Clinical and pathological analysis on Traditional Chinese Medicine syndromes in children with immunoglobulin A nephropathy

Objective

To evaluate the common Traditional Chinese Medicine (TCM) syndromes and analyze their relationship to clinical and pathological manifestations in children with IgA nephropathy.

Methods

Forty five children diagnosed as having primary IgA nephropathy by renal biopsy for the first time were enrolled in this trial, and their TCM syndromes were evaluated and the distribution of TCM syndromes was observed. All the sick children were growed? according to clinical manifestations and pathological damages, and the differences in TCM syndromes were compared between the groups.

Results

The first 5 TCM symptoms were common cold, hyperhidrosis, red dry throat, dark yellow urine and lassitude. In the acute nephritis group, edema and aching pain in loin and knees were significant (P=0.021 and P=0.000). In the severe pathological damage group, edema was obvious (P= 0.004), and 24 h urinary protein was positively correlated with edema (P=0.015) while negatively with common cold (P=0,007). The score of mesangial cell proliferation was correlated with edema, red dry throat and common cold (P=0.006, 0.013 and 0.029 respectively). The score of segmental pathological change was positively correlated with edema (P=0.039).

Conclusion

Common cold, hyperhidrosis, red dry throat, dark yellow urine, lassitude and other symptoms of qi deficiency of the spleen and lung mainly seen in children with IgA nephropathy may bear a close relationship to clinical manifestations and pathological damages.     

Ethnomedicinal knowledge, belief and self-reported practice of local inhabitants on traditional antimalarial plants and phytotherapy

Ethnopharmacological relevance

This paper reveals the trend of knowledge and practice of traditional antimalarial plants (TAPs) to prevent/treat malaria.

Materials and methods

Stratified, systematic random sampling was adopted. The ethnomedicinal survey was conducted between January and March 2011 by involving the selected 371 household members on knowledge and practice of TAPs by administering a pre-tested questionnaire.

Results

Overall, 54.4% respondents had adequate awareness and usage custom of TAPs and 16 types of plant have been most commonly known and employed by the respondents to prevent/treat malaria. Leaves (57.2%) were most commonly used plant part to prepare traditional antimalarial phytotherapy remedies. Decoction was one of the most commonly used methods to administer TAPs. The chi-square test result revealed that a significant association is found between the usage custom of traditional antimalarial plants and gender (P-value = 0.0282), age (P-value = 0.0024), educational status (P-value = 0.0295), and monthly income (P-value = 0.0001), although not with the ethnicity (P-value = 0.7933) of the respondents.

Conclusion

TAPs usage is an integral part of the tradition and custom of the Ethiopians. However, nearly half of the respondents have had lack of awareness about TAPs and majority of them are reluctant in exercising either due to its ineffectiveness or its bitter taste. Therefore, further laboratory-based research is extremely imperative to identify their antiplasmodial activity and bioactive molecules which could pave the way to formulate the novel affordable as well as accessible potent antimalarials in the near future.     

Effect of didrovaltrate on I-calcium current in rabbit ventricular myocytes

Objective

To investigate the effect of didrovaltrate on L-type calcium current (I_ca-L) in rabbit ventricular myocytes.

Methods

We used the whole cell patch clamp recording technique.

Results

Didrovaltrate at concentrations of 30 μg/L and 100 μg/L significantly decreased peak ICa-L (ICa-Lmax) from (6.01 ± 0.48) pA/pF to (3.45±0.27) pA/pF and (2.16 ± 0.19) pA/pF (42.6% and 64.1%, n=8, P<0.01), respectively. Didrovaltrate shifted upwards the current-voltage curves of ICa-L without changing their active, peak and reverse potentials. Didrovaltrate affected the steady-state inactivation of ICa-L. The half activation potential (V_1/2) was significantly shifted from (−26 ± 2) to (−36 ± 3) mV (n=6, P<0.05), with a significant change in the slope factor (k) (from 8.8 ± 0.8 to 11.1 ± 0.9, n=6, P<0.05). Didrovaltrate did not affect the activation curve.

Conclusion

Didrovaltrate blocks ICa-L in a concentration-dependent manner and probably inhibits ICa-L in its inactive state, which may contribute to its cardiovascular effect.     

Pharmacokinetic study of salvianolic acid A in beagle dog after oral administration by a liquid chromatography–mass spectrometry method: A study on bioavailability and dose proportionality

Ethnopharmacological relevance

Salvianolic acid A (SAA) is one of the main water-soluble components isolated from Salvia miltiorrhiza Bunge. Pharmacological researches revealed that it had various curative activities after oral and intravenous administration, including beneficial effects on diabetes and its complications, cardioprotective effect, anti-platelet aggregation, and so on. However, there is no report regarding the pharmacokinetics of SAA in beagle dogs after oral administration up to now.

Aim of the study

To study the pharmacokinetics of different doses of SAA in beagle dogs and figure out the absolute bioavailability and dose proportionality of SAA after oral administration.

Materials and methods

Male and female beagle dogs were orally administered SAA 5, 10 and 20 mg/kg randomly. The plasma drug concentration was detected by a rapid, sensitive and reproducible liquid chromatography–mass spectrometry (LC–MS) method. The pharmacokinetic parameters were calculated from plasma concentration–time data using the DAS pharmacokinetic software Data Analysis System Version 3.0 program.

Results

After single-dose oral administration of SAA, the mean peak plasma concentration (C_max) values for groups treated with 5, 10 and 20 mg/kg doses ranged from 14.38 to 38.18 µg/L, and the mean area under the concentration–time curve (AUC_(0–t)) values ranged from 38.77 to 130.33 (µg/L⋅ h). SAA showed lack of dose proportionality over the dose range 5–20 mg/kg, based on the power model. However, the increase in systemic exposure with dose appeared linear. The absolute bioavailability was calculated to range from 1.47% to 1.84%.

Conclusion

The pharmacokinetic properties of SAA in beagle dogs after oral administration were characterized as rapid oral absorption, quick clearance, and poor absolute bioavailability. Systemic exposure exhibited lack of dose proportionality over the dose range 5–20 mg/kg. Furthermore, a readily preparative LC–MS method was demonstrated in this study for the research of traditional Chinese medicine.     

A prospective,randomized, double-blind,multicenter comparative study on the safety and efficacy of Celecoxib and GCSB-5, dried extracts of six herbs,for the treatment of osteoarthritis of knee joint

Ethnopharmacological relevance

This prospective, randomized, double-blind, multicenter study compared the efficacy and safety of Celecoxib and GCSB-5, a new product from extracts of six herbs, for the treatment of knee osteoarthritis.

Materials and methods

A total of 198 eligible patients were randomly assigned to the Celecoxib group (n=99 patients) or the GCSB-5 group (n=99 patients) for the 12-week study. The amount of change and percentage of the change in Western Ontario and McMaster Universities (WOMAC) Arthritis Index from the baseline, the change in pain on walking by visual analogue scale (VAS), physician's global assessment on response to therapy (PGART) by five point Likert scale, and the amount of rescue medicine taken were used as parameters for efficacy. Adverse drug reactions (ADRs) were carefully investigated.

Results

The WOMAC score improved in both the Celecoxib group and GCSB-5 group by 20.5 and 21.3 (P=0.79). The percentage of the change in WOMAC score were −42.0% and −38.9% (P=0.54). The pain VAS score decreased by 29.9 and 27.9 (P=0.58). The responders by PGART were 95.3% and 93.8% (P= 0.66), and the median amount of rescue medicine taken were 2.0 and 6.5 tablets (P=0.06). The incidence of ADRs were 31.3% and 21.2% (P=0.11). The most common ADRs were gastrointestinal system related; 17.2% in GCSB-5 group and 22.2% in Celecoxib group. Any severe ADR was not observed in either group.

Conclusions

The result of this study supports that GCSB-5 is comparable to Celecoxib in terms of the efficacy and safety for the treatment of osteoarthritis of knee joint.     

Treatment of osteoporotic vertebral compressive fractures with percutaneous kyphoplasty and oral Zishengukang

Objective

To observe the therapeutic effect of percutaneous kyphoplasty (PKP) and oral Zishengukang (ZSGK) for the treatment of osteoporotic vertebral compression fractures (OVCFs).

Methods

Seventy patients were randomly divided into a control group (PKP group) and an experimental group (PKP plus ZSGK group). The 35 patients in the experimental group were prescribed 6 g oral ZSGK three times a day for 90 days after PKP. Visual analog pain scale (VAS), Oswestry functional score, vertebral height and Cobb's angle were recorded and compared before treatment and at one week, one month and three months after treatment.

Results

Vertebral height and Cobb's angle significantly improved and VAS and Oswestry functional score were significantly lower in both groups after PKP than pre-operatively (P<0.01). Three months after treatment, VAS and Oswestry functional score in the experimental group were lower than controls (P<0.05), even though vertebral height and Cobb's angle were comparable (P>0.05).

Conclusion

PKP combined with oral ZSGK provide superior short-term and long-term symptom control after OVCF than PKP alone.     

Treatment with Azadirachta indica in diabetic pregnant rats: Negative effects on maternal outcome

Ethnopharmacological relevance

The role of Azadirachta indica (neem) against Chagas disease and its antibiotic and antidiabetic action have been demonstrated in non-pregnant animals. However, the effects of neem on lipid metabolism and oxidative stress during pregnancy remain to be investigated. The objective of this study was to evaluate the effects of Azadirachta indica (neem) on maternal reproductive performance and biochemical parameters in non-diabetic and streptozotocin-induced mild diabetic rats (MD).

Materials and methods

Pregnant rats were randomly distributed into six experimental groups: ND=non-treated non-diabetic (n=13); NDOil=non-diabetic treated with 1.2 mL/day neem seed oil (n=12); NDPA=non-diabetic treated with 1.0 mg/mL/day azadirachtin (n=12); D=non-treated diabetic (n=13); DOil: diabetic treated with neem seed oil (n=12), and DPA=diabetic treated with azadirachtin, n=13. Treatment with either neem oil (1.2 mL/day) or azadirachtin (1.0 mg/mL/day) was orally administered throughout pregnancy. Glucose test tolerance (GTT) was performed at day 17 of pregnancy and used as an inclusion criterion. At term pregnancy, maternal reproductive outcomes, lipid profile and oxidative stress status were assessed.

Results

Treatment with neem oil and azadirachtin during pregnancy (1) had no hypoglycemic and anti-hyperglycemic effects on non-diabetic and diabetic rats, respectively; (2) affected OGTT glycemic levels in diabetic rats; (3) increased the proportion of fetuses classified as small for pregnancy age (SPA) in all groups; and (4) did not interfere with the lipid profile in non-diabetic dams. Neem oil reduced the rate of total cholesterol and NEFA in diabetic animals. Both neem oil and azadirachtin increased lipoperoxidation, characterized by increased MDA levels in non-diabetic rats.

Conclusion

Both neem seed oil and azadirachtin impaired intrauterine development and altered antioxidant/oxidative status during pregnancy.     

Therapeutic evaluation of lumbar tender point deep massage for chronic non-specific low back pain

Objective

To observe the therapeutic effect of lumbar tender point deep tissue massage plus lumbar traction on chronic non-specific low back pain using change in pressure pain threshold, muscle hardness and pain intensity as indices.

Methods

We randomly divided 64 patients into a treatment group (32 cases) and a control group (32 cases). Two drop-outs occurred in each group. Patients in the treatment group received tender point deep tissue massage plus lumbar traction and patients in the control group received lumbar traction, alone. We used a tissue hardness meter/algometer and visual analog scale (VAS) to assess the pressure pain threshold, muscle hardness and pain intensity.

Results

Following treatment, we obtained the following results in the treatment and control groups, respectively: the pressure pain threshold difference was 1.5±0.8 and 1.1±0.7; the muscle hardness difference was 4.2±1.6 and 3.5±1.3; and the VAS score difference was 1.9±0.9 and 1.4±0.8. Compared to the control group, the treatment group had higher pressure pain threshold (t=2.09, P<0.05), and lower muscle hardness (t=2.05, P<0.05) and pain intensity (t=2.46, P<0.05).

Conclusion

Lumbar tender point deep tissue massage combined with lumbar traction produced better improvement in pressure pain threshold, muscle hardness and pain intensity in patients with chronic non-specific low back pain than with lumbar traction alone.     

Medium- and long-term efficacy of ligustrazine plus conventional medication on ischemic stroke: a systematic review and meta-analysis

Objective

To evaluate the medium- to long-term efficacy of ligustrazine plus conventional medicine treating ischemic stroke.

Methods

Randomized controlled trials (RCTs) testing ligustrazine in the treatment of acute ischemic stroke were retrieved from Cochrane Library, PubMed, Excerpta Medica Database, Chinese Medical Journal Database, Chinese Biomedical Database, China National Knowledge Infrastructure Database, and Chinese Clinical Trial Register, and then identified by the inclusive and exclusive criteria. The quality of trials was assessed with the Cochrane Handbook 5.1, a risk of bias assessment tool. RevMan 5.1 was used for meta-analysis.

Results

Three RCTs involving 643 patients were included. Compared to conventional medicine treatment alone, ligustrazine plus conventional medicine treatment showed significant difference in reduction of stroke recurrence either at the end of 1-year follow-up [RR=0.42, 95% CI (0.18, 0.94), P< 0.05] or 3-years observation [RR=0.48, 95% CI (0.27, 0.83), P<0.05]. The ligustrazine group also showed higher survival rate [RR=1.67, 95% CI (1.02, 0.2.71), P<0.05] and significantly better effective rate [RR=1.28, 95% CI (1.10, 1.50), P<0.05] than that of the control group at the end of 1 year visit. Only one trial conducted safety assessment and no adverse events were reported. The methodological quality of all the trials included was generally poor.

Conclusion

The findings provided evidence that the combination of ligustrazine and conventional medication was medium- and long-term beneficial to the patients suffering ischemic stroke. But more RCTs of high quality are needed to further prove the efficacy and safety of using ligustrazine for ischemic stroke.     

Safflower yellow injection combined with conventional therapy in treating unstable angina pectoris: a meta-analysis

Objective

To evaluate the clinical efficacy of safflower yellow injection combined with conventional therapy in treating unstable angina pectoris.

Methods

We searched online databases: Chinese journal full-text database, China National Knowledge Infrastructure, Wanfang database, Chinese journal full-text database, Pubmed, ScienceDirect, Embase, and the Cochrane Library with manual-screening of relevant literature. Eligible randomized controlled trials (RCT) on angina pectoris were included. We conducted meta-analysis using the RevMan 5.1 software from The Cochrane Collaboration. We treated the relief rate of angina symptoms and electrocardiograph (ECG) as evaluation.

Results

Seven articles, including in 1134 patients, were enrolled after the evaluation. There was no significant heterogeneity among the studies (χ²=1.08, df=6, P=0.98, I²=0%). The safflower yellow injection with conventional therapy has a higher effective rate than the control group in relieving the symptoms of angina pectoris [odds ratio (OR) = 2.95, 95% (CI) (1.81, 4.81)] and improving ischemic ECG [OR=2.85, 95% CI (1.67, 4.86)]. The difference was statistically significant in the “80 mg dosage” and “100 mg dosage” subgroups (P<0.05) for improving clinical symptoms and ECG. The funnel graphic was nearly symmetrical. Sensitivity analysis suggested that the results were stable.

Conclusion

Safflower yellow injection as an adjunct therapy with conventional drugs shows advantages in easing the clinical symptoms of unstable angina and improving ECG over basic therapy alone. However, the conclusions should be interpreted with care until more high-quality RCTs are reported.     

Efficacy and safety of Traditional Chinese Medicine for the treatment of acquired immunodeficiency syndrome: a systematic review

Objective

To systematically review the efficacy and safety of Traditional Chinese Medicine (TCM) interventions, compared with control interventions (placebo or conventional Western medical therapy), in the treatment of acquired immunodeficiency syndrome (AIDS).

Methods

Electronic databases including PubMed, the Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data were searched to identify relevant randomized controlled trials (RCTs) published as of May 2012. Studies were selected according to the specified inclusion and exclusion criteria and then subjected to methodological quality assessment, data extraction, and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions.

Results

Twelve RCTs involving 881 patients with AIDS were included. Methodological quality assessment showed that two were high-quality, two were moderate-quality, and eight were low-quality. Meta-analysis showed that TCM interventions were associated with significantly reduced plasma viral load compared with placebo [odds ratio OR=2.46, 95% confidence interval CI (1.02, 5.94); P=0.04]. However, the reductions in plasma viral load significantly favored conventional Western medical therapy alone over integrated traditional Chinese and Western medical therapy [OR=0.16, 95% CI (0.05, 0.55); P=0.004]. Patients receiving TCM interventions had significantly higher CD4 + T lymphocyte counts compared with those on placebo [OR=2.54, 95% CI (1.40, 4.60); P=0.002]. In addition, TCM interventions were significantly more likely to have improved clinical symptoms [OR=2.82, 95% CI (1.85, 4.31); P < 0.00001]. TCM interventions conferred a similar risk of adverse events (AEs) compared with control interventions [OR=1.87, 95% CI (0.58, 6.01); P=0.29].

Conclusion

Current evidence suggests that TCM interventions are significantly more effective than placebo in reducing plasma viral load and increasing CD4+ T lymphocyte count in patients with AIDS. When compared with conventional Western medical therapy, TCM interventions were significantly less effective in reducing plasma viral load, although they were associated with a higher percentage of patients with improved symptoms. Patients receiving TCM interventions did not seem to be at an increased risk of AEs.     

Spleen-Yang-deficiency patients with polycystic ovary syndrome have higher levels of visfatin

Objective

To study serum visfatin levels in women with polycystic ovary syndrome (PCOS) grouped by Traditional Chinese Medicine (TCM) patterns. To study the correlations of serum visfatin levels with homeostatic model assessment insulin resistance (HOMA-IR), fasting plasma glucose (FPG), fasting insulin (FINS), body mass index (BMI), testosterone (T), total cholesterol (TC), and triglycerides (TG).

Methods

Two hundred and twelve PCOS patients were placed into the following TCM pattern subgroups: Kidney-Yang deficiency (KYD) group, Spleen-Yang deficiency (SYD) group, stagnant Liver-Qi transforming into heat (SLQTH) group, and Kidney-Yin deficiency (KYIND) group. The correlations between serum visfatin levels and HOMA-IR, FPG, FINS, BMI, T, TC, and TG were analyzed.

Results

Of all patients with PCOS, there were 82 in the KYD group (38.6%), 67 in the SYD group (31.6%), 37 in the SLQTH group (17.5%), and 26 in the KYIND group (12.3%). Visfatin levels in all PCOS subgroups were higher than those in the control group (P<0.01 or P<0.05). Among these subgroups, the visfatin levels in the SYD group were significantly higher than those in the other three TCM pattern groups (P<0.05). There were no statistical differences among the remaining three pattern groups. The levels of BMI, FINS, HOMA-IR, T, and TG were significantly higher in all subgroups than those in the control group (P<0.05). There were no significant differences in FPG and TC between all PCOS subgroups and the control group (P>0.05). The SYD group had higher levels of FINS and HOMA-IR compared with the KYD, SLQTH, and KYIND groups (P<0.05). In all subgroups, after controlling for BMI, TG, TC, and age, visfatin was positively correlated with FINS (r= 0.197, P=0.015) and HOMA-IR (r=0.173, P=0.033), and was not correlated with T.

Conclusion

KYD and SYD patterns are most common in PCOS patients. Increased visfatin is a common pathophysiologic manifestation in PCOS patients. The SYD group had the highest levels of visfatin, and visfatin was positively correlated with FINS and HOMA-IR.     

Clinical effect of Jiutengzhuyu tablets on promoting blood circulation in women with oviducal obstruction

Objective

To test the clinical curative effect of Jiutengzhuyu tablets, a patented Chinese vine-derived drug used for promoting blood circulation, on women with oviducal obstruction.

Methods

Patients with tubal infertility were divided randomly into two groups: 58 patients in the treatment group and 57 in a control group. The treated patients took Jiutengzhuyu tablets orally for 25 days. The control group received an intrauterine infusion of 5 mg dexamethasone sodium phosphate, 4000 units of chymotrypsin, 80 000 units of gentamicin sulfate dissolved in 20 mL of normal saline at 1 mL/min. After 3 months of treatment, the curative effect on tubal patency was assessed and a 1-year follow-up visit was used to document any pregnancies.

Results

The total effective rate was 78% in the treatment group and 32% in the control group with a statistically significant difference (χ²=24.57, P<0.01).

Conclusion

Jiutengzhuyu was effective in treating infertility caused by tubal infertility with a Traditional Chinese Medicine diagnosis of blood stasis.     

Therapeutic potential of intravenous Xuebijing on transforming growth factor β1 and procollagen type Ⅲ peptide in patients with acute paraquat poisoning

Objective

Paraquat (PQ) poisoning-induced pulmonary fibrosis causes asphyxiation and death. The therapeutic potential of intravenous Xuebijing therapy in PQ poisoning patients and its underlying immunomodulatory effects on transforming growth factor (TGF)-β₁, and procollagen type III peptide (PIIIP) were investigated.

Methods

Thirty-six acute PQ poisoning patients were randomly assigned to conventional therapy (Group A) and intravenous Xuebijing administration plus conventional therapy (Group B). Twenty volunteers served as controls (Group C). Blood samples were collected upon admission (day 0) and at post-treatment days 5, 10, and 14. TGF-β₁ and PIIIP concentrations were determined by ELISA and analyzed for intra- and inter-group differences over time. One-month follow-up was conducted for determining the mortality rate.

Results

TGF-β₁, and PIIIP levels were significantly higher in PQ poisoning patients and increased over time (Groups A and B vs C, P<0.01). However, the TGF-β₁ and PIIIP levels were consistently significantly lower in Group B compared with those of Group A (P<0.01). The 1-month mortality rate was also lower in Group B compared with that of Group A (P<0.05). PQ poisoning patients showed remarkably high levels of TGF-β₁ and PIIIP, which increased as PQ-induced pulmonary fibrosis progressed.

Conclusion

Treatment with intravenous Xuebijing plus conventional therapy significantly lowered TGF-β₁ and PIIIP levels, which indicates therapeutic efficacy in the treatment of PQ poisoning patients.     

Bu-Fei Yi-Shen granule combined with acupoint sticking therapy in patients with stable chronic obstructive pulmonary disease: a randomized, double-blind, double-dummy, active-controlled, 4-center study

Ethnopharmacological relevance

Bu-Fei Yi-Shen granule combined with acupoint sticking therapy has been used in the patients with stable chronic obstructive pulmonary disease (COPD) as major traditional interventions for the treatment of the disease.

Aim of the study

The objective of this study was to evaluate the efficacy and safety of traditional Chinese herbal medicine, the Bu-Fei Yi-Shen granule combined with acupoint sticking therapy in patients with stable COPD.

Methods

A 4-center, double-blinded, double-dummy and randomized controlled method was conducted. 244 patients who were divided into the trial group (n = 122, treated with Bu-Fei Yi-Shen granule combined with Shu-Fei Tie acupoint sticking therapy and oral placebo sustained-release theophylline) and the control group (n = 122, treated with oral sustained-release theophylline and placebo Bu-Fei Yi-Shen granule combined with placebo Shu-Fei Tie acupoint sticking therapy). The frequency and duration of acute exacerbation, lung function, clinical symptoms, six-minute walking distance, dyspnea grade and quality of life were observed during the 4-month treatment period, and for a further 6 months follow-up.

Results

Two hundred and twenty one patients fully completed the study, intent-to-treat (ITT) population was 234 and per-protocol (PP) population was 221. After treatment for 4 months and follow-up for 6 months, there were differences between the experimental and control group in frequency of acute exacerbation (ITT: P = 0.007, P = 0.013; PP: P = 0.045, P = 0.046); duration of acute exacerbation (ITT: P = 0.030, P = 0.005; PP: P = 0.048, P = 0.006); scores of symptoms (ITT: P = 0.000, P = 0.000; PP: P = 0.000, P = 0.000); six-minute walking distance (ITT: P = 0.002, P = 0.001; PP: P = 0.002, P = 0.001); dyspnea grade (ITT: P = 0.014, P = 0.009; PP: P = 0.018, P = 0.012); physiological aspects (ITT: P = 0.003, P = 0.000; PP: P = 0.001, P = 0.000); psychological aspects (ITT: P = 0.007, P = 0.001; PP: P = 0.001, P = 0.000) and environment aspects (ITT: P = 0.003, P = 0.000; PP: P = 0.001, P = 0.000) of the WHOQOL-BREF questionnaire. There were no differences between the experimental and control group in FVC, FEV1 and FEV1% and adverse events.

Conclusions

Bu-Fei Yi-Shen granule combined with acupoint sticking therapy showed beneficial effects for patients with stable COPD in the measured parameters over the 4-month treatment period and 6 months follow-up, with no relevant between-group differences in adverse events.     

Busuishengxue ranules mediate their effects upon non-severe aplastic anemia via mitogen-activated protein kinase/extracellular signal-regulated kinase pathway

Objective

To observe the clinical efficacy of Busuishengxue granules on non-severe aplastic anemia (NSAA) and investigate its effect on the mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) pathway.

Methods

Sixty NSAA patients were divided equally into two groups. Subjects in the experimental group were treated with Busuishengxue granules, and the control group with Zaizaoshengxue tablets. The treatment course was 6 months and curative efficacy was compared between the two groups as well as with 10 healthy individuals. Flow cytometry (FCM) was used to detect the intracellular concentration of Ca^{2 +} ([Ca^{2 +}]_i). Western blotting was employed to detect the expression of enzymes in the MAPK/ERK pathway.

Results

The efficacy of Busuishengxue granules was significantly better than that of Zaizaoshengxue tablets (P<0.05). Before treatment, expression of JNK, phospho-ERK 1/2 and p-JNK was higher, and [Ca^{2 +}]_i higher, than that of the control group (P< 0.05). After treatment with Busuishengxue granules, expression of all enzymes related to signal transduction pathways in the blood cells of NSSA patients were altered to different degrees.

Conclusion

Busuishengxue granules had a better effect with regard to improving symptom scores, increasing the number of blood leukocytes, and increasing hemoglobin levels than Zaizaoshengxue tablets, and they differed slightly in terms of increasing the number of platelets.     

Correlation between tongue manifestations and glucose,total cholesterol,and high-density lipoprotein cholesterol in patients with acute cerebral infarction

Objective

To analyze the association between tongue manifestations and the levels of glucose (GLU), total cholesterol (TCH), and high-density lipoprotein cholesterol (HDL-C) in subjects with acute cerebral infarction.

Methods

Hospitalized patients with first unilateral cerebral infarction in the Neurological Department of Xuanwu Hospital were included and the correlation between tongue fur color, fur nature, and the levels of GLU, TCH, HDL-C were analyzed.

Results

HDL level in the thin fur group was higher than that in the thick fur group (P=0.02). The difference in the levels of GLU, TCH, and HDL-C among the groups was significant (P<0.05), classified in terms of slippery, moist, and dry fur. Further comparison between the groups by Student-Newman-Keuls test showed that GLU level in the dry fur group was the highest. Moreover, the TCH level in the slippery fur group was higher than the other two groups.

Conclusion

A correlation between tongue manifestations and GLU, TCH, HDL-C was identified in the patients with acute cerebral infarction.     

Effect of American ginseng (Panax quinquefolius L.) on arterial stiffness in subjects with type-2 diabetes and concomitant hypertension

Ethnopharmacological relevance

Substantial pre-clinical and some clinical data are available showing that Asian ginseng (Panax ginseng C.A. Meyer) varieties or its particular ginsenosides exert a vasodilatating effect, thus may modulate vascular function. However, the clinical evidence for American ginseng (Panax quinquefolius L.) is scarce. Therefore, this study evaluates the effect of American ginseng (AG) on arterial stiffness, as measured by augmentation index (AI), and blood pressure (BP), in type 2 diabetes patients with concomitant hypertension.

Materials and methods

Using a double-blind, placebo-controlled, parallel design, each participant was randomized to either the selected AG extract or placebo at daily dose of 3 g for 12 weeks as an adjunct to their usual antihypertensive and anti-diabetic therapy (diet and/or medications). AI and BP were measured by applanation tonometry at baseline and after 12 weeks of treatment.

Results

A total of 64 individuals with well-controlled essential hypertension and type 2 diabetes (gender: 22 M:42 F, age:63±9.3 years, BP: 145±10.8/84±8.0 mmHg, HbA1c: 7.0±1.3%, fasting blood glucose (FBG): 8.1±2.3 mmol/L) completed the study. Compared to placebo, 3 g of AG significantly lowered radial AI by 5.3% (P=0.041) and systolic BP by 11.7% (P<0.001) at 12 weeks. No effect was observed with diastolic BP.

Conclusions

Addition of AG extract to conventional therapy in diabetes with concomitant hypertension improved arterial stiffness and attenuated systolic BP, thus warrants further investigation on long-term endothelial parameters before recommended as an adjunct treatment.     

Role of Dongchongxiacao (Cordyceps) in prevention of contrast-induced nephropathy in patients with stable angina pectoris

Objective

To study the preventative effects of Dongchongxiacao (Cordyceps) on contrast-induced nephropathy (CIN) in patients with stable angina pectoris (SAP).

Methods

One-hundred and three SAP inpatients were divided randomly into two groups: basic treatment (n=51) and Dongchongxiacao (Cordyceps) treatment (n=52); corbrin capsules (3 g; t.d.s.) were used 3 days before angioplasty and 3 days after angioplasty). Serum creatinine (Scr) was assessed at the time of hospital admission and 1, 2, and 3 days after angioplasty. Values of kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL) and interleukin (IL) 18 in the kidney were detected before angioplasty and 1 day after angioplasty in the patients of both groups. The prevalence of CIN between the two groups was then compared.

Results

CIN occurred in 9 of 103 patients (8.74%). The prevalence of CIN in the Dongchongxiacao (Cordyceps) treatment group was lower than that of the basic treatment group (5.77% vs 11.76%) but the difference was not significant (P>0.05). The post-procedure mean peak of Scr, post-procedure increase in Scr levels from baseline, and urine levels of KIM-1, NGAL and IL18 after the procedure in the Dongchongxiacao (Cordyceps) treatment group were significantly lower than those in the basic treatment group (P<0.05).

Conclusion

Prophylactic treatment with Dongchongxiacao (Cordyceps) in SAP patients who undergo coronary angiography or coronary intervention could prevent contrast-induced renal impairment.