[Association between risk factors during maternal pregnancy and the neonatal period and childhood bronchial asthma].

OBJECTIVE: To study the association of the risk factors during maternal pregnancy and the neonatal period with childhood bronchial asthma. METHODS: A total of 306 children with asthma (asthma group) and 250 healthy children (control group) were enrolled. Their clinical data during the neonatal period and the maternal data during pregnancy were retrospectively studied. RESULTS: The univariate analysis showed that there were significant differences in the rates of maternal use of antibiotics during pregnancy, use of antibiotics and probiotics during the neonatal period, preterm birth, cesarean section, low birth weight, and breast feeding (>6 months) between the asthma and control groups (P<0.05). The multivariate logistic regression analysis showed that use of antibiotics during pregnancy (OR=3.908, 95%CI: 1.277-11.962), use of antibiotics during neonatal period (OR=24.154, 95%CI: 7.864-74.183), preterm birth (OR=8.535, 95%CI: 2.733-26.652), and cesarean section (OR=4.588, 95%CI: 2.887-7.291) were independent risk factors for childhood asthma. The use of probiotics during the neonatal period (OR=0.014, 95%CI: 0.004-0.046) and breast feeding (>6 months) (OR=0.161, 95%CI: 0.103-0.253) were protective factors for childhood asthma. CONCLUSIONS: The early prevention of childhood asthma can be improved by reducing the use of antibiotics during pregnancy, reducing cesarean section, avoiding abuse of antibiotics during the neonatal period, trying breast feeding and taking probiotics in early stage.

[Treatment of rheumatoid arthritis by Yangxue Tongluo Recipe combined with immunosuppressive agents: a clinical observation].

OBJECTIVE: To observe the therapeutic effect of Yangxue Tongluo Recipe (YTR) combined with immunosuppressive agents in the treatment of rheumatoid arthritis (RA). METHODS: Totally 88 RA patients were randomly assigned to the treatment group [47 cases, YTR combined Methotrexate (MTX) + Leflunomide (LEF) treatment] and the control group (41 cases, MTX + LEF therapy). All patients received 12-week treatment. Clinical symptoms and signs, laboratory tests [erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), and C reactive protein (CRP)], and adverse reactions were observed before and after treatment. RESULTS: The total effective rate was 91.5% (43/47 cases) in the treatment group, and the total effective rate was 75.6% (31/41 cases) in the control group. There was statistical difference between the two groups (P < 0.05). The morning stiffness, the rest pain, the number of tender joints, the number of swollen joints, tender joint index, swollen joint index, ESR, RF, and CRP were significantly improved in the two groups after treatment (P < 0.01). Besides, clinical symptoms and signs, ESR, RF, and CRP were more improved in the treatment group after treatment, when compared with those in the control group (P < 0.05). Gastrointestinal discomfort was the main adverse reaction in the two groups, but the occurrence was lower in the treatment group than in the control group (P > 0.05). CONCLUSIONS: The clinical efficacy of YTR combined MTX + LEF in the treatment of RA was better than using Western medicine alone. It was more safe with less adverse reactions.

NADPH oxidase-dependent formation of reactive oxygen species contributes to transforming growth factor ß1-induced epithelial-mesenchymal transition in rat peritoneal mesothelial cells, and the role of astragalus intervention.

OBJECTIVE: To investigate the role of nicotinamide-adenine dinucleotide phosphate (NADPH) oxidasedependent formation of reactive oxygen species (ROS) in the transforming growth factor ß1 (TGF-ß1)-induced epithelial-mesenchymal transition (EMT) in rat peritoneal mesothelial cells (RPMCs), and the effect of Astragalus injection (AGI) intervention. METHODS: Primary RPMCs were cultured to the second generation in vitro. After synchronization for 24 h, the cells were randomly assigned to the following groups: control (Group A), AGI (2 g/mL; Group B), TGF-ß1 (10 ng/mL; Group C), TGF-ß1 (10 ng/mL) + AGI (2 g/mL; Group D; pretreated for 1 h with AGI before TGF-ß1 stimulation). Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis were employed to evaluate the mRNA and protein expression of the NADPH oxidase subunit p67phox, α-smooth muscle actin (α-SMA) and E-cadherin. The dichlorofluorescein-sensitive cellular ROS levels were measured by a fluorometric assay and confocal microscopy. RESULTS: TGF-ß1 significantly induced NADPH oxidase subunit p67phox mRNA and protein expression in RPMCs, as well as inducing the production of intracellular ROS. AGI inhibited this TGF-ß1-induced up-regulation by 39.3% and 47.8%, respectively (P<0.05), as well as inhibiting the TGF-ß1-induced ROS generation by 56.3% (P<0.05). TGF-ß1 also induced α-SMA mRNA and protein expression, and down-regulated E-cadherin mRNA and protein expression (P<0.05). This effect was suppressed by AGI (P<0.05). CONCLUSIONS: NADPH oxidase-dependent formation of ROS may mediate the TGF-ß1-dependent EMT in RPMCs. AGI could inhibit this process, providing a theoretical basis for AGI in the prevention of peritoneal fibrosis.

Optimized project of traditional Chinese medicine in treating chronic kidney disease stage 3: a multicenter double-blinded randomized controlled trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Stage 3 is the key phase of chronic kidney disease. Traditional Chinese medicine (TCM) has been used for the treatment of chronic kidney disease. But a large sample trial is desirable. MATERIALS AND METHODS: A total of 578 Chinese patients with primary glomerulonephritis in CKD stage 3 were randomly assigned to three groups: patients received TCM (TCM group), benazepril (Ben group), TCM combined with benazepril (TCM+Ben group). Patients were followed up for 24 weeks. The primary endpoint was the time to the composite of 50% increased of serum creatinine, end stage renal disease or death. RESULTS: eGFR in the TCM and the TCM+Ben group were improved (week 24 vs. baseline, P<0.05) while eGFR in the Ben group was decreased (week 24 vs. baseline, P>0.05). 24h urinary protein excretion (UP) and urinary albumin/creatinine (UAlb/Cr) were decreased in the TCM+Ben (week 24 vs. baseline, P<0.05) and the Ben group (week 24 vs. baseline, P>0.05). UP and UAlb/Cr were increased in the TCM group to week 12, then were stable (week 24 vs. baseline, P<0.05). The hemoglobin in the TCM group was also improved (week 24 vs. baseline, P<0.05). The accumulative survival rate in the TCM+Ben group was higher than that in the TCM group and the Ben group (P=0.044). Side effects in the TCM group were the lowest in these groups (P<0.05). The patients with dry cough in the TCM+Ben group and the Ben group were increased as compared with the TCM group (P<0.05). Hyperkalemia happened less frequently in the TCM group as compared with the other two groups (P=0.052). CONCLUSIONS: For the patients with CKD stage 3, TCM can improve eGFR and hemoglobin with lower side effects. Benazepril significantly decreased the proteinuria. Chinese medicine integrated with benazepril can ameliorate renal function and decrease proteinuria synergistically.

Systemic lupus erythematosus complicated with femoral head ischemic necrosis treated by Chinese medicine therapy for activating blood and dredging collaterals method.

OBJECTIVE: To observe the effect and mechanism of Chinese medicine therapy for activating blood and dredging collaterals (ABDC) on treating systemic lupus erythematosus complicated with avascular necrosis of the femoral head (SLE-ANFH). METHODS: Thirty-four patients (51 joints) with SLE-ANFH were assigned by a random number table to two groups: 22 patients (32 joints) in the treatment group and 12 patients (19 joints) in the control group. All received Western medical conventional treatment for anti-inflammation and immunosuppression, but an additional Chinese medicine decoction prescribed based on ABDC principle was administered to patients in the treatment group. The observation on the patients' condition and therapeutic effect lasted for 3 years. RESULTS: The patients' conditions in the two groups, as assessed by Association for Research Circulation Osseous (ARCO) staging, were similar before treatment. After treatment, comparison between groups showed significant difference (P<0.05), and the raised Harris functional scores in the treatment group were higher than that in the control group (P<0.01). The post-treatment symptom improving rate in the treated group was 72.73%, which was higher than that in the control group (50.00%, P<0.05). Moreover, the former was superior in improving hematologic and hemorrheologic parameters in terms of prolonging activated partial thromboplastin time, lowering whole blood middle/low shear viscosity, and plasma viscosity (P<0.05 or P<0.01). Two patients in the control group but none in the treatment group received hip joint replacement operation during the observation period. CONCLUSIONS: Chinese medicine ABDC therapy could effectively alleviate clinical symptoms and improve joint function of patients with SLE-ANFH. The mechanism may be related to its effects on improving high coagulation manner and trend for getting embolism.

[Effect of shenmai injection on patients suffering from malnutrition-inflammation complex syndrome during the maintenance hemodialysis].

OBJECTIVE: To investigate the effect of Shenmai Injection (SMI) on patients undergoing maintenance hemodialysis (MHD) suffered from malnutrition-inflammation complex syndrome (MICS). METHODS: Forty patients undergoing MHD were randomly allocated into two groups, the SMI group and the control group, 20 in each group. They were treated for three months. Blood levels of albumin (Alb), high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6) and interleukin 1beta (IL-1beta) as well as stomatologic parameters were measured before and after treatment. Meantime, the modified subjective global analysis of nutrition (SGAN) was used to assess patients' nutritional status, and the quantitative scoring system was adopted to get the malnutrition score (MS). RESULTS: In the SMI group after treatment, levels of MS, hs-CRP, IL-6 and IL-1beta were lowered, levels of Alb, body weight, and SSF were increased significantly (P <0.05 or P <0.01); as compared with those in the control group, MS, hs-CRP and IL-6 were lower, while SSF and Alb were higher (P<0.05 or P< 0.01). Levels of IL-6 and IL-1beta, either in the SMI group or in the control group, were all higher than normal range (P<0.05). Correlation analysis showed significant correlation presented between MS value with levels of Alb (P<0.01) and IL-6 (P <0.05), also between IL-6 and Alb (P<0.05). CONCLUSION: SMI can reduce the blood levels of hs-CRP, IL-6 and IL-1beta in patients undergoing MHD, improve their nutritional indices, suggesting that it could alleviate the MICS in these patients.

Regulatory effect of Langchuang serial recipes on T-lymphocyte subsets Th and Tc in patients with systemic lupus erythematosus.

OBJECTIVE: To study the principle of clearing Fei (), cooling blood, and detoxification as well as nourishing yin and moisening Fei (abbr. as CCD-NM) in regulating the levels of peripheral T-lymphocyte subsets Th and Tc cells to explore its mechanism for lowering the incidence of infection in patients with systemic lupus erythematosus (SLE). METHODS: Sixty SLE patients without complicated infection were assigned to the treatment group and the control group, 30 in each group. The control group was treated with Western medicine alone, while the treatment group was treated with the same program of Western medicine, but additionally administered with either Langchuang No.1 (I) or 2 (II), serial concerted Chinese recipes, applied respectively in patients in the active stage or in the resting stage. The total time of treatment for both groups was 1 year. Further, a healthy control group was set up with 20 healthy subjects. The expressions of Th1, Th2, and Tc1 and Tc2 cells in peripheral blood were detected and compared with those in the healthy control group. RESULTS: (1) As compared with the healthy control group, ratios of Th1/Th2 and Tc1/Tc2 in SLE patients, whether complicated with infection or not, were significantly lower (P<0.05 or P<0.01). (2) Comparison between patients with complications and those uncomplicated with infection showed that the two ratios and Th1 expression were lower and Tc2 was higher in the former than those in the latter (all P<0.05). (3) Ratios of Th1/Th2 and Tc1/Tc2 increased after treatment in patients of both the treatment group and the control group (P<0.05 and P<0.01), but the changes in the treatment group were more significant (P<0.05). CONCLUSION: The principle of CCD-NM could regulate the Th and Tc subsets toward equilibrium in SLE patients, which might be one of the mechanisms of action for alleviating complicated infection.

[Clinical research on effect of TCM treatment beginning with Fei in treating systemic lupus erythematosus for reducing incidence of complicated infection].

OBJECTIVE: To observe the effect of TCM treatment beginning with Fei in reducing the incidence of complicated infection and the antibiotic utilization rate in patients with systemic lupus erythematosus (SLE). METHODS: One hundred and ten SLE patients were randomly assigned to 2 groups equally, the control group treated with the conventional Western medicinal treatment and the treated group treated with the same conventional treatment and SLE I formula (in active stage) or SLE II formula (in silent period) additionally. RESULTS: After 3-month and 6-month treatment, the total effective rate was 83.64% , 87.27% in the treated group, and 78.18%, 81.82% in the control group respectively, showing insignificant difference between the two groups. It lowered in both groups after 1-year treatment, however, which in the treated group (78.18%) was higher than that in the control group (60.00%, P < 0.05). But the difference became insignificant again after 2-year treatment, it being 87.27% in the treated group and 72.73% in the control group. The incidence of complicated infection and antibiotic utilization rate in the 2-year treatment was 23.6%, 55.0% respectively in the treated group, markedly lower than those (50.9% and 100%) in the control group respectively (P < 0.01). CONCLUSION: TCM treatment beginning with Fei could decrease the incidence of complicated infection and the antibiotic utilization rate in SLE patients.