials and experimental researches of traditional Chinese medicine (TCM) have been conducted for decades and provided support for the prevention and treatment of acute coronary syndrome (ACS). However the level of evidence and the proper application of TCM were still barely satisfactory. METHODS: In this study, we divided ACS into 3 different stages, including unstable angina, acute myocardial infarction, and post myocardial infarction. Then we systematically reviewed and meta-analyzed the existing randomized controlled trials on both clinical manifestations and objective indicators, in these 3 aspects. RESULTS: The results indicate that TCM can both improve the clinical manifestations and ameliorate the objective parameters in different courses of ACS, including C-reactive protein in unstable angina, left ventricular ejection fraction in acute myocardial infarction and post myocardial infarction. And the incidence of short-term cardiovascular events are lower in TCM intervention group. Some of the improvements lead to potential long-term benefits. CONCLUSION: TCM treatment is beneficial to different courses of ACS. To acquire more solid and comprehensive evidence of TCM in treating ACS, more rigorously designed randomized controlled trials with longer follow-up duration are warranted.

Bibliometric Analysis of the Results of Cardio-Oncology Research.

OBJECTIVE: To analyze the development of cardio-oncology, summarize the research achievements, and provide proposals for its future research. METHODS: The web of science database was used to search for "cardio-oncology" and "oncocardiology" related articles from the beginning of the database (1970) to April 5, 2019. Excel 2016 and Cytoscape were used to analyze the trend of cardio-oncology research. RESULTS: A total of 356 articles were obtained. The number of articles has grown rapidly in recent years. Cardiac injury caused by tumor therapy was a research hotspot (n = 107). Researchers paid more attention to the prevention and treatment of cardiotoxicity (n = 54). Experimental researches were a small part of all studies (n = 72), mainly focusing on the study of cancer drugs' cardiac injury, test indicators of cardiotoxicity, and preventive drugs. The United States (n = 156.25), Italy (n = 48.5), and Canada (n = 23.5) published the most articles, making a great contribution to the development of cardio-oncology. CONCLUSIONS: Cardio-oncology has been developing rapidly and receiving a large amount of research efforts in recent years. Most articles on cardio-oncology were published by the authors from the United States (44%) and Italy (17%), while other countries need to pay more attention to cardio-oncology. As an independent discipline, cardio-oncology is certainly in need of significant progress, but it has formed a basic framework, which has obtained many leading theories and meaningful achievements in diagnostic criteria, diagnostic methods, prevention and treatment, mechanism research, and influencing factor. Cardiac injury of tumor drugs has always been a research hotspot in this discipline, and there is still a lot of research space. The research about detection methods of cardiotoxicity and preventive drugs is gradually increasing. Basic research lags behind, and many mechanisms are still unclear.

[Antipyretic effect of moxibustion at different temperatures and its relationship with the activity of temperature sensitive neurons in thermotaxic center].

OBJECTIVE: To discover the central mechanisms of antipyretic effect of moxibustion and its relationship with the acupoint sensor so as to provide the scientific evidence for "the treatment of heat syndrome with moxibustion". METHODS: Eighteen New Zealand Rabbits were randomly assigned into three groups, named group A (modeling with intravenous injection of Endotoxin), group B (moxibustion at 40 degrees C after Endotoxin injection) and group C (moxibustion at 48 degrees C after Endotoxin injection), 6 rabbits in each one. The experiment was undergoing in the condition of muscular relaxation and artificial respiration for the animals. The spotlight moxibustion at constant temperature was applied to "Zhiyang" (GV 9). The discharge of heat sensitive neurons (HSNs) at the preoptic region and anterior hypothalamus (POAH) was taken as the index. The impacts of the treatment on HSNs were observed in each group. RESULTS AND CONCLUSION: Moxibustion had significant antagonism to the pyrogen on its inhibition to the activity of HSNs in the thermotaxic center. As a result, the antipyretic effect was obtained. It is concluded that the effective result of moxibustion is achieved by stimulating polymodal receptors of acupoints.

[Studies on the chemical constituents of Toricellia angulata var. intermedia].

OBJECTIVE: To study the chemical constituents of Toricellia angulata var. intermedia. METHODS: The constituents were isolated and purified by repeated column chromatography and their structures were elucidated by spectroscopic analysis. RESULTS: Twelve compounds including beta-sitoterol (1), 7-hydroxy-3-ethylphthalide (2), 3beta-methoxy-stigmast-7-ene (3), stigmast-5-ene (4), trans-p-methylcinnamaldehyde (5), stigmate-7-en-3beta-ol (6), o. p-dimethoxybenzoicacid (7), beta-daucosterol (8), ursolicacid (9), stearic acid (10), docosanoic acid (11), palmitic acid (12) were isolated and identified from this plant. CONCLUSION: All the compounds are isolated from the plant for the first time, compounds 3 -7, 10 -12 are isolated from this genus for the first time.

[Effects of strong and weak electroacupuncture on endotoxin-induced changes of electrical activities of heat-sensitive neurons in preoptic area and anterior hypothalamus in rabbits].

OBJECTIVE: To observe the effects of weak and strong electroacupuncture (EA) on endotoxin (ET) thermolysis-induced changes of discharges of neurons in the preoptic region and anterior hypothalamus (PO-AH) so as to explore its underlying mechanism in antipyretic and thermolytic actions and its relation to the receptive system of acupoints. METHODS: Eighteen New Zealand rabbits were randomly divided into ET group, ET + weak-EA group and ET + strong-EA group. Extracellular discharges of the PO-AH neurons were recorded by using tungsten microelectrodes. A "U"-shape stainless steel tube was implanted in the region (P0.4-A4.4, L0.5-1.7) crossing the hypothalamus for changing local temperature by perfusion of cool (25 degrees C) or warm (41 degrees C) solution in order to distinguish the heat sensitive neurons (HSN), cold sensitive neurons (CSN) and insensitve neurons to temperature changes. Intravenous injection of endotoxin (25 EU/rabbit) was given to rabbits to induce increase of tempe rature. EA (8 Hz, wave width 0.1 ms, weak stimulation: 4.5 V, strong stimulation: 25 V) was applied to bilateral "Yongquan" (KI 1) for observing changes of firing rates of HSN in PO-AH. RESULTS: Compared with the basal values of firing rates of PO-AH neurons in each group, the average changing ratios of both ET and ET + weak-EA groups decreased significantly from 55-60 min on in ET group and from 40-45 min on in ET + weak-EA group after intravenous injection of ET (P<0.05), suggesting no marked effect of weak EA for preventing discharges of PO-AH neurons from decrease. While in ET + strong-EA group, the firing rates of HSN of PO-AH kept stable after injection of ET during EA and after cease of EA (P>0.05 vs basal value), suggesting that strong EA could antagonize ET thermolysis-induced decrease of firing rates of PO-AH neurons. CONCLUSION: Stronger EA stimulation of KI1 can antagonize ET thermolysis-induced effect on electrical activities of PO-AH HSN, which may be initiated by the activation of the high-threshold thin nerve fibers in the acupoint region.