RESUMO
BACKGROUND: Previous studies have proposed that the totally mechanical Collard (TMC) method may reduce anastomotic leakage and stricture. This study aimed to compare the TMC method and the circular stapled (CS) method for cervical anastomosis after minimally invasive esophagectomy (MIE) for esophageal cancer. METHODS: From May 2017 to September 2020, 308 patients (165 in the CS group and 143 in the TMC group) were included in this study. The primary endpoints were anastomotic leakage and anastomotic stricture within 12 months. Propensity score matching was used to control potential selection bias. RESULTS: Anastomotic leak, anastomotic stricture, and refractory stricture (≥ 3 dilations) occurred in 30 (9.7%), 28 (9.1%), and 18 (5.8%) patients, respectively. The rate of anastomotic leak was similar in the CS and TMC methods (9.7 vs. 9.8%; P = 0.978), but anastomotic stricture (3.5 vs. 13.9%; P = 0.001) and refractory stricture (2.8 vs. 9.1%, P = 0.022) occurred less frequently in the TMC method. Propensity score matching yielded 128 patient pairs and confirmed these results. Multivariable analyses found that CS method, anastomotic leakage, and diabetes were independent predictors for both anastomotic stricture and refractory stricture. Subgroup analysis revealed that for patients with anastomotic leakage, the postoperative hospital stay in the TMC group was significantly longer than that in the CS group. CONCLUSION: In cervical anastomosis after MIE, the TMC method is superior to the CS method regarding anastomotic stricture and refractory stricture formation. However, compared to the CS method, the TMC method cannot lower the probability of anastomotic leakage, and anastomotic leakage with the TMC method requires a longer healing time.
Assuntos
Neoplasias Esofágicas , Esofagectomia , Humanos , Esofagectomia/métodos , Fístula Anastomótica/cirurgia , Constrição Patológica/cirurgia , Resultado do Tratamento , Anastomose Cirúrgica/métodos , Neoplasias Esofágicas/cirurgia , Pontuação de Propensão , Complicações Pós-Operatórias/cirurgia , Estudos RetrospectivosRESUMO
OBJECTIVES: To retrospectively assess the clinical effectiveness of CT-guided cyanoacrylate localization for multiple ipsilateral small pulmonary nodules (SPNs) and to determine the independent predictors for pneumothorax. METHODS: In total, 81 patients with 169 lesions undergoing CT-guided cyanoacrylate localization for multiple ipsilateral SPNs between September 2016 and July 2020 were enrolled (group M). Another 284 patients who received single SPN localization during the same period served as the control group (group S). Propensity score analysis was performed to minimize selection bias. Possible independent predictors for pneumothorax were evaluated using multivariate logistic regression analysis. RESULTS: Multiple ipsilateral SPN localization was successfully performed in all 81 patients. The incidences of successful targeting during localization and surgery were 100% and 98.8%, respectively. Seventy-seven patients (95.1%) underwent the procedure on the day before the surgery. Propensity matching created 81 pairs of patients. There were no significant differences in the incidence of successful targeting during localization and surgery, localization-related pain score, and additional morphine use between the two groups. However, group M was associated with a significant longer localization procedural time (p < 0.001) and a higher incidence of pneumothorax (p < 0.001). In multivariate analysis, position change was significantly associated with a sevenfold increase in the risk for pneumothorax (p = 0.001). CONCLUSIONS: CT-guided cyanoacrylate injection for multiple ipsilateral SPN localization was safe and reliable, and allowed a flexible surgical schedule, despite a lengthy procedure and an increased incidence of pneumothorax. Avoiding position change may help to reduce the occurrence of pneumothorax. KEY POINTS: ⢠Compared to single SPN localization, multiple ipsilateral SPN localization using cyanoacrylate injection achieved comparable safety, reliability, and comfort. ⢠CT-guided cyanoacrylate localization for multiple ipsilateral SPNs allowed a flexible surgical schedule. ⢠Position change was the only independent risk factor for pneumothorax during the multiple ipsilateral SPN localization.
Assuntos
Neoplasias Pulmonares , Nódulos Pulmonares Múltiplos , Nódulo Pulmonar Solitário , Cianoacrilatos , Humanos , Pulmão , Reprodutibilidade dos Testes , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND AND OBJECTIVES: Uniportal video-assisted thoracoscopic surgery (U-VATS) lobectomy has been increasingly adopted to manage early stage lung cancer. However, little information is available on whether this technique can be taught to surgeons inexperienced in open lobectomy. This study aimed to investigate the learning curve for U-VATS lobectomy performed by a single surgeon with limited open lobectomy experience. METHODS: From July 2018 to September 2020, 103 patients received U-VATS lobectomy for lung cancer by a single surgeon. The learning curve was assessed using three statistical methods: the moving average analysis, cumulative sum (CUSUM) analysis, and risk-adjusted CUSUM (RA-CUSUM) analysis. RESULTS: The moving average analysis showed a continuous decrease in operative time throughout the study period. The CUSUM analysis demonstrated three well-differentiated learning phases: Phase 1 (the initial 34 cases) representing the initial learning, Phase 2 (the middle 33 cases) representing the improvement of competence, and Phase 3 (the final 36 cases) representing technical proficiency. RA-CUSUM analysis revealed that the maximized cumulative surgical failure, defined as the maximum cumulative difference between the observed and predicted surgical failures, was found in the 61st case. CONCLUSIONS: U-VATS lobectomy is feasible for surgeons with limited open lobectomy experience. Multidimensional statistical analyses suggested that 61-67 cases were required to gain technical proficiency and ensure acceptable surgical outcomes.
Assuntos
Neoplasias Pulmonares , Cirurgia Torácica Vídeoassistida , Humanos , Curva de Aprendizado , Neoplasias Pulmonares/cirurgia , Pneumonectomia/métodos , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida/métodosRESUMO
BACKGROUND: The use of a small circular stapler (CS) has been reported to increase the incidence of benign anastomotic stricture of the intrathoracic anastomosis after esophagectomy, but no study has evaluated the effects of the CS size on cervical esophagogastrostomy. Based on a propensity-matched comparison, the present study was designed to determine whether the perioperative outcomes differ between 21- and 25-mm CSs after minimally invasive esophagectomy with cervical anastomosis. METHODS: From January 2015 to December 2017, 162 patients who received CS cervical esophagogastric anastomosis after minimally invasive esophagectomy for esophageal cancer were identified from our surgical database. A propensity-matched analysis was used to compare the outcomes between the 21- and 25-mm CS groups. Endpoints included anastomotic leak, dysphagia, reflux, stricture, and other major postoperative outcomes within 6 postoperative months. RESULTS: There were 69 and 93 patients in the 21- and 25-mm CS groups, respectively. Propensity matching produced 57 patients in each group. The two groups were not remarkably different in benign anastomotic stricture rate (P = 0.528). All strictures were resolved by balloon dilatation. The 25-mm CS group had a significantly longer operative time in cervical anastomosis than the 21-mm group (P = 0.005). No statistically significant differences in anastomotic leak rates, dysphagia scores, reflux scores, or other postoperative complications were noted between the two groups. CONCLUSIONS: The use of a 21-mm CS in minimally invasive esophagectomy with cervical esophagogastric anastomosis did not result in greater anastomotic stricture as compared with a 25-mm CS. The 21-mm CS was associated with a significantly shorter operative time.
Assuntos
Fístula Anastomótica/epidemiologia , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Refluxo Gastroesofágico/epidemiologia , Grampeadores Cirúrgicos/efeitos adversos , Idoso , Anastomose Cirúrgica/efeitos adversos , Fístula Anastomótica/etiologia , Constrição Patológica/epidemiologia , Constrição Patológica/etiologia , Esofagectomia/instrumentação , Esofagectomia/métodos , Esofagostomia/efeitos adversos , Esofagostomia/instrumentação , Esofagostomia/métodos , Feminino , Refluxo Gastroesofágico/etiologia , Gastrostomia/efeitos adversos , Gastrostomia/instrumentação , Gastrostomia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Pontuação de Propensão , Estudos Retrospectivos , Grampeamento Cirúrgico/efeitos adversos , Grampeamento Cirúrgico/instrumentação , Grampeamento Cirúrgico/métodos , Fatores de Tempo , Resultado do TratamentoRESUMO
AIMS: The present study was to investigate the role of calpain in reactive oxygen species (ROS) production in endothelial cells and endothelium-dependent vascular dysfunction under experimental conditions of diabetes. METHODS AND RESULTS: Exposure to high glucose activated calpain, induced apoptosis and reduced nitric oxide (NO) production without changing eNOS protein expression, its phosphorylation and dimers formation in primary human umbilical vein endothelial cells (HUVECs). These effects of high glucose correlated with intracellular ROS production and mitochondrial superoxide generation. Selectively scavenging mitochondrial superoxide increased NO production in high glucose-stimulated HUVECs. Inhibition of calpain using over-expression of calpastatin or pharmacological calpain inhibitor prevented high glucose-induced ROS production, mitochondrial superoxide generation and apoptosis, which were concurrent with an elevation of NO production in HUVECs. In mouse models of streptozotocin-induced type-1 diabetes and OVE26 type-1 diabetic mice, calpain activation correlated with an increase in ROS production and peroxynitrite formation in aortas. Transgenic over-expression of calpastatin reduced ROS production and peroxynitrite formation in diabetic mice. In parallel, diabetes-induced reduction of endothelium-dependent relaxation in aortic ring was reversed by over-expression of calpastatin in mouse models of diabetes. However, the protective effect of calpastatin on endothelium-dependent relaxation was abrogated by eNOS deletion in diabetic mice. CONCLUSIONS: This study suggests that calpain may play a role in vascular endothelial cell ROS production and endothelium-dependent dysfunction in diabetes. Thus, calpain may be an important therapeutic target to overcome diabetes-induced vascular dysfunction.
Assuntos
Calpaína/antagonistas & inibidores , Diabetes Mellitus/metabolismo , Endotélio Vascular/metabolismo , Estresse Oxidativo/fisiologia , Animais , Calpaína/fisiologia , Diabetes Mellitus/prevenção & controle , Endotélio Vascular/efeitos dos fármacos , Glicoproteínas/farmacologia , Glicoproteínas/uso terapêutico , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Técnicas de Cultura de Órgãos , Estresse Oxidativo/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismoRESUMO
As a widely used traditional Chinese medicine (TCM), Radix Aconiti Lateralis Preparata (Fuzi) is not only efficacious but also poisonous. Its toxicity and processed products should be taken into account and effectively evaluated. In this study, a non-invasive and non-destructive microcalorimetric method was employed to evaluate and compare the toxicity of Fuzi and its three processed products including Yanfupian, Heifupian, and Danfupian on Escherichia coli (E. coli). Some important metabolic information, such as the power-time curves and some quantitative thermokinetic parameters including growth rate constant k, heat output power P, inhibitory ratio I, and half inhibitory concentration IC50, of E. coli growth affected by various concentrations of Fuzi and its processed products were obtained. Combined with chemometric techniques including multivariate analysis of variance and principal component analysis on this information, it could be seen that Fuzi and its processed products could be distinguished according to their toxic effects on E. coli. The IC50 values of 14.6 mg/mL for Fuzi, 59.2 mg/mL for Yanfupian, 118.3 mg/mL for Heifupian, and 182.7 mg/mL for Danfupian illustrated that the sequence of toxicity on E. coli was Fuzi > Yanfupian > Heifupian > Danfupian. This study provided a useful method and idea of the combination of microcalorimetry and chemometrics for studying the toxic effects of TCMs and other substances.
Assuntos
Aconitum/química , Analgésicos/farmacologia , Analgésicos/toxicidade , Escherichia coli/efeitos dos fármacos , Extratos Vegetais/farmacologia , Extratos Vegetais/toxicidade , Analgésicos/isolamento & purificação , Calorimetria , Concentração Inibidora 50 , Extratos Vegetais/isolamento & purificaçãoRESUMO
Lipopolysaccharides (LPS) induce tumor necrosis factor-alpha (TNF-alpha) production in cardiomyocytes, which contributes to myocardial depression during sepsis. However, the underlying mechanisms remain not fully understood. This study was undertaken to investigate the contribution of histone deacetylase (HDAC) to TNF-alpha expression in cardiomyocytes and the signaling mechanism of LPS-induced HDAC activation. Here, we show for the first time that LPS increases HDAC activity and that inhibition of HDAC decreases LPS-stimulated TNF-alpha expression via the accumulation of NF-kappaB/p65 at the TNF-alpha promoter in cardiomyocytes. Using a positive screen, we have further identified HDAC3 as a specific member of the HDAC family able to regulate TNF-alpha production. Furthermore, our data reveal that LPS-induced HDAC activity is mediated through reactive oxygen species from mitochondria and c-Src signaling. In summary, this study demonstrates a novel signaling mechanism by which LPS via mitochondrial reactive oxygen species/c-Src/HDAC3 pathways mediate TNF-alpha expression in cardiomyocytes.
Assuntos
Ativação Enzimática , Histona Desacetilases/metabolismo , Lipopolissacarídeos/metabolismo , Miócitos Cardíacos/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Adenoviridae/genética , Animais , Proteína Tirosina Quinase CSK , Células Cultivadas , Imunoprecipitação da Cromatina , Camundongos , Camundongos Endogâmicos C57BL , Proteínas Tirosina Quinases/metabolismo , Espécies Reativas de Oxigênio , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transdução de Sinais , Quinases da Família srcRESUMO
The purpose of this study was to investigate the role of Rac1 and estrogen in sex difference of cardiac tumor necrosis factor-alpha (TNF-alpha) expression during endotoxemia. Endotoxemia was induced in male and female mice by peritoneal injection of lipopolysaccharide (LPS, 4 mg/kg). Compared with female mice, male mice produced more TNF-alpha in the heart 4 h after LPS treatment, which were correlated with higher Rac1 and NADPH oxidase activity, more phosphorylation of ERK1/2 and p38 MAPK, and up-regulation of toll-like receptor-4 (TLR-4) expression in male mice. Cardiac specific Rac1 knockout or administration of 17beta-estradiol down-regulated Rac1 expression, attenuated gp91(phox)-NADPH oxidase expression and activity, decreased phosphorylation of ERK1/2/p38 MAPK and inhibited cardiac TNF-alpha expression induced by LPS, suggesting an important role of Rac1 and estrogen in LPS-stimulated TNF-alpha expression in the heart. More importantly, the sex difference in TNF-alpha expression was abrogated by Rac1 knockout or gp91(phox) knockout and by administration of apocynin or N-acetylcysteine in LPS-stimulated mice. To investigate the functional significance of sex difference in endotoxemia, heart function was measured in isolated hearts with a Langendorff system. Male mice exhibited worse myocardial dysfunction compared with female in endotoxemia. Treatment of male mice with 17beta-estradiol attenuated myocardial dysfunction during endotoxemia. In conclusion, LPS induces Rac1 activation, which contributes to NADPH oxidase activity and phosphorylation of ERK1/2/p38 MAPK, leading to TNF-alpha expression in the heart. The sex difference in TNF-alpha expression is estrogen-dependent and mediated via Rac1 dependent NADPH oxidase/ERK1/2 and p38 MAPK pathway in LPS-stimulated hearts.
Assuntos
Endotoxemia/enzimologia , Glicoproteínas de Membrana/metabolismo , Miocárdio/enzimologia , NADPH Oxidases/metabolismo , Caracteres Sexuais , Fator de Necrose Tumoral alfa/metabolismo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Proteínas rac1 de Ligação ao GTP/metabolismo , Animais , Endotoxemia/fisiopatologia , Estradiol/farmacologia , Feminino , Testes de Função Cardíaca , Lipopolissacarídeos/farmacologia , Masculino , Camundongos , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Miocárdio/patologia , NADPH Oxidase 2 , Fosforilação/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo , Receptor 4 Toll-Like/metabolismoRESUMO
BACKGROUND: Localizing small pulmonary nodules (SPNs) is a challenge during thoracoscopic resection, but preoperative computed tomography (CT)-guided localization using either cyanoacrylate or hookwire can be helpful. This study compared the safety, efficiency, and operability of the two techniques. METHODS: From September 2013 to November 2018, 269 patients (269 SPNs) who underwent preoperative CT-guided SPN localization were enrolled. A propensity-matched analysis, incorporating 13 variables, was performed to control potential selection bias. RESULTS: All the patients were divided into two groups: CT-guided cyanoacrylate localization group (Group C, nâ¯=â¯149) and CT-guided hookwire localization group (Group H, nâ¯=â¯120). Eighty-six patients were propensity-matched in each group. All SPNs were successfully removed thoracoscopically, and no conversion was required. Localization-related complications in the two groups were similar, including intrapulmonary focal hemorrhage (pâ¯=â¯0.823), pneumothorax (pâ¯=â¯1.000), or hemoptysis (pâ¯=â¯0.121). For pain assessment and management, the cyanoacrylate localization saw a lower pain score (pâ¯<â¯0.001) and less morphine use (pâ¯<â¯0.001). In Group H, the localization took a significantly longer time (pâ¯<â¯0.001). Covering only the patients in Group C, the sub-analysis found that cyanoacrylate localization on the day before surgery did not compromise the accuracy of intraoperative targeting or increase the incidence of complications, compared with the localization on the day of surgery (all pâ¯>â¯0.05). CONCLUSION: Compared to hookwire localization, CT-guided cyanoacrylate localization decreased pain and morphine use and allowed flexible surgical schedules, suggestive of its preferability for the resection of SPNs.
Assuntos
Cianoacrilatos , Neoplasias Pulmonares/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Dor Processual/epidemiologia , Instrumentos Cirúrgicos , Tomografia Computadorizada por Raios X/métodos , Idoso , Estudos de Coortes , Feminino , Humanos , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Nódulos Pulmonares Múltiplos/cirurgia , Medição da Dor , Dor Processual/etiologia , Pontuação de Propensão , Cirurgia Torácica Vídeoassistida/métodos , Tomografia Computadorizada por Raios X/efeitos adversosRESUMO
This work investigated the spectrum-effect relationships between HPLC fingerprints and the anti-bacterial activities of EtOAc extracts from Radix Isatidis. Fingerprints of EtOAc extracts of Radix Isatidis from various sources were established by a High-Performance Liquid Chromatography. The process of Escherichia coli (E. coli) growth affected by EtOAc extracts was monitored using a Thermal Activity Monitor (TAM) Air Isothermal Calorimeter by microcalorimetry. By analyzing the power-time curves, quantitative parameters, such as growth rate constant k, maximum heat-production rate P(m), appearance time t and total heat-production Q were obtained to characterize the interactions of E. coli and the EtOAc extracts from Radix Isatidis. The HPLC fingerprints were investigated using hierarchical clustering analysis. The main thermo-kinetic parameters from the power-time curves were analyzed using principal component analysis. The spectrum-effect relationships between the HPLC fingerprints and anti-bacterial activities were analyzed with multivariant correlation analysis. Close correlation existed between the spectrum-effect relationships of the EtOAc extracts. Salicylic acid in the HPLC fingerprints might be one of the anti-bacterial components. This work provides a general model of the combination of HPLC and microcalorimetry to study the spectrum-effect relationships of EtOAc extracts from Radix Isatidis, which can be used to search for principal components of Radix Isatidis on bioactivity.
Assuntos
Brassicaceae/química , Medicamentos de Ervas Chinesas/farmacologia , Extratos Vegetais/farmacologia , Raízes de Plantas/química , Acetatos/química , Calorimetria , Cromatografia Líquida de Alta Pressão , Escherichia coli/efeitos dos fármacos , Análise MultivariadaRESUMO
OBJECTIVE: To investigate the effect of Radix Isatidis polysaccharides (RIP) on the immunological function and expression of immune related cytokines in mice. METHODS: Sixty mice were randomly divided into six groups, the normal group, cyclophosphamide (Cy) model group, Levamisole (positive control) group, RIP low, medium and high dose groups (0.08 g/kg, 0.16 g/kg, 0.32 g/kg, respectively), ten in each group. By detecting the value of abdominal macrophage phagocytic index, serum hemolysin (HC50), proliferation of lymphocytes and expression of related cytokines, interleukin (IL-2) and interferon gamma (INF-gamma), the effect of RIP on immunological function and its mechanism were studied. RESULTS: RIP could improve the level of hemolysin in immunological function depressed mice. The results showed that the value of macrophage phagocytic index in the high dose RIP group increased from 1.11+/-0.13 to 1.42+/-0.26. The level of IL-2 and INF-gamma could be decreased by Cy to 38.12+/-6.88 ng/L and 139.23+/-29.87 ng/L, respectively, while RIP in high dose could increase the secretion of IL-2 and INF-gamma to 53.54+/-14.43 ng/L and 189.91+/-32.63 ng/L, respectively. CONCLUSION: RIP could enhance non-specific immunological function, humoral immunity and cellular immunity in mice.
Assuntos
Citocinas/metabolismo , Medicamentos de Ervas Chinesas/farmacologia , Imunidade/efeitos dos fármacos , Polissacarídeos/farmacologia , Animais , Proliferação de Células/efeitos dos fármacos , Galinhas , Ciclofosfamida/farmacologia , Citocinas/sangue , Terapia de Imunossupressão , Interferon gama/sangue , Interleucina-2/sangue , Macrófagos/citologia , Macrófagos/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos BALB C , Fagocitose/efeitos dos fármacos , Baço/citologiaRESUMO
OBJECTIVE: To establish a novel pattern and method to evaluate the quality of Radix Isatis based on analysis of biothermic activity. METHODS: Chemical and biothermodynamic methods were used and compared to investigate the quality of different Radix Isatis samples. And a mathematic model was established by computer aided pattern recognition to evaluate the quality of Radix Isatis. RESULTS: The quality of Radix Isatis was partially related to the content of organic acids and polycose, but it could not be correctly recognized by both chemical determination and HPLC fingerprint. On the other hand, the mathematic model based on the main four parameters of biothermodynamic analysis was very correct (misjudgment ratio of 1.39%) to recognize the quality of Radix Isatis. CONCLUSION: The established model in this paper based on analysis of biothermic activity is more accurate and reliable than that of chemical methods to evaluate the quality of Radix Isatis.
Assuntos
Antibacterianos/farmacologia , Medicamentos de Ervas Chinesas/farmacologia , Escherichia coli/crescimento & desenvolvimento , Isatis/química , Plantas Medicinais/química , Animais , Antibacterianos/química , Antibacterianos/isolamento & purificação , Calorimetria , Cromatografia Líquida de Alta Pressão/métodos , Medicamentos de Ervas Chinesas/química , Medicamentos de Ervas Chinesas/isolamento & purificação , Escherichia coli/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Modelos Teóricos , Raízes de Plantas/química , Polissacarídeos/análise , Polissacarídeos/normas , Controle de Qualidade , Reprodutibilidade dos Testes , TermodinâmicaRESUMO
OBJECTIVE: Hyperbilirubinemia is one of the most devastating pathologies induced by various liver diseases. Formulae related to Paeoniae Radix Rubra (PRR) at high doses have been applied to treat hyperbilirubinemia in traditional Chinese medicine (TCM). The aim of this systematic review and meta-analysis is to assess the efficacy and safety of formulae relevant to high-dose PRR in patients suffering from hyperbilirubinemia induced by viral hepatitis. METHODS: We performed a meta-analysis of randomized-controlled clinical trials to evaluate the efficacy and safety of formulae that apply a high dose of PRR for hyperbilirubinemia. Seven databases were searched until April, 2015. All studies were included according to detailed criteria and assessed for methodological quality. The outcome measurements were recorded for further analysis using the RevMan 5.2.11 software. RESULTS: Fifteen articles involving 1323 patients with hyperbilirubinemia were included. Formulae with high-dose PRR might promote the efficacy of either a combined application ([OR: 3.98, 95% CI (2.91, 5.43)]; P < 0.01) or a single application ([OR: 4.00, 95% CI (1.50, 10.68)]; P < 0.01) for hyperbilirubinemia. The indices of TBIL, ALT, and AST significantly decreased ([MD: -75.57, 95% CI (-94.88, -56.26)], [MD: -26.54, 95% CI (-36.19, -16.88)], and ([MD: -28.94, 95% CI (-46.26, -11.61)]; P < 0.01), respectively. In addition, formulae with high-dose PRR could enhance the treatment efficacy of hyperbilirubinemia triggered by hepatitis B ([OR: 2.98, 95% CI (1.75, 5.05)]; P < 0.01). Furthermore, the efficacy was enhanced with an increasing dosage of PRR. Two articles reported that no side effects occurred in clinical trials, and three studies noted that patients presented light digestive tract symptoms. CONCLUSION: Formulae relevant to high-dose PRR ameliorate hyperbilirubinemia and might constitute a promising therapeutic approach. For widespread acceptance by practitioners, more rigorously designed multicenter, double-blind, randomized, and large-scale controlled trials are required.
RESUMO
OBJECTIVE: To explore the activities of Composite Artemisia Capillaris Tablet (CACT) against hepatitis B virus replication in vitro. METHODS: By means of radioimmunoassay (RIA), Dot blot and Southern blot, the surface and e antigen production of 2.2.15 cells, HBV DNA in 2.2.15 cell culture medium and that in 2.2.15 cells were examined respectively. RESULTS: HBsAg, HBeAg values of 2.2.15 cells treated by CACT were lower than those of the control, the HBV DNA quantities in culture medium and in 2.2.15 cells decreased as compared with those cells with no treatment by CACT given to them. CONCLUSION: CACT could inhibit HBV DNA replication, showing its potential antiviral activity in hepatitis B treatment.
Assuntos
Vírus da Hepatite B/fisiologia , Medicina Tradicional Chinesa , Preparações de Plantas/farmacologia , Replicação Viral/efeitos dos fármacos , Linhagem Celular Tumoral , DNA Viral/antagonistas & inibidores , Antígenos de Superfície da Hepatite B/metabolismo , Antígenos E da Hepatite B/metabolismo , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Humanos , Preparações de Plantas/administração & dosagem , Preparações de Plantas/toxicidade , Radioimunoensaio , ComprimidosRESUMO
The pharmacological characteristics of the endothelial target for acetylcholine induced vascular relaxation were investigated in this experiment. The isolated preparations of arteries were suspended for the measurement of isometric force in modified Krebs-Ringer bicarbonate solution (37 degrees C aerated with 95% O2 and 5% CO2). Similar to acetylcholine, carbachol rather than thiocholine, butylcholine and choline could induce endothelium-dependent relaxation. Among cholinergic receptor agonists, arecoline and oxotremorine rather than nicotine could mimic the effects of acetylcholine. But muscarinic agonist pilocarpine had no effect. This phenomenon was observed in rat, cat and rabbit aorta, as well as cat mesenteric. femoral and renal arteries. The new compound tricyclopinate and phenyl cyclopentyl hydroxyl-ethoxy quinuclidines, the competitive antagonists against muscarinic receptors, displayed noncompetitive antagonism against the endothelial target for acetylcholine. Among the six isomers of the novel compound 2-(2'-cyclopentyl-2'-phenyl-2'-hydroxyl-ethoxy) tropane, the isomers with IS-2alpha-2'R and 1S-2alpha-2'S configuration caused the dose-response curves of acetylcholine for inducing vascular relaxation shift rightward with a parallel manner, while the isomers IR-2alpha-2'R and IR-2alpha-2'S with a nonparallel manner. In addition, the antagonistic effects of the isomer IS-2alpha-2'R against the endothelial target for acetylcholine and against muscarinic receptors were 4570 and 10 times greater than those of the isomer IS-2alpha-2'S respectively. In conclusion, the endothelial target for acetylcholine had the unique pharmacological characteristics different from those of muscarinic receptors.
Assuntos
Acetilcolina/farmacologia , Colinérgicos/farmacologia , Endotélio Vascular/efeitos dos fármacos , Relaxamento Muscular/efeitos dos fármacos , Acetilcolina/agonistas , Acetilcolina/antagonistas & inibidores , Animais , Artérias/efeitos dos fármacos , Carbacol/farmacologia , Gatos , Relação Dose-Resposta a Droga , Técnicas In Vitro , Músculo Liso Vascular/efeitos dos fármacos , Norepinefrina/farmacologia , Coelhos , Ratos , Ratos Wistar , Receptores Muscarínicos/efeitos dos fármacos , Receptores Muscarínicos/metabolismo , Especificidade da EspécieRESUMO
AIM: To investigate the antagonistic effects of the novel compounds on vasoconstriction induced by ET-1 and the effect on the blood pressure of stroke-prone spontaneously hypertensive rats. METHODS: Organ bath experiment and whole cardiac function experiment were used. RESULTS: The analogues of o-CPhe-D-Trp-D-Phe(-X)-OH showed good ability against endothelin biological effects. When X was displaced by 3-F, 3-Cl or 4-Cl, the novel compounds inhibit the vascular constriction induced by ET-1 in a concentration-dependent manner, the IC50 +/- L95 were (0.09 +/- 0.05), (0.15 +/- 0.06) or (0.11 +/- 0.03) mumol.L-1 respectively. The blood pressure of stroke-prone spontaneously hypertensive rats was decreased. No significant effect on cardiac function of rats was discovered. CONCLUSION: The results demonstrate that among the six kinds of compounds, those with o-CPhe-D-Trp-D-Phe (-X)-OH configuration showed good biological effects.
Assuntos
Pressão Sanguínea/efeitos dos fármacos , Antagonistas dos Receptores de Endotelina , Hipertensão/fisiopatologia , Peptídeos/farmacologia , Vasoconstrição/efeitos dos fármacos , Animais , Aorta/efeitos dos fármacos , Endotelinas/farmacologia , Hipertensão/tratamento farmacológico , Masculino , Estrutura Molecular , Peptídeos/síntese química , Peptídeos/química , Peptídeos/uso terapêutico , Ratos , Ratos Endogâmicos SHR , Ratos Wistar , Relação Estrutura-AtividadeRESUMO
The anthraco-propulsion and the drug induced mice diarrhea models were used to observe the intestine propulsion and the anti-diarrhea effect of "Tao Hua Zhi Xie Granule" (THZXG), and the anti-inflammation effect of THZXG was studied. The results showed that THZXG could obviously reduce the incidence and frequency of the mice diarrhea induced by Folium Sennae and castor-oil, and propelling movement of mice small intestine after hypodermic injection of neostigmine. The actions were acted in a dose-dependent manner. 11.70 and 17.55 mg/kg THZXG(ig) could also inhibit the increased permeability of intraperitoneal capillary induced by acetic acid in mice.
Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Antidiarreicos/farmacologia , Medicamentos de Ervas Chinesas/farmacologia , Materia Medica/farmacologia , Animais , Permeabilidade Capilar/efeitos dos fármacos , Óleo de Rícino , Diarreia/tratamento farmacológico , Diarreia/fisiopatologia , Combinação de Medicamentos , Medicamentos de Ervas Chinesas/administração & dosagem , Motilidade Gastrointestinal/efeitos dos fármacos , Masculino , Materia Medica/administração & dosagem , Camundongos , Plantas Medicinais/químicaRESUMO
OBJECTIVE: To observe the effect of Composite Yinchen Tablet (CYT) on lymphocytes proliferation in mice. METHODS: By the method of 3H-TdR admixing, the effect of CYT on lymphocytes proliferation in mice were detected in vivo and in vitro. RESULTS: CYT in high, medium and low dose could significantly increase the cpm level of 3H-TdR. CYT could improve the lymphocytes function of mice. CONCLUSION: CYT could enhance cellular immune function.
Assuntos
Artemisia/química , Medicamentos de Ervas Chinesas/farmacologia , Linfócitos T/citologia , Animais , Divisão Celular/efeitos dos fármacos , Combinação de Medicamentos , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/isolamento & purificação , Imunidade Celular/efeitos dos fármacos , Camundongos , Plantas Medicinais/química , Baço/citologia , Linfócitos T/efeitos dos fármacos , ComprimidosRESUMO
By referred to a lot of data, some new drug delivery systems(DDSs) including the Sustained and Controlled DDS, the Targeted DDS, the Transdermal DDS, the Bioadhensive DDS, the PowderJect DDS and the Self-Emulsifying DDS and their applications in TCD since 2000, will be summarized and some latest DDSs in the world including drug-eluting stents, gene therapy carrier system, biological chip, biomolecular motor-powered nanodevice and nanotrap will be also introduced in this paper. The objective of this paper is to introduce the new DDSs proceedings of and their applications in the Traditional Chinese Drugs(TCDs) and to provide some references for the pharmaceutics of TCD. For several recent years, the great success have been achieved in studying the new DDS application in the change of preparation of TCD by the investigators at home, but there is a large difference between at home and at board. So it is necessary to make a greater advance. During the modernization of TCD, there is an effective way that the new drug delivery systems(DDSs) will be applied in the change of the preparation of TCD.
Assuntos
Sistemas de Liberação de Medicamentos , Medicamentos de Ervas Chinesas/administração & dosagem , Plantas Medicinais , Administração Cutânea , Animais , Preparações de Ação Retardada , Vias de Administração de Medicamentos , Portadores de Fármacos , Medicamentos de Ervas Chinesas/isolamento & purificação , Humanos , Nanotecnologia , Plantas Medicinais/química , Absorção Cutânea , Tecnologia FarmacêuticaRESUMO
HIF-1α/mTOR signaling pathway is considered to play a crucial role in genesis and progress of tissue fibrosis. The elevation of HIF-1α and mTOR is relevant to CCl4 induced liver fibrotic rats. Paeoniflorin has been consistently shown to exhibit multiple pharmacological effects in liver disease. However, so far, no research demonstrates the relationship between paeoniflorin and HIF-1α/mTOR fibrogenesis pathway in liver fibrosis. In this study, the liver fibrosis was performed by CCl4 rats and HSC-T6 cell line. The data demonstrated that paeoniflorin treatment could attenuate liver fibrosis and inhibit the activation of HSC. Moreover, paeoniflorin significantly enhanced hepatic function by decreasing serum level of ALT, AST and ALP, and increasing level of ALB, TP. Meanwhile, ECM degradation was modulated by paeoniflorin treated rats with a remarkable reduce of α-SMA and collagen III mRNA expression. Moreover, the alleviation effect of liver fibrosis was relevant to inhibiting HIF-1α and phosphor-mTOR. Our data indicate that paeoniflorin alleviates liver fibrosis by inhibiting HIF-1α expression partly through mTOR pathway and paeoniflorin may be a potential therapeutic agent for liver fibrosis.