Evaluation of Clinical Efficacy of Contrast-Enhanced Ultrasound in the Diagnosis of Ectopic Tubal Pregnancy.

Objective: To explore whether contrast-enhanced ultrasound (CEUS) can improve tubal ectopic pregnancy detection rate, tubal dilation, tubal hematoma, and gestational sac. Methods: This retrospective study included 34 patients with suspected ectopic pregnancy who underwent contrast-enhanced ultrasound at Dongzhimen Hospital of Beijing University of Chinese Medicine between March 2021 and September 2016. Of these, 27 patients were confirmed to have tubal pregnancy by laparoscopic surgery and histopathology. Four ultrasound physicians (2 experts and 2 non-experts) conducted a retrospective analysis of conventional color Doppler ultrasound and the combination of conventional color Doppler ultrasound with contrast-enhanced ultrasound (color Doppler ultrasound + CEUS). They analyzed the differences in confidence levels and reproducibility in identifying tubal dilation, tubal hematoma, and gestational sac implantation sites. Additionally, the characteristic features of ectopic pregnancy on contrast-enhanced ultrasound were summarized, including gestational sac morphology, triple ring sign, enhancement patterns (branching or punctate), tubal dilation (with or without hematoma), contrast enhancement of tubal walls, and presence of free fluid. Results: In the expert group, the correct identification rate of the gestational sac implantation site on ultrasound images increased from 13/34 (38.2%) with conventional color Doppler ultrasound to 20/34 (58.8%) with color Doppler ultrasound + CEUS, the differences were statistically significant (38.2% vs. 58.8%, P = .039). The correct identification rate of tubal dilation increased from 6/34 (17.7%) to 25/34 (73.5%) (P = .001), and the correct identification rate of tubal hematoma increased from 3/34 (8.8%) to 17/34 (50.0%) with color Doppler ultrasound + CEUS (P < .001). In the non-expert group, the correct identification rate of the gestational sac implantation site increased from 8/24 (23.5%) with conventional ultrasound to 19/34 (55.9%) with ultrasound + CEUS (P = .003). The correct identification rate of tubal dilation increased from 6/34 (17.7%) to 23/34 (67.7%) (P < .001), and the correct identification rate of tubal hematoma increased from 3/34 (8.82%) to 12/34 (35.3%) with color Doppler ultrasound + CEUS (P = .012). Conclusion: The analysis of contrast-enhanced ultrasound images provides characteristic features and diagnostic points for tubal ectopic pregnancy, including gestational sac, thick ring sign, tubal dilation, and tubal dilation with hematoma. This approach improves the accuracy of partial pregnancy of unknown location (PUL) diagnosis and reduces the technical dependence on ultrasound personnel.

YYFZBJS inhibits colorectal tumorigenesis by enhancing Tregs-induced immunosuppression through HIF-1α mediated hypoxia in vivo and in vitro.

BACKGROUND AND PURPOSE: The occurrence of colorectal cancer (CRC) is associated with a variety of factors. Accumulating evidence shows that peripheral differentiation of regulatory T cells (Tregs) is critical in controlling tumorigenesis. Our previous studies demonstrated that the Yi-Yi-Fu-Zi-Bai-Jiang-San (YYFZBJS) extract exerted potent anticancer activities by significantly enhancing immunosuppression in ApcMin/+ mice. However, there is limited knowledge on the effect of YYFZBJS in the prevention of colorectal cancer and the underlying mechanisms of action. METHODS: In this study, we investigated the effect of oral administration of YYFZBJS in preventing azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced tumorigenesis. We found that YYFZBJS treatment decreased tumor load, tumor number, histology, and the severity of disease activity index (DAI) scores. To investigate if YYFZBJS inhibited tumorigenesis by regulating regulatory T cells, we depleted Tregs in AOM/DSS mice. We then analyzed the effect of intragastric administration of YYFZBJS on tumorigenesis and the regulation of tumor microenvironment. RESULTS: As expected, intragastric administration of YYFZBJS in AOM/DSS mice model significantly increased immune responses in the tumor microenvironment through its hypoxia-associated anti-cancer activities. Additionally, YYFZBJS regulated the polarization of peripheral Treg (pTreg) to suppress CRC cell proliferation and infiltration. This was demonstrated by the decrease in tumor proliferation-related proteins including p-STAT3, p-NF-κB and MMPs in a dose-dependent manner. Clinically, the increase in the levels of Tregs in human tissues during CRC progression was associated with low expression of HIF-1α in the stroma, and correlated with CRC survival and prognosis. CONCLUSION: Altogether, we demonstrated that HIF-1α may promote pTreg -induced carcinogenesis and progression of CRC cells, indicating that YYFZBJS is a promising protective agent against HIF-1α-mediated Treg activation in colorectal cancer. This study is the first to imply a novel clinical significance of a traditional Chinese herbal medicine from Synopsis of Golden Chamber in the cancer treatment and clarify the important role of tumor microenvironment in preventing tumorigenesis.

Quantitative 1H NMR for the Direct Quantification of Saikosaponins in Bupleurum chinense DC.

Saikosaponin a and saikosaponin d are used as chemical standards for the quality evaluation of Bupleurum chinense DC. by the high-performance liquid chromatography method in current Chinese Pharmacopoeia. However, other saikosaponins, such as saikosaponin c and saikosaponin b2, also possess pharmaceutical activity, but are not used as chemical standards. In this study, a quantitative proton nuclear magnetic resonance (1H NMR) method was developed to determine the total mass percentage (mg/g) of SSa, SSb1, SSb2 and SSd in B. chinense DC., using the H-24 (δH 0.71) signal. Furthermore, the molality (mol/kg) of type I saikosaponins (epoxy-ether structure) was also determined by quantitative 1H NMR in the area of H-11 (δH 5.95) for a more accurate quality evaluation. Validation of the method confirmed that it has acceptable selectivity, precision, stability, and repeatability. The results indicated that this method has the potential to be a reliable method for the quantification of saikosaponins in Bupleurum scorzonerifolium Willd., vinegar baked B. chinense DC. and B. scorzonerifolium Willd., Chaihu Koufuye (oral liquid of Chaihu).

Mechanisms of indigo naturalis on treating ulcerative colitis explored by GEO gene chips combined with network pharmacology and molecular docking.

Oral administration of indigo naturalis (IN) can induce remission in ulcerative colitis (UC); however, the underlying mechanism remains unknown. The main active components and targets of IN were obtained by searching three traditional Chinese medicine network databases such as TCMSP and five Targets fishing databases such as PharmMapper. UC disease targets were obtained from three disease databases such as DrugBank,combined with four GEO gene chips. IN-UC targets were identified by matching the two. A protein-protein interaction network was constructed, and the core targets were screened according to the topological structure. GO and KEGG enrichment analysis and bioGPS localization were performed,and an Herbs-Components-Targets network, a Compound Targets-Organs location network, and a Core Targets-Signal Pathways network were established. Molecular docking technology was used to verify the main compounds-targets. Ten core active components and 184 compound targets of IN-UC, of which 43 were core targets, were enriched and analyzed by bioGPS, GO, and KEGG. The therapeutic effect of IN on UC may involve activation of systemic immunity, which is involved in the regulation of nuclear transcription, protein phosphorylation, cytokine activity, reactive oxygen metabolism, epithelial cell proliferation, and cell apoptosis through Th17 cell differentiation, the Jak-STAT and IL-17 signaling pathways, toll-like and NOD-like receptors, and other cellular and innate immune signaling pathways. The molecular mechanism underlying the effect of IN on inducing UC remission was predicted using a network pharmacology method, thereby providing a theoretical basis for further study of the effective components and mechanism of IN in the treatment of UC.

An Investigation of the Mechanism of Rapid Relief of Ulcerative Colitis Induced by Five-flavor Sophora Flavescens Enteric-coated Capsules Based on Network Pharmacology.

AIM AND OBJECTIVE: Five-Flavor Sophora flavescens Enteric-Coated Capsules (FSEC) are the only proprietary Chinese medicine approved for the treatment of ulcerative colitis (UC) in China. Phase II and III clinical trials have shown that the curative effect of FSEC in relieving UC was not inferior to that of mesalazine granules and enteric-coated tablets, but its pharmacological mechanism is unclear. Therefore, the network pharmacology is used to reveal the more comprehensive effective components and targets of FSEC in the treatment of UC. METHODS: We screened the components of FSEC based on the TCMSP database, determined the action targets of these compounds through target fishing, and integrated the UC disease targets of several disease gene databases. The FSEC-UC composite targets were obtained by matching the two results, and then a PPI network was constructed to analyze the relationship between these targets, and the core targets were selected by topological correlation parameters. Finally, GO-BP and KEGG enrichment analyses were carried out using the clusterProfiler software package. RESULTS: One hundred and sixty active components of FSEC were identified and 77 targets were obtained. Of these, 30 core targets were the main targets of FESC in the treatment of UC. And quercetin, kaempferol, luteolin and mangiferin were regarded as the core active components of FSEC. The results screened by GO and KEGG enrichment analysis showed that FSEC played a comprehensive therapeutic role in immune recognition, anti-inflammation and antioxidation mainly through IL-17, TNF, Toll-like receptor, NF-kappa B, and Th17 cell differentiation. CONCLUSION: The molecular mechanism of UC remission induced by FSEC was predicted by network pharmacology. These findings provide an important theoretical basis for further study of the effective substances and mechanism of FSEC in the treatment of UC.

In vitro and in vivo bactericidal activity of Tinospora sagittata (Oliv.) Gagnep. var. craveniana (S.Y.Hu) Lo and its main effective component, palmatine, against porcine Helicobacter pylori.

BACKGROUND: Tinospora sagittata (Oliv.) Gagnep. var. craveniana (S.Y.Hu) Lo (TSG) is a traditional Chinese herb that has been used for the treatment of upper respiratory tract infection and has anti-bacterial and anti-ulcer activity. Our study investigated the bactericidal effects of TSG and its major component, palmatine, against a Helicobacter pylori (H. pylori) strain isolated from pig and the standard strain H. pylori SS1 in vitro and in vivo. METHODS: H. pylori was isolated from pig and named H. pylori SCYA201401. For in vitro experiments, the inhibitory activity of TSG and palmatine against H. pylori SCYA201401 and H. pylori SS1 were tested by use of the agar cup diffusion technique. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were determined from the absence of H. pylori colonies on agar plates. Time-kill curves were used to evaluate bactericidal activity; the average number of colonies was calculated at 0 to 48 h after liquid incubation, with concentrations of drugs at 0.5, 1, and 2 × MIC. For in vivo experiments, H. pylori SCYA201401-infected mice were randomly divided into TSG, palmatine, triple therapy (omeprazole, clarithromycin, and amoxicillin), blank control, and model groups. The eradication ratios were determined by use of rapid urease tests and bacterial culture. RESULTS: In vitro, the MIC and MBC of TSG against H. pylori SCYA201401 and SS1 were both 6250 µg/mL, whereas palmatine against H. pylori SCYA201401 was 6.25 µg/mL and against H. pylori SS1 was 3.12 µg/mL. The time-kill curves showed a dose-dependent, progressive decline in the numbers of viable bacteria up to 40 h. In vivo, the eradication ratios in the TSG and palmatine groups of mice were 80 and 50 % compared with 70 % in the triple-therapy group. CONCLUSION: TSG and its major component, palmatine, have bactericidal activity against H. pylori in vitro and in vivo. The possibility that TSG or palmatine can be effective in the treatment of human and animals H. pylori infection deserves investigation.

Effects of nitric oxide treatment on the cell wall softening related enzymes and several hormones of papaya fruit during storage.

Papaya fruits (Carica papaya L. cv 'Sui you 2') harvested with < 5% yellow surface at the blossom end were fumigated with 60 microL/L of nitric oxide for 3 h and then stored at 20 degrees C with 85% relative humility for 20 days. The effects of nitric oxide treatment on ethylene production rate, the activities of cell wall softening related enzymes including polygalacturonase, pectin methyl esterase, pectate lyase and cellulase and the levels of hormones including indole acetic acid, abscisic acid, gibberellin and zeatin riboside were examined. The results showed that papaya fruits treated with nitric oxide had a significantly lower rate of ethylene production and a lesser loss of firmness during storage. A decrease in polygalacturonase, pectin methyl esterase, pectate lyase and cellulase activities was observed in nitric oxide treated fruit. In addition, the contents of indole acetic acid, abscisic acid and zeatin riboside were reduced in nitric oxide treated fruit, but no significant reduction in the level of gibberellin was found. These results indicate that nitric oxide treatment can effectively delay the softening and ripening of papaya fruit, likely via the regulation of cell wall softening related enzymes and certain hormones.

[Classification study of Coptis chinensis based on quantitative physical property characteristics of appearance and internal quality evaluation].

OBJECTIVE: Combining the quantitative physical property characteristics of the appearance with the internal quality evaluation index, its aims to provide experimental basis for the classification and quality evaluation of Coptis chinensis. METHOD: Fourteen batches of C. chinensis from different areas were respectively measured in size (total length, total width, root length, taproot diameter, branch number, branch length, branch diameter, length of the bridge, weight), color (external color, internal color), content (epiberberine, coptisine, palmatine, berberine). Then the determination data were evaluated by spss principal component analysis and cluster analysis. RESULT: Three principal components were extracted from the original data. The principal component analysis results showed that the characteristic elements might be the total length, main root length, taproot diameter, branch length, weight, the total color value of the appearance and content of epiberberine and berberine. The results of cluster analysis showed that 14 batches of samples could be clustered reasonably into two groups. In terms of the appearance and quality, there were some differences between in the geo-authentic and non-authentic producing areas of C. chinensis. CONCLUSION: The method which was combining the quantitative physical property characteristics of the appearance with the internal quality evaluation index, and through the processing of mathematical statistics, could be used for the the classification of C. chinensis.