Xinfeng Capsule(新风胶囊)for the Treatment of Rheumatoid Arthritis Patients with Decreased Pulmonary Function—A Randomized Controlled Clinical Trial

Objective:To determine the effectiveness and safety of Xinfeng Capsules(新风胶囊,XFC) for the treatment of rheumatoid arthritis(RA) patients with decreased pulmonary function.Methods:This was a randomized controlled clinical trial of 80 RA patients.Participants were assigned to the trial group(40 cases) and the control group(40 cases) by block randomization.The trial group was treated with XFC,three pills each time three times daily for 2 months.The control group was treated with tripterygium glycoside(TPT),two pills each time three times daily for 2 months.Both groups were followed up after 2 months.The clinical effects,changes in joint and pulmonary function,and quality of life before and after treatment were observed;safety indices were also evaluated.Results:Pain,swelling,tenderness,and duration of morning stiffness of joints were obviously decreased after treatment in both the trial and the control groups compared with baseline(P0.01).Compared with before treatment,hand grip strength increased significantly after treatment in the trial group(P=0.0000);pulmonary function parameters such as forced expiratory volume in the first second of expiration/forced vital capacity(FEV_1/FVC),50%of the expiratory flow of forced vital capacity(FEF_(50)),carbon monoxide diffusing capacity(DLco) were increased(P0.01 or P0.05);measures of quality of life such as role-physical,body pain,vitality and mental health were also improved after treatment in the trial group(all P0.05).Joint swelling in the trial group decreased compared with the control group(P=0.0043),while hand grip strength was increased after treatment(P=0.0000).The increase in FEF_(50),DLco,and the dimensions of quality of life such as vitality and mental health were all significantly greater in the trial group than the control group(P0.05 or P0.01).Conclusions:XFC not only relieved joint pain in RA patients,but also significantly improved the ventilation and diffusion function of the lungs.Therefore,XFC could improve the whole body function and enhance the quality of life of RA patients.     

Age-associated changes in pulmonary function: a comparison of pulmonary function parameters in healthy young adults and the elderly living in Shanghai

Background  The respiratory system changes with age and a better understanding of the changes contribute to detect and prevent respiratory dysfunctions in old population. The purpose of this study was to observe age-associated changes of pulmonary function parameters in healthy young adults and the elderly.

Methods  A cross-sectional study was conducted among 600 male and female subjects aged 19 to 92 years. The subjects were divided into three groups by age: young adult (19–39 years), middle-aged adult (40–59 years), and the elderly (≥60 years). The pulmonary function was measured with routine examination methods and 13 parameters including vital capacity (VC), residual volume (RV), functional residual capacity (FRC), total lung capacity (TLC), RV/TLC, forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), FEV₁/FVC, peak expiratory flow (PEF), forced expiratory flow at 25% of FVC exhaled (FEF₂₅), forced expiratory flow at 50% of FVC exhaled (FEF₅₀), diffusion capacity of the lung for carbon monoxide (D_LCO), and specific diffusion capacity of CO (KCO) were collected and analyzed. Changes in pulmonary function parameters among the pre-elderly and elderly subjects, especially the aging influence on FEV₁/FVC and RV were studied further.

Results  Ten pulmonary function parameters including VC, FVC, FEV₁, FEV₁/FVC, PEF, FEF₂₅, FEF₅₀, TLC, D_LCO and KCO decreased significantly with age in both male and female subjects (P <0.01). RV and RV/TLC were increased with age (P <0.01). FRC remained stable during aging. Except FRC, the linear relationship was significant between age and other pulmonary function parameters. In the pre-elderly and elderly subjects, RV had a non-significantly increasing tendency with age (P >0.05), and FEV₁/FVC did not change significantly with age (P >0.05).

Conclusion  Total pulmonary function was declined with advancing age, but FRC was stable, and the increasing tendency of RV and decreasing tendency of FEV₁/FVC obviously slowed down in the pre-elderly and elderly subjects.

     

Lung function after growing rod surgery for progressive early-onset scoliosis: a preliminary study

Background  Pulmonary problems often occur in patients with early-onset scoliosis (EOS). However, lung function in patients with EOS after growing rod surgery has not been documented. The aim of this study was to investigate lung function after the treatment for EOS with growing rod and its possible correlative factors.

Methods  Eight patients with EOS were treated with growing rod surgery at Peking Union Medical College Hospital from September 2002 to September 2009. Four patients had finished the final fusion surgery (group 1), and the other 4 (group 2) were in the process of periodic lengthening. Preoperative forced vital capacity (FVC), ratio of FVC to predicted FVC, forced expiratory volume in 1 second (FEV1), ratio of FEV1 to predicted FEV1, and radiographic measurements of Cobb’s angle and C7–S1 distance were recorded. Lung function changes and correlations between lung function changes and radiographic changes (Cobb’s angle and C7–S1 distance) were analyzed.

Results  In group 1, FVC and FEV1 both increased. FVC showed a significant difference (P=0.01), but FEV1 did not (P =0.05). In group 2, FVC and FEV1 also increased, and both showed a significant difference (P=0.04 and P=0.02, respectively). Ratio of FVC to predicted FVC and ratio of FEV1 to predicted FEV1 changed similarly and did not show statistical differences in the 2 groups. There were no significant correlations between lung function changes and radiographic changes (Cobb’s angle and C7–S1 distance) (P=0.10 and P=0.41, respectively).

Conclusions  Lung function increases after growing rod surgery in patients with EOS. Lung function changes do not correlate with Cobb’s angle changes or C7–S1 distance changes.

     

Acute Effects of Individual Exposure to Fine Particulate Matter on Pulmonary Function in Schoolchildren

Objective This panel study aimed to determine the acute effects of exposure to fine particulate matter(PM_(2.5)) on schoolchildren's pulmonary function.Methods We selected 51 schoolchildren aged 9–12 years attending a full-time boarding school in Beijing, China, measured the indoor and outdoor PM_(2.5) concentrations for five consecutive days,calculated the PM_(2.5) time-weighted individual exposure levels based on the school micro-environmental concentrations and the time activity pattern recorded by schoolchildren, measured schoolchildren's pulmonary function on the fifth day. The survey was performed three times from December 2018 to April 2019. We used a linear mixed-effects model to evaluate the associations between PM_(2.5) and pulmonary function.Results During the three surveys, the median PM_(2.5) time-weighted individual exposure concentrations were 15.30 μg/m3, 48.92 μg/m3, and 42.89 μg/m3, respectively. There was a significant difference between the three surveys in vital capacity(VC), forced vital capacity(FVC), forced expiratory volume in one second(FEV_1) and forced expiratory volume in one second/forced vital capacity(FEV1/FVC)(P 0.05). The relevance analysis found that PM_(2.5) had lag effect on schoolchildren's pulmonary function,each 10 μg/m~3 increase in PM_(2.5) could cause largest decreases in FEF25%–75%, FEV_1/FVC, FEF75%, and FEV1 on lag 0–1 d(80.44 m L/s, 35.85%, 78.58 m L/s, and 61.34 m L, respectively), and largest decreases in FEF25% on lag 1 d(83.68 m L/s), in VC on lag 4 d(32.34 m L), and in FVC on lag 0–4 d(37.76 m L). Gender subgroup analysis revealed that the increase in PM_(2.5) caused a decrease in FEV_1/FVC and VC on the day of physical examination only in boys, and on lag days it caused changes in different pulmonary function indicators, both for boys and girls, but most of the pulmonary function indicators decreased more in boys than in girls.Conclusion Our findings show that acute PM_(2.5) exposure has significant effects on pulmonary function within 0–4 d, on both small airway indicators and large airway indicators. Boys' pulmonary function is more sensitive to PM_(2.5) than girls.     

Prognostic value of echocardiographic right/left ventricular end-diastolic diameter ratio in idiopathic pulmonary arterial hypertension

Background An echocardiographic right/left ventricular end-diastolic diameter ratio (RV/LV ratio) ≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. Right ventricular dilation is a common characteristic of both acute pulmonary embolism and idiopathic pulmonary arterial hypertension (IPAH).However, the prognostic value of the RV/LV ratio in patients with IPAH is unknown.Methods Ninety-five consecutive patients with newly diagnosed IPAH were included, 17 were re-evaluated by echocardiography after 3-12 months of targeted therapy. Follow-up data were obtained by telephone interviews and review of the patients' records.Results Higher RV/LV ratios were associated with greater functional impairment and with a higher mean right atrial pressure.The RV/LV ratio was positively correlated with pulmonary vascular resistance (r=0.549, P ＜0.001) and plasma N-terminal pro-brain natriuretic peptide level (r=0.575, P ＜0.001), but negatively correlated with cardiac output (r= -0.517, P ＜0.001) and mixed venous oxygen saturation (r= -0.599, P ＜0.001). During a follow-up period of (21 ± 15) months, 27 patients died.Sensitivity and specificity of an RV/LV ratio ≥0.84 for predicting death were 85.2% and 51.5%, respectively. The RV/LV ratio and body mass index were independent predictors of death by multivariate Cox analysis (P ＜0.01). A baseline RV/LV ratio ≥0.84 or a further increase in the RV/LV ratio during targeted therapy indicated a poor prognosis (P ＜0.01).Conclusion The RV/LV ratio helps to assess the severity of IPAH and may serve as an independent predictor of prognosis in patients with IPAH.     

Roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction

Background  It has been stated that preoperative pulmonary function tests are essential to assess the surgical risk in patients with scoliosis. Arterial blood gas tests have also been used to evaluate pulmonary function before scoliotic surgery. However, few studies have been reported. The aim of this study was to investigate the roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction.

Methods  This study involved scoliotic patients with moderate or severe pulmonary dysfunction (forced vital capacity <60%) who underwent surgical treatment between January 2002 and April 2010. A total of 73 scoliotic patients (23 males and 50 females) with moderate or severe pulmonary dysfunction were included. The average age of the patients was 16.53 years (ranged 10–44). The demographic distribution, medical records, and radiographs of all patients were collected. All patients received arterial blood gas tests and pulmonary function tests before surgery. The arterial blood gas tests included five parameters: partial pressure of arterial oxygen, partial pressure of arterial carbon dioxide, alveolar-arterial oxygen tension gradient, pH, and standard bases excess. The pulmonary function tests included three parameters: forced expiratory volume in 1 second ratio, forced vital capacity ratio, and peak expiratory flow ratio. All five parameters of the arterial blood gas tests were compared between the two groups with or without postoperative pulmonary complications by variance analysis. Similarly, all three parameters of the pulmonary function tests were compared.

Results  The average coronal Cobb angle before surgery was 97.42° (range, 50°–180°). A total of 15 (20.5%) patients had postoperative pulmonary complications, including hypoxemia in 5 cases (33.3%), increased requirement for postoperative ventilatory support in 4 (26.7%), pneumonia in 2 (13.3%), atelectasis in 2 (13.3%), pneumothorax in 1 (6.7%), and hydrothorax in 1 (6.7%). No significant differences in demographic characteristics or perioperative factors (P >0.05) existed between the two groups with or without postoperative pulmonary complications. According to the variance analysis, there were no statistically significant differences in any parameter of the arterial blood gas tests between the two groups.

Conclusions  No significant correlation between the results of the preoperative arterial blood gas tests and postoperative pulmonary complications existed in scoliotic patients with moderate or severe pulmonary dysfunction. However, the postoperative complications tended to increase with the decrease of partial pressure of arterial oxygen in the arterial blood gas tests.

     

Inhaling β2-agonist with heliox-driven in bronchial asthma

Objective To evaluate the effectiveness of a helium-oxygen mixture (79% He- 21% O2) as an aerosolizing compressed gas for β2-agonist therapy in patients with an asthma exacerbation.Methods Twenty-four patients in the outpatient department with a mild to moderate exacerbation of asthma were enrolled. The patients were randomly divided into an experimental group (13 cases) and a control group (11 cases). The experimental group inhaled Berotec with heliox-driven, and the control group inhaled Berotec with compressed air-driven. Eight hospitalized patients in the respiratory department with severe exacerbation of asthma were enrolled. The patients inhaled Berotec with heliox-driven or compressed air-driven in a random order.Results The results of spirometric parameters and arterial blood-gas analysis were measured. In the mild to moderate asthma patients, no statistical differences between the two groups for forced vital capacity ( FVC), forced expired volume in one second ( FEV1 ), and expiratory flow in 50% forced vital capacity (FEF50) were presented. But the severe patients showed significant differences between heliox-driven and compressed air-driven for FVC, FEV1, FEF50 and partial pressure of oxygen (PaO2).Conclusions Compared with the traditional inhalation of β2-agonist therapy using compressed airdriven, the method of inhaling β2-agonist with heliox-driven has more obvious benefits for those suffering from severe asthma. This is likely due to the cooperative effects between inhaling heliox on its physical gas properties and improving delivery of β2-agonist in the treatment of exacerbation of severe asthma.     

Evaluation of right ventricular global longitudinal function in patients with tetralogy of fallot by two-dimensional ultrasound speckle tracking imaging

Quantification of right ventricular(RV)volume and function remains a challenge because of RV complex geometry by conventional echocardiography.The purpose of this study was to assess RV global longitudinal function in patients with tetralogy of Fallot(TOF)by 2-dimensional ultrasound speckle tracking imaging(STI).Thirty-eight patients with TOF were enrolled in this study and divided into child group(n=25)and adult group(n=13)according to age.Thirty-eight age-and sex-matched normal subjects were selected as c...     

Effect of lung volume reduction surgery on early function of lung and pulmonary hemodynamics in COPD

Objective To evaluate the effects of lung volume reduction surgery (LVRS) on early lung function and pulmonary hemodynamics in severe chronic obstructive pulmonary disease (COPD). Methods 31 patients with severe COPD underwent LVRS, bilateral LVRS in 11 patients and unilateral in 20 patients. The results of lung function (FEV1, RV, TLC), arterial blood gas analysis (PAO2, PACO2 ) and color Doppler echocardiography (CD,CI,FS,EF,PAP) were analyzed before and 3 month after LVRS in 26 cases. Results FEV1, RV and TLC were improved significantly after surgery ( P < 0. 01). PaO2 increased (P < 0. 05 ) and PaCO2, decreased postoperatively (P < 0. 01). According to the Doppler echocardiography, there were no statistic differences in cardiac functions (CO, CI, FS, EF, and PAP) between pre- and post-operation. The 6-minute-walk-distance in 26 patients was (227 ± 88) m, significantly increased after surgery. Conclusion LVRS is effective in the treatment of patients with severe COPD. 3 months after operation, the l     

Association between Genetic Variants and Characteristic Symptoms of Type 2 Diabetes: A Matched Case-Control Study

Objective

To examine the association of genetic variants with characteristic symptoms of type 2 diabetes mellitus (T2DM).

Methods

A matched case-control study was performed to investigate the association between common variants in four genes (CDKAL1, GLIS3, GRK5, and TCF7L2) and symptoms of T2DM. Symptoms were examined with questionnaire for 710 subjects. Genomic DNA was extracted from peripheral blood mononuclear cell by salting-out procedure. Genotyping was carried out by direct sequencing of the unpurified polymerase chain reaction products.

Result

Most of the T2DM patients pressented characteristic symptoms, such as feeling weak in limbs (P =0.0057), hand tremor (P =0.0208), bradymasesis (P =0.0234), and polyuria (P =0.0051). Some of the T2DM patients shared characteristic symptoms, such as desire for cold drinks (P =0.0304), polyphagia (P =0.0051), and furred tongue (P =0.028). The impaired glucose regulation (IGR) cases took only one characteristic symptom of frequent micturition (P =0.0422). GLIS3 rs7034200 and GRK5 rs10886471 were significantly associated with increased T2DM risk (GLIS3 rs7034200 under dominant model: P=0.0307; GRK5 rs10886471 under recessive model: P=0.0092). However, only the rs10886471 polymorphism in GRK5 showed a significant effect on both differentiated symptoms and T2DM risk. The C-allele was involved in both dampness-heat encumbering Pi (Spleen) syndrome (P =0.047) and qi-yin deficiency syndrome (P =0.002) via increased GRK5 expression.

Conclusions

Both T2DM and IGR exhibited its corresponding characteristic symptoms. The variants of GRK5 were involved with both qi-yin deficiency syndrome and dampness-heat encumbering Pi syndrome.

     

Association of Platelet-Activating Factor Receptor Gene rs5938 (G/T) and rs313152 (T/C) Polymorphisms with Coronary Heart Disease and Blood Stasis Syndrome in A Chinese Han Population

Objective

To explore the association of the platelet-activating factor receptor (PAFR) gene rs5938, rs313152 and rs76744145 polymorphisms with coronary heart disease (CHD) and blood stasis syndrome (BSS) of CHD in Chinese Han population.

Methods

A total of 570 CHD patients (299 with BSS and 271 with non-BSS) and 317 controls were enrolled. The PAFR gene rs5938, rs313152 and rs76744145 polymorphisms were genotyped using the multiplex SNaPshot technology. The statistical analysis was conducted using a multiple variable logistic regression model.

Results

Significant differences were detected in the genotypes frequency distributions of the rs5938 (P<0.01), but not the rs313152 (P>0.05), between the controls and CHD patients. Individuals with an rs5938 or rs313152 mutated allele had a low risk for CHD [adjusted odds ratio (aOR)=0.35, 95% confidence interval (CI): 0.23 to 0.56, P<0.01; aOR=0.65, 95% CI: 0.46 to 0.91, P<0.05, respectively]. After the CHD patients were stratified as BSS or non-BSS according to their Chinese medicine patterns, the rs5938 polymorphism mutated alleles had a significant association with a low risk for BSS of CHD (aOR=0.32, 95% CI: 0.18 to 0.57, P<0.01) and non-BSS of CHD (aOR=0.31, 95% CI: 0.17 to 0.55, P<0.01). The rs313152 polymorphism was associated with a low risk for BSS (aOR=0.51, 95% CI: 0.33 to 0.79, P<0.01), but not for non-BSS (aOR=1.22, 95% CI: 0.81 to 1.85, P<0.05). Furthermore, the interaction effect of the rs5938 and rs313152 polymorphisms for BSS of CHD was significantly based on an aOR value associated with the combination of the rs5938 GT genotype with the rs313152 TC genotype of 0.27 (95% CI: 0.1 to 0.7, P<0.01).

Conclusion

The PAFR gene rs5938 or rs313152 polymorphisms might be a potential biomarker for susceptibility to CHD, especially to BSS of CHD in Chinese Han population.

     

Effect of Health Education Based on Integrative Therapy of Chinese and Western Medicine for Adult Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study

Objective: To investigate the effects of health education based on integrative therapy of Chinese and Western medicine for type 2 diabetes mellitus(T2DM) from the aspects of knowledge, attitude and practice(KAP), health-related quality of life(HRQo L), body mass index(BMI) and glucose control. Methods: Patients were individually randomized into intervention group(receiving integrative education, n=120) and control group(receiving usual education, n=120). The primary outcome was the changes in glycosylated hemoglobin A1c(HbA1c) levels after 3, 6, 9 and 12 months from baseline. Hierarchical linear models(HLMs) were used to assess within-group changes in outcomes over time and between-group differences in patterns of change. Secondary outcomes were KAP scores, HRQo L scores and BMI after 6 and 12 months, paired-sample t test was used to assess within-group changes in outcomes in 6 and 12 months, independent-sample t test was used to assess between-group differences in patterns of change. Results: HbA1c decreased statistically from baseline to 3 months, from 3 to 6 months, from 6 to 9 months and from 9 to 12 months in the intervention group(all P0.01); and decreased significantly from baseline to 3 months, and from 3 to 6 months in the control group(P0.01). There were significant between-group differences from baseline to 3 months(P=0.044), from 6 to 9 months(P0.01) and from 9 to 12 months(P0.01). Significant improvements in the intervention group along with significant between-group differences were found in KAP and HRQo L scores respectively(all P0.05). The number in the intervention group of normal weight increased from 56 at baseline to 81(6 months), 94(12 months), the number in the control group were 63(baseline), 69(6 months), 70(12 months), the χ~2 of hierarchical analysis of BMI were 6.93(P=0.075), 10.31(P=0.016), 15.53(P0.01), respectively. Conclusion: Health education based on integrative therapy of Chinese and Western medicine is beneficial to the control of T2DM and should be recommended for T2DM.     

Clinical Presentation and Treatment Strategies for Ulcerative Colitis: A Retrospective Study of 247 Inpatients

Objective

Complementary and alternative medicine, particularly herbal therapy, is widely used by patients with ulcerative colitis (UC), but controlled data are limited. To describe the clinical presentation and treatment strategies for UC in inpatients from Shanghai, China and to improve the therapeutic outcomes for patients with UC.

Methods

Medical records from 247 patients with UC who were admitted to Longhua Hospital Affifiliated to Shanghai University of Traditional Chinese Medicine between January 2008 and June 2013 were analyzed for gender, age, course of the disease, clinical type, extent and severity of the disease, treatment strategies, and therapeutic outcomes.

Results

Gender ratios and disease onset of inpatients with UC in the Shanghai area were consistent with other reports in the literature. In contrast to previous studies, most patients exhibited disease of the left colon, over half of the patients had problems of the rectum or sigmoid colon, and most patients had either mild or moderate UC. Comparison of Sutherland Disease Actirity Index scores for patients treated with Chinese medicine (CM) and those treated with integrated CM and Western medicine revealed signifificant reductions in scores for both groups after treatment (P<0.01), with no signifificant difference in therapeutic effects between groups (P=0.938).

Conclusions

Herbal medicine has been widely used in patients with mild to moderate disease and as adjunct therapy in patients with moderate to severe disease. Therefore, the strategy was proposed for the treatment of UC with CM therapy based on 2 steps according to the stage of the disease, even in the clinical setting.

     

Effects of Senegenin against Hypoxia/Reoxygenation-Induced Injury in PC12 Cells

Objective:To investigate the effect and the potential mechanism of Senegenin(Sen) against injury induced by hypoxia/reoxygenation(H/R) in highly differentiated PC12 cells.Methods:The cultured PC12 cells were treated with H/R in the presence or absence of Sen(60 μmol/L).Four groups were included in the experiment:control group,H/R group,H/R+Sen group and Sen group.Cell viability of each group and the level of lactate dehydrogenase(LDH) in culture medium were detected for the pharmacological effect of Sen.Hoechst 33258 staining and annexin V/propidium iodide double staining were used to analyze the apoptosis rate.Moreover,mitochondrial membrane potential(△Ψm),reactive oxygen species(ROS) and intracellular free calcium([Ca~(2+)]i) were measured by fluorescent staining and flow cytometry.Cleaved caspase-3and activity of NADPH oxidase(NOX) were determined by colorimetric protease assay and enzyme linked immunosorbent assay,respectively.Results:Sen significantly elevated cell viability(P0.05),decreased the leakage of LDH(P0.05) and apoptosis rate(P0.05) in H/R-injured PC12 cells.Sen maintained the value of△Ψm(P0.05) and suppressed the activity of caspase-3(P0.05).Moreover,Sen reduced ROS accumulation(P0.05) and[Ca~(2+)]i increment(P0.05) by inhibiting the activity of NOX(P0.05).Conclusion:Sen may exert cytoprotection against H/R injury by decreasing the levels of intracellular ROS and[Ca~(2+)]_i,thereby suppressing the mitochondrial pathway of cellular apoptosis.     

Synchronous Dynamic Research on Respiratory and Intestinal Microflora of Chronic Bronchitis Rat Model

Objectives

To investigate the mechanism of the Chinese medicine theory that Fei (Lung) and Dachang (Large Intestine) are exteriorly and interiorly related via synchronous observation on the dynamic changes of the respiratory and intestinal microflora.

Methods

Forty specific pathogen free Sprague-Dawley rats were selected and randomly divided into blank (10 rats) and chronic bronchitis model groups (30 rats). The blank group rats were put into the smoke-free environment and the model group rats were put into the smoke environment in order to establish pulmonary disease (chronic bronchitis) model. Then the corresponding changes of the respiratory and intestinal microflflora of the model on 20th, 50th and 70th days were synchronously observed.

Results

The respiratory tract microflflora showed an increase in the total aerobic and Staphylococcus aureus and reduced anaerobic amount signifificantly on 20th day in the respiratory tract microflflora (P<0.05 or 0.01). On 50th day, total aerobic, total anaerobic amount and bififidobacterium signifificantly increased (P<0.05). On 70th day, Staphylococcus aureus reduced and lactobacillus increased signifificantly (P<0.01). The intestinal microflflora showed an increase in the total aerobic, Clostridium perfringens, enterobacter and enterococcus significantly increased on 20th day (P<0.05 or 0.01). Staphylococcus aureus on 50th day increased significantly (P<0.05). Total aerobic and enterococcus increased, total anaerobic and Clostridium perfringens reduced signifificantly on 70th day (P<0.05 or 0.01).

Conclusion

The microecosystem of respiratory tract and intestine of rat model during the pathological process showed a dynamic disorder, indicating an interaction between the lung and large intestine which may be one of the connotations as they exteriorly and interiorly related.

     

In Vivo and In Vitro Anti-inflammatory Effects of Ethanol Fraction from Periploca forrestii Schltr.

Objective: To determine the anti-inflammatory effects of an ethanol fraction of Periploca forrestii Schltr. (EFPF) and to investigate the potential mechanisms underlying in vivo and in vitro models. Methods: The anti-inflammatory effects of EFPF were evaluated using the xylene-induced mouse ear edema and carrageenan-induced rat paw edema models in vivo. In vitro, RAW264.7 cells were exposed to 0–800 μg/mL EFPF and the cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Then cells were treated with different concentrations of EFPF (100–400 μg/mL) and stimulated with lipopolysaccharide (LPS, 1 μg/mL) for 24 h. The supernatant was analyzed for nitric oxide (NO) using the Griess reagent, and the levels of inflammatory mediators and cytokines were determined using enzyme-linked immunosorbent assays for prostaglandin E2 (PGE2), tumor necrosis factor α (TNF-α), interleukin (IL) 6, and IL-10. The protein expressions of inducible NO synthase (iNOS), cyclooxygenase-2 (COX-2), nuclear factor κB (NF-κB), and mitogen-activated protein kinases (MAPKs) including extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38 MAPK were examined by Western blot. Results: Compared with the control group, EFPF significantly reduced mouse ear edema and rat paw edema rate (P<0.05 or P<0.01). Compared with the LPS group, EFPF significantly inhibited the LPS-stimulated production of NO, PGE2, TNF-α and IL-6 (P<0.05 or P<0.01), and increased the IL-10 production (P<0.05). EFPF also significantly inhibited LPS-induced protein expressions of iNOS and COX-2, suppressed the phosphorylation and degradation of inhibitor of NF-κB-α, decreased p65 level, and inhibited the phosphorylation of p38, ERK1/2 and JNK (P<0.05 or P<0.01). Conclusion: EFPF exerted anti-inflammatory effect by reducing protein expressions of iNOS and COX-2 and the production of the inflammation factors, including TNF-α, IL-6, NO and PGE2, mainly through inhibition of LPS-mediated stimulation of NF-κB and MAPK signaling pathways.     

Contribution of Water and Lipid Soluble Substances in the Relaxant Effects of Tymus Vulgaris Extract on Guinea Pig Tracheal Smooth Muscle in Vitro

Objective:To examine the relaxant effects of hydro-ethanolic,macerated aqueous(MA) and lipidfree macerated aqueous(LFMA) extract of Tymus vulgaris on tracheal chains of guinea pigs.Methods:The relaxant effects of five cumulative concentrations of each extract(0.4,0.8,1.2,1.6 and 2.0 g/100 mL) were compared with saline as negative control and five cumulative concentrations of theophylline(0.1,0.2,0.4,0.6 and 0.8 mmol/L) on precontracted tracheal smooth muscle of guinea pig with 60 mmol/L KCI(group 1) and 10 μmol/L methacholine(group 2,n=6 for each group).Results:In group 1 all concentrations of theophylline,three higher concentrations of hydro-ethanolic,two concentrations of LFMA and last concentration of MA extracts showed significant relaxant effects compared with that of saline(P0.05 or P0.01).Two lower concentrations of LFMA and all concentrations of MA except higher one caused contraction compared with saline(P0.05 or 0.01).In group 2 experiments,all concentrations of theophylline,hydro-ethanolic,MA and LFMA extracts showed significant relaxant effects compared to that of saline(P0.05 or P0.01).In both groups,the relaxant effect of all concentrations of hydro-ethanolic extract were significantly higher than most concentrations of others(P0.05 or P0.01).The relaxant effect of different concentrations of three extracts were significantly greater in group 2 compared with group 1 experiments(all P0.01).There were significantly positive correlations between the relaxant effects and concentrations for theophylline and ail extracts in both groups(P0.05 or P0.01).Conclusion:Hydro-ethanolic extract has a potent weaker relaxant effect for other extracts from Tymus vulgaris on tracheal chains of guinea pigs.     

Chinese Medicine for Idiopathic Parkinson's Disease: A Meta Analysis of Randomized Controlled Trials

Objective:To evaluate the efficacy of Chinese medicine(CM) adjunct to conventional medications for idiopathic Parkinson's disease(PD).Methods:Electronic English and Chinese databases including PubMed,Cochrane Library,Web of Science,Chinese Medical Current Contents,China National Knowledge Infrastructure,China Science and Technology Journal Database,Wanfang Med Database,and Traditional Chinese Medical Database System were used for key words searching in a highly sensitive search strategy.The extracted data was analyzed by the Review Manager 5.0.Results:Twelve trials involving 869 participants were included in the meta-analysis.Unified PD Rating Scale(UPDRS) I,Ⅱ,Ⅲ,Ⅳ scores and UPDRS Ⅰ-Ⅳ total scores were used to be the primary outcomes,Parkinson Disease Question-39(PDQ-39) and Scores of Chinese Medical Symptoms were the secondary outcomes.CM adjunct therapy had greater improvement in UPDRS Ⅰ[2 trials;standardized mean difference(SMD)-0.40,95%confidence interval(CI)-0.71 to-0.09;Z=2.49(P=0.01)],Ⅱ[5 trials;SMD-0.47,95%CI-0.69 to-0.25;Z=4.20(P0.01)],Ⅲ[5 trials;SMD-0.35,95%CI-0.57 to-0.13;Z=3.16(P=0.002)],Ⅳ scores[3 trials;SMD-0.32,95%CI-0.60 to-0.03;Z=2.17(P=0.03)],UPDRS Ⅰ-Ⅳ total scores[7 trials;SMD-0.36,95%CI-0.53 to-0.20;Z=4.24(P0.05)].PDQ-39 and Chinese medical symptoms compared to the conventional medication only.Conclusion:CM adjunct therapy has potential therapeutic benefits by decreasing UPDRS scores and reducing adverse effect.