Bu-Fei Yi-Shen Granules Reduce Acute Exacerbations in Patients with GOLD 3-4 COPD: A Randomized Controlled Trial.

Purpose: Chronic obstructive pulmonary disease (COPD) is a disease characterized by frequent acute exacerbations (AEs), especially in severe and very severe cases. We aimed to evaluate the efficacy and safety of Bu-fei Yi-shen granules (BYGs) for COPD. Patients and Methods: We conducted a multicenter, randomized, double-blinded, placebo-controlled trial of 348 COPD patients with GOLD 3-4 COPD. The patients were randomly assigned into experimental or control groups in a 1:1 ratio. Patients in the experimental group were prescribed BYG, while those in the control group were administered a placebo, orally, twice daily, with 5 days on and 2 days off per week for 52 weeks. The outcomes included AEs, pulmonary function, clinical signs and symptoms, dyspnea scores (mMRC), quality of life scores, and a 6-minute walk test (6MWT). Results: A total of 280 patients completed the trial, including 135 patients in the experimental group and 145 in the control group. Compared to the control group, significant differences were observed in frequencies of AEs (mean difference: -0.35; 95% CI: -0.61, -0.10; P = 0.006) and AE-related hospitalizations (-0.18; 95% CI: -0.36, -0.01; P = 0.04), 6MWD (40.93 m; 95% CI: 32.03, 49.83; P < 0.001), mMRC (-0.57; 95% CI: -0.76, -0.37; P < 0.001), total symptoms (-2.18; 95% CI: -2.84, -1.53; P < 0.001), SF-36 (11.60; 95% CI: 8.23, 14.97; P < 0.001), and mCOPD-PRO (-0.45; 95% CI: -0.57, -0.33; P < 0.001) after treatment. However, there were no significant differences in mortality, pulmonary function, and mESQ-PRO scores (P > 0.05). No obvious adverse events were observed. Conclusion: BYG, as compared to a placebo, could significantly reduce the frequencies of AEs and AE-related hospitalizations for GOLD 3-4 COPD patients. Clinical symptoms, treatment satisfaction, quality of life, and exercise capacity improved. There was no significant improvement in mortality and pulmonary function.

Network Pharmacology Prediction and Experimental Validation of Trichosanthes-Fritillaria thunbergii Action Mechanism Against Lung Adenocarcinoma.

We aimed to study the mechanism of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma (LUAD) based on network pharmacology and experimental verification. The effective components and potential targets of Trichosanthis and Fritillaria thunbergii were collected by high-throughput experiment and reference-guided (HERB) database of traditional Chinese medicine and a similarity ensemble approach (SEA) database, and the LUAD-related targets were queried by the GeneCards and Online Mendelian Inheritance in Man (OMIM) databases. A drug-component-disease-target network was constructed by Cytoscape software. Protein-protein interaction (PPI) network, gene ontology (GO) function, and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analyses were conducted to obtain core targets and key pathways. An aqueous extract of Trichosanthes-Fritillaria thunbergii and A549 cells were used for the subsequent experimental validation. Through the HERB database and literature search, 31 effective compounds and 157 potential target genes of Trichosanthes-Fritillaria thunbergii were screened, of which 144 were regulatory targets of Trichosanthes-Fritillaria thunbergii in the treatment of lung adenocarcinoma. The GO functional enrichment analysis showed that the mechanism of action of Trichosanthes-Fritillaria thunbergii against lung adenocarcinoma is mainly protein phosphorylation. The KEGG pathway enrichment analysis suggested that the treatment of lung adenocarcinoma by Trichosanthes-Fritillaria thunbergii mainly involves the PI3K/AKT signaling pathway. The experimental validation showed that an aqueous extract of Trichosanthes-Fritillaria thunbergii could inhibit the proliferation of A549 cells and the phosphorylation of AKT. Through network pharmacology and experimental validation, it was verified that the PI3K/AKT signaling pathway plays a vital role in the action of Trichosanthes-Fritillaria thunbergii in treating lung adenocarcinoma.

[Expert consensus statement on Pudilan Xiaoyan Oral Liquid in clinical practice].

Pudilan Xiaoyan Oral Liquid has effects in clearing away heat and detoxifying,and is used to treat pharynx and throat swelling caused by the syndrome of excessive heat and toxin accumulation. Its efficacy is to relieve swelling and pain( redness,swelling and hot pain). It is included in the Chinese Pharmacopoeia of 2015 Edition,and has been listed in provincial health insurance directories of Shaanxi,Jiangsu,Liaoning,Hunan,Tianjin,Xinjiang and Hebei. It has been recommended by health departments of Beijing,Chongqing and other provinces as a preferred drug for the prevention and treatment of H1 N1 and HFMD,and listed in the diagnosis and Treatment Guide of HFMD by the Ministry of Health,the Clinical Application Guide of Chinese Patent Medicine edited by the Lung Department Disease Branch of China Association of Chinese Medicine,and the Clinical Practice Guide of Single Administration/Combined Administration of Antibiotics in Treatment of Common Infectious Diseases by China Association of Chinese Medicine. To further improve the clinician's understanding of drugs and better guide the rational clinical application,we invited front-line clinical experts from respiratory department,infectious department and dermatology of traditional Chinese and Western medicine to develop and compile the expert consensus. The consensus fully considered the clinical evidence and the expert clinical experience to give recommendations for clinical problems with evidence support and consensus suggestions for clinical problems without evidence support by the nominal group method.This consensus is based on clinical research evidence and expert experience in a simple and clear format,which provides a preliminary reference for the clinical use of the drug.

Lovastatin induces neuroprotection by inhibiting inflammatory cytokines in 6-hydroxydopamine treated microglia cells.

PURPOSE/AIM: This study aims to investigate the impact of lovastatin on neuroinflammation in 6-OHDA-treated microglia cells. MATERIALS AND METHODS: 6-Hydroxydopamine (6-OHDA)-treated microglia cells were used to investigate the neuroprotective nature of lovastatin. After incubation with 6-OHDA and/or lovastatin for 24 h, test kits were used to detect the levels of LDH and glutamate, which were released from PC12 cells exposed to different culture media. The mRNA levels of TNF-α, IL-6 and IL-1ß were determined by RT-PCR and the protein levels were analyzed by Western blot. RESULTS: LDH and glutamate levels in 6-OHDA-incubated PC12 cells increased, when compared with those in the controls, while incubation with lovastatin inhibited this elevation. The expression levels of TNF-α IL-6 and IL-1ß were significantly upregulated after treatment with 6-OHDA. The 6-OHDA-stimulated mRNA and protein levels of TNF-α IL-6 and IL-1ß were reduced by lovastatin. CONCLUSIONS: Our results suggest that Lovastatin is able to induce neuroprotection by inhibiting inflammatory cytokines. The data provide direct evidence of the potential application of lovastatin for the treatment of neuroinflammatory diseases.

[Correlation between essential elements of Chinese medicine syndrome and the lung function in patients with acute aggravating chronic obstructive pulmonary disease].

OBJECTIVE: To study the correlation between essential elements of Chinese medicine syndrome (EECMS) and the lung function in patients with acute aggravating chronic obstructive pulmonary disease (AACOPD). METHODS: Adopting clinical epidemiological method, the Chinese medicine syndrome of 199 AACOPD patients with various grades of the lung function was differentiated, and EECMS in them were picked up, summarized and analyzed statistically. RESULTS: Along with the deteriorating of the lung ventilation, the EECMS of disease-position was progressed correspondingly, i.e. in patients with lung function of grade I, disease was positioned mainly on Fei (88.89%); in patients of grade II, on Fei-Shen (25.97%), Fei-Pi (9.09%), and Fei-Gan (3.90%); in those of grade III, on Fei-Shen (51.32%), Fei-Pi (7.89%), Fei-Pi-Shen (19.74%), and Fei-Pi-Shen-Xin (2.63%); in those of grade IV: on Fei-Shen (56.76%), Fei-Pi-Shen (27.03%). The EECMS of disease-property was also progressed, that for excessive syndromes were disposed as: grade I - II, phlegm (23.76%); grade III: phlegm-heat (30.26%), phlegm-stasis (15.79%), and phlegm-retention (9.21%); grade IV: phlegm-stasis (24.32%), phlegm-heat-stasis (29.73%), phlegm-retention-stasis (2.70%); and for deficiency syndromes were arranged as qi-deficiency --> qi-yin deficiency --> qi-yang deficiency --> qi-yin-yang deficiency. CONCLUSION: The lung function could be taken as the objective and quantitative index for the progression of Chinese medicine syndromes in patients with AACOPD.

[Effect of TCM therapy by principle for nourishing Qi, activating blood circulation and resolving phlegm on quality of life of patients with chronic obstructive pulmonary disease].

OBJECTIVE: To observe the effect of TCM therapy, by principle for nourishing Qi, activating blood circulation and resolving phlegm, on quality of life of patients with chronic obstructive pulmonary disease (COPD). METHODS: Seventy-two COPD patients with Qi-deficiency, blood stasis and phlegm retention syndrome were randomly divided into two groups. Thirty-five patients in the treated group were treated with the integrative traditional and Western medicine, that is, conventional Western medicine combined with Chinese compound recipe prescribed based on the principle of nourishing Qi, activating blood circulation and resolving phlegm, or with Feikang granule and Bailing capsule, while 37 in the control group was treated with conventional Western medicine alone. The clinical efficacy was evaluated by assessment software of COPD quality of life after patients were treated for 3 months. RESULTS: The clinical efficacy in the treated group was superior to that in the control group, showing significant difference (P < 0.01). CONCLUSION: Compound recipe prescribed according to the therapeutic principle for nourishing Qi, activating blood circulation and resolving phlegm can improve the symptoms of patients with COPD at stable stage, elevate their quality of life.